Perceptions of drones, digital adherence monitoring technologies and educational videos for tuberculosis control in remote Madagascar: a mixed-method study protocol
Perceptions of drones, digital adherence monitoring technologies and educational videos for tuberculosis control in remote Madagascar: a mixed-method study protocol
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DOI：
10.1136/bmjopen-2018-028073
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发表时间：
2019-05-01
期刊：
影响因子：
2.9
通讯作者：
Lapierre, Simon Grandjean
中科院分区：
文献类型：
--
作者：
Nouvet, Elysee;Knoblauch, Astrid M.;Lapierre, Simon Grandjean
1.在世界许多地区，道路和通信基础设施薄弱对结核病控制构成重大挑战。结核病监测和患者支持往往落在社区卫生工作者（CHW）的肩上，他们可能缺乏这项工作所需的时间或知识。为了实现到2035年将结核病发病率降低90%的目标，世卫组织呼吁加强研究和创新，包括快速采用新的工具、干预措施和战略。“跨越”基础设施挑战并支持社区卫生工作者承担结核病控制责任的技术有可能极大地改变偏远地区的结核病结果。这些技术可以加强在面临挑战的国家结核病治疗和控制规划（NTPs）内的结核病控制活动，并加以调整以应对其他公共卫生挑战。创新技术的部署需要根据具体情况有区别地加以调整。无人机观察治疗系统（DrOTS）项目于2017年在马达加斯加启动，该项目整合了一系列创新技术，包括无人机、数字依从性监测技术和基于移动的设备的教育视频，以支持结核病控制。方法和分析这项混合方法研究收集并分析了主要利益相关者对DrOTS项目的文化认知：患者、社区成员、社区卫生工作者、村长和NTP-DrOTS移动的卫生队。从2018年6月至2019年6月收集的问卷调查，半结构化访谈，焦点小组讨论（FGD）和人种学观察的数据进行了主题分析和比较，以确定DrOTS利益相关者如何看待和与DrOTS技术，其注册过程，伦理学获得了马达加斯加国家生物伦理学研究委员会和斯托尼布鲁克大学机构审查的批准纸板.研究结果将提交同行评审发表。在马达加斯加，研究结果将通过马达加斯加巴斯德研究所（Institut Pasteur de Madagascar）亲自提交给卫生部和其他马达加斯加决策者。患者和公众参与本研究旨在突出DrOTS项目中患者和潜在患者的声音。CHW在这项研究中的参与者也支持研究信息会议和招聘策略的设计。移动的健康小组的一名成员就烟气脱硫和访谈指南的措辞和内容提供了详细的意见。研究结果将通过法语和马达加斯加语的报告向CHW、移动的卫生团队和其他可以访问电子邮件/互联网的村级参与者展示。
Introduction Poor road and communication infrastructure pose major challenges to tuberculosis (TB) control in many regions of the world. TB surveillance and patient support often fall to community health workers (CHWs) who may lack the time or knowledge needed for this work. To meet the End TB Strategy goal of reducing TB incidence by 90% by 2035, the WHO calls for intensified research and innovation including the rapid uptake of new tools, interventions and strategies. Technologies that 'leapfrog' infrastructure challenges and support CHWs in TB control responsibilities have the potential to dramatically change TB outcomes in remote regions. Such technologies may strengthen TB control activities within challenged national tuberculosis treatment and control programmes (NTPs), and be adapted to address other public health challenges. The deployment of innovative technologies needs to be differentially adapted to context-specific factors. The Drone Observed Therapy System (DrOTS) project was launched in Madagascar in 2017 and integrates a bundle of innovative technologies including drones, digital adherence monitoring technology and mobile device-based educational videos to support TB control.Methods and analysis This mixed-methods study gathers and analyses cultural perceptions of the DrOTS project among key stakeholders: patients, community members, CHWs, village chiefs and NTP-DrOTS mobile health teams. Data from questionnaires, semistructured interviews, focus group discussions (FGD) and ethnographic observation gathered from June 2018 to June 2019 are thematically analysed and compared to identify patterns and singularities in how DrOTS stakeholders perceive and interact with DrOTS technologies, its enrolment processes, objectives and team.Ethics and dissemination Ethics approval was obtained from the National Bioethics Research Committee of Madagascar and Stony Brook University institutional review board. Study results will be submitted for peer-reviewed publication. In Madagascar, results will be presented in person to Ministry and other Malagasy decision-makers through the Institut Pasteur de Madagascar.Patient and public involvement This study is designed to foreground the voices of patients and potential patients in the DrOTS programme. CHW participants in this study also supported the design of study information sessions and recruitment strategies. One member of the mobile health team provided detailed input on the wording and content of FGD and interview guides. Study findings will be presented via a report in French and Malagasy to CHW, mobile health team and other village-level participants who have email/internet access.