title: Impact of a mHealth intervention for peer health workers on AIDS care in rural Uganda: a mixed methods evaluation of a cluster-randomized trial.
abstract: Mobile phone access in low and middle-income countries is rapidly expanding and offers an opportunity to leverage limited human resources for health. We conducted a mixed methods evaluation of a cluster-randomized trial exploratory substudy on the impact of a mHealth (mobile phone) support intervention used by community-based peer health workers (PHW) on AIDS care in rural Uganda. 29 PHWs at 10 clinics were randomized by clinic to receive the intervention or not. PHWs used phones to call and text higher level providers with patient-specific clinical information. 970 patients cared for by the PHWs were followed over a 26 month period. No significant differences were found in patients' risk of virologic failure. Qualitative analyses found improvements in patient care and logistics and broad support for the mHealth intervention among patients, clinic staff, and PHWs. Key challenges identified included variable patient phone access, privacy concerns, and phone maintenance.
authors: Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA. larrywillchang@gmail.com
authors: Larry W
authors: LW
authors: Chang
authors: Joseph
authors: J
authors: Kagaayi
authors: Hannah
authors: H
authors: Arem
authors: Gertrude
authors: G
authors: Nakigozi
authors: Victor
authors: V
authors: Ssempijja
authors: David
authors: D
authors: Serwadda
authors: Thomas C
authors: TC
authors: Quinn
authors: Ronald H
authors: RH
authors: Gray
authors: Robert C
authors: RC
authors: Bollinger
authors: Steven J
authors: SJ
authors: Reynolds
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D040421:Cell Phone; D016000:Cluster Analysis; D003142:Communication; D003153:Community Health Services / Q000458:organization & administration*; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D010379:Peer Group; D016032:Randomized Controlled Trials as Topic; D012424:Rural Population; D017216:Telemedicine; D014454:Uganda
chemical_list: D019380:Anti-HIV Agents