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Published in: BMC Medical Informatics and Decision Making 1/2012

Open Access 01-12-2012 | Research article

High acceptability for cell phone text messages to improve communication of laboratory results with HIV-infected patients in rural Uganda: a cross-sectional survey study

Authors: Mark J Siedner, Jessica E Haberer, Mwebesa Bosco Bwana, Norma C Ware, David R Bangsberg

Published in: BMC Medical Informatics and Decision Making | Issue 1/2012

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Abstract

Background

Patient-provider communication is a major challenge in resource-limited settings with large catchment areas. Though mobile phone usership increased 20-fold in Africa over the past decade, little is known about acceptability of, perceptions about disclosure and confidentiality, and preferences for cell phone communication of health information in the region.

Methods

We performed structured interviews of fifty patients at the Immune Suppression Syndrome clinic in Mbarara, Uganda to assess four domains of health-related communication: a) cell phone use practices and literacy, b) preferences for laboratory results communication, c) privacy and confidentiality, and d) acceptability of and preferences for text messaging to notify patients of abnormal test results.

Results

Participants had a median of 38 years, were 56% female, and were residents of a large catchment area throughout southwestern Uganda. All participants expressed interest in a service to receive information about laboratory results by cell phone text message, stating benefits of increased awareness of their health and decreased transportation costs. Ninety percent reported that they would not be concerned for unintended disclosure. A minority additionally expressed concerns about difficulty interpreting messages, discouragement upon learning bad news, and technical issues. Though all respondents expressed interest in password protection of messages, there was also a strong desire for direct messages to limit misinterpretation of information.

Conclusions

Cell phone text messaging for communication of abnormal laboratory results is highly acceptable in this cohort of HIV-infected patients in rural Uganda. The feasibility of text messaging, including an optimal balance between privacy and comprehension, should be further studied.
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Literature
1.
go back to reference Geng EH, Bangsberg DR, Musinguzi N, Emenyonu N, Bwana MB, Yiannoutsos CT, Glidden DV, Deeks SG, Martin JN: Understanding Reasons for and Outcomes of Patients Lost to Follow-Up in Antiretroviral Therapy Programs in Africa Through a Sampling-Based Approach. J Acquir Immune Defic Syndr. 2010, 53 (3): 405-411. 10.1097/QAI.0b013e3181b843f0.CrossRefPubMedPubMedCentral Geng EH, Bangsberg DR, Musinguzi N, Emenyonu N, Bwana MB, Yiannoutsos CT, Glidden DV, Deeks SG, Martin JN: Understanding Reasons for and Outcomes of Patients Lost to Follow-Up in Antiretroviral Therapy Programs in Africa Through a Sampling-Based Approach. J Acquir Immune Defic Syndr. 2010, 53 (3): 405-411. 10.1097/QAI.0b013e3181b843f0.CrossRefPubMedPubMedCentral
2.
go back to reference Maskew M, MacPhail P, Menezes C, Rubel D: Lost to follow up: contributing factors and challenges in South African patients on antiretroviral therapy. S Afr Med J. 2007, 97 (9): 853-857.PubMed Maskew M, MacPhail P, Menezes C, Rubel D: Lost to follow up: contributing factors and challenges in South African patients on antiretroviral therapy. S Afr Med J. 2007, 97 (9): 853-857.PubMed
3.
go back to reference Tuller DM, Bangsberg DR, Senkungu J, Ware NC, Emenyonu N, Weiser SD: Transportation costs impede sustained adherence and access to HAART in a clinic population in southwestern Uganda: a qualitative study. AIDS Behav. 2010, 14 (4): 778-784. 10.1007/s10461-009-9533-2.CrossRefPubMed Tuller DM, Bangsberg DR, Senkungu J, Ware NC, Emenyonu N, Weiser SD: Transportation costs impede sustained adherence and access to HAART in a clinic population in southwestern Uganda: a qualitative study. AIDS Behav. 2010, 14 (4): 778-784. 10.1007/s10461-009-9533-2.CrossRefPubMed
4.
go back to reference Weiser S, Wolfe W, Bangsberg D, Thior I, Gilbert P, Makhema J, Kebaabetswe P, Dickenson D, Mompati K, Essex M: Barriers to antiretroviral adherence for patients living with HIV infection and AIDS in Botswana. J Acquir Immune Defic Syndr. 2003, 34 (3): 281-288. 10.1097/00126334-200311010-00004.CrossRefPubMed Weiser S, Wolfe W, Bangsberg D, Thior I, Gilbert P, Makhema J, Kebaabetswe P, Dickenson D, Mompati K, Essex M: Barriers to antiretroviral adherence for patients living with HIV infection and AIDS in Botswana. J Acquir Immune Defic Syndr. 2003, 34 (3): 281-288. 10.1097/00126334-200311010-00004.CrossRefPubMed
6.
go back to reference Lester RT, Gelmon L, Plummer FA: Cell phones: tightening the communication gap in resource-limited antiretroviral programmes?. AIDS. 2006, 20 (17): 2242-2244. 10.1097/QAD.0b013e3280108508.CrossRefPubMed Lester RT, Gelmon L, Plummer FA: Cell phones: tightening the communication gap in resource-limited antiretroviral programmes?. AIDS. 2006, 20 (17): 2242-2244. 10.1097/QAD.0b013e3280108508.CrossRefPubMed
8.
go back to reference Aker JC, Mbiti IM: Mobile Phones and Economic Development in Africa. Journal of Economic Perspectives. 2010, 24 (3): 207-232. 10.1257/jep.24.3.207.CrossRef Aker JC, Mbiti IM: Mobile Phones and Economic Development in Africa. Journal of Economic Perspectives. 2010, 24 (3): 207-232. 10.1257/jep.24.3.207.CrossRef
9.
go back to reference Armstrong AW, Watson AJ, Makredes M, Frangos JE, Kimball AB, Kvedar JC: Text-message reminders to improve sunscreen use: a randomized, controlled trial using electronic monitoring. Arch Dermatol. 2009, 145 (11): 1230-1236. 10.1001/archdermatol.2009.269.CrossRefPubMed Armstrong AW, Watson AJ, Makredes M, Frangos JE, Kimball AB, Kvedar JC: Text-message reminders to improve sunscreen use: a randomized, controlled trial using electronic monitoring. Arch Dermatol. 2009, 145 (11): 1230-1236. 10.1001/archdermatol.2009.269.CrossRefPubMed
10.
go back to reference Rodgers A, Corbett T, Bramley D, Riddell T, Wills M, Lin RB, Jones M: Do u smoke after txt? Results of a randomised trial of smoking cessation using mobile phone text messaging. Tob Control. 2005, 14 (4): 255-261. 10.1136/tc.2005.011577.CrossRefPubMedPubMedCentral Rodgers A, Corbett T, Bramley D, Riddell T, Wills M, Lin RB, Jones M: Do u smoke after txt? Results of a randomised trial of smoking cessation using mobile phone text messaging. Tob Control. 2005, 14 (4): 255-261. 10.1136/tc.2005.011577.CrossRefPubMedPubMedCentral
11.
go back to reference Menon-Johansson AS, McNaught F, Mandalia S, Sullivan AK: Texting decreases the time to treatment for genital Chlamydia trachomatis infection. Sex Transm Infect. 2006, 82 (1): 49-51. 10.1136/sti.2004.014381.CrossRefPubMedPubMedCentral Menon-Johansson AS, McNaught F, Mandalia S, Sullivan AK: Texting decreases the time to treatment for genital Chlamydia trachomatis infection. Sex Transm Infect. 2006, 82 (1): 49-51. 10.1136/sti.2004.014381.CrossRefPubMedPubMedCentral
12.
go back to reference Kim SI, Kim HS: Effectiveness of mobile and internet intervention in patients with obese type 2 diabetes. Int J Med Inform. 2008, 77 (6): 399-404. 10.1016/j.ijmedinf.2007.07.006.CrossRefPubMed Kim SI, Kim HS: Effectiveness of mobile and internet intervention in patients with obese type 2 diabetes. Int J Med Inform. 2008, 77 (6): 399-404. 10.1016/j.ijmedinf.2007.07.006.CrossRefPubMed
13.
go back to reference Rami B, Popow C, Horn W, Waldhoer T, Schober E: Telemedical support to improve glycemic control in adolescents with type 1 diabetes mellitus. Eur J Pediatr. 2006, 165 (10): 701-705. 10.1007/s00431-006-0156-6.CrossRefPubMed Rami B, Popow C, Horn W, Waldhoer T, Schober E: Telemedical support to improve glycemic control in adolescents with type 1 diabetes mellitus. Eur J Pediatr. 2006, 165 (10): 701-705. 10.1007/s00431-006-0156-6.CrossRefPubMed
14.
go back to reference Patrick K, Raab F, Adams MA, Dillon L, Zabinski M, Rock CL, Griswold WG, Norman GJ: A text message-based intervention for weight loss: randomized controlled trial. J Med Internet Res. 2009, 11 (1): e1-10.2196/jmir.1100.CrossRefPubMedPubMedCentral Patrick K, Raab F, Adams MA, Dillon L, Zabinski M, Rock CL, Griswold WG, Norman GJ: A text message-based intervention for weight loss: randomized controlled trial. J Med Internet Res. 2009, 11 (1): e1-10.2196/jmir.1100.CrossRefPubMedPubMedCentral
15.
go back to reference Pop-Eleches C, Thirumurthy H, Habyarimana JP, Zivin JG, Goldstein MP, de Walque D, MacKeen L, Haberer J, Kimaiyo S, Sidle J: Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders. AIDS. 2011, 25 (6): 825-834. 10.1097/QAD.0b013e32834380c1.CrossRefPubMedPubMedCentral Pop-Eleches C, Thirumurthy H, Habyarimana JP, Zivin JG, Goldstein MP, de Walque D, MacKeen L, Haberer J, Kimaiyo S, Sidle J: Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders. AIDS. 2011, 25 (6): 825-834. 10.1097/QAD.0b013e32834380c1.CrossRefPubMedPubMedCentral
16.
go back to reference Lester RT, Ritvo P, Mills EJ, Kariri A, Karanja S, Chung MH, Jack W, Habyarimana J, Sadatsafavi M, Najafzadeh M: Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial. Lancet. 2010, 376 (9755): 1838-1845. 10.1016/S0140-6736(10)61997-6.CrossRefPubMed Lester RT, Ritvo P, Mills EJ, Kariri A, Karanja S, Chung MH, Jack W, Habyarimana J, Sadatsafavi M, Najafzadeh M: Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial. Lancet. 2010, 376 (9755): 1838-1845. 10.1016/S0140-6736(10)61997-6.CrossRefPubMed
17.
go back to reference Leong KC, Chen WS, Leong KW, Mastura I, Mimi O, Sheikh MA, Zailinawati AH, Ng CJ, Phua KL, Teng CL: The use of text messaging to improve attendance in primary care: a randomized controlled trial. Fam Pract. 2006, 23 (6): 699-705. 10.1093/fampra/cml044.CrossRefPubMed Leong KC, Chen WS, Leong KW, Mastura I, Mimi O, Sheikh MA, Zailinawati AH, Ng CJ, Phua KL, Teng CL: The use of text messaging to improve attendance in primary care: a randomized controlled trial. Fam Pract. 2006, 23 (6): 699-705. 10.1093/fampra/cml044.CrossRefPubMed
18.
go back to reference Crankshaw T, Corless IB, Giddy J, Nicholas PK, Eichbaum Q, Butler LM: Exploring the patterns of use and the feasibility of using cellular phones for clinic appointment reminders and adherence messages in an antiretroviral treatment clinic, Durban, South Africa. AIDS Patient Care STDS. 2010, 24 (11): 729-734. 10.1089/apc.2010.0146.CrossRefPubMed Crankshaw T, Corless IB, Giddy J, Nicholas PK, Eichbaum Q, Butler LM: Exploring the patterns of use and the feasibility of using cellular phones for clinic appointment reminders and adherence messages in an antiretroviral treatment clinic, Durban, South Africa. AIDS Patient Care STDS. 2010, 24 (11): 729-734. 10.1089/apc.2010.0146.CrossRefPubMed
19.
go back to reference Curioso WH, Kurth AE: Access, use and perceptions regarding Internet, cell phones and PDAs as a means for health promotion for people living with HIV in Peru. BMC Med Inform Decis Mak. 2007, 7: 24-10.1186/1472-6947-7-24.CrossRefPubMedPubMedCentral Curioso WH, Kurth AE: Access, use and perceptions regarding Internet, cell phones and PDAs as a means for health promotion for people living with HIV in Peru. BMC Med Inform Decis Mak. 2007, 7: 24-10.1186/1472-6947-7-24.CrossRefPubMedPubMedCentral
20.
go back to reference Shet A, Arumugam K, Rodrigues R, Rajagopalan N, Shubha K, Raj T, D'Souza G, De Costa A: Designing a mobile phone-based intervention to promote adherence to antiretroviral therapy in South India. AIDS Behav. 2010, 14 (3): 716-720. 10.1007/s10461-009-9658-3.CrossRefPubMed Shet A, Arumugam K, Rodrigues R, Rajagopalan N, Shubha K, Raj T, D'Souza G, De Costa A: Designing a mobile phone-based intervention to promote adherence to antiretroviral therapy in South India. AIDS Behav. 2010, 14 (3): 716-720. 10.1007/s10461-009-9658-3.CrossRefPubMed
21.
go back to reference National Water Development Report. Directorate of Water Development, Ugandan Ministry of Water & Environment. 2010,www.mwe.go.ug, National Water Development Report. Directorate of Water Development, Ugandan Ministry of Water & Environment. 2010,www.​mwe.​go.​ug,
22.
go back to reference Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG: Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009, 42 (2): 377-381. 10.1016/j.jbi.2008.08.010.CrossRefPubMed Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG: Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009, 42 (2): 377-381. 10.1016/j.jbi.2008.08.010.CrossRefPubMed
23.
go back to reference Seidel G: Confidentiality and HIV status in Kwazulu-Natal, South Africa: implications, resistances and challenges. Health Policy Plan. 1996, 11 (4): 418-427. 10.1093/heapol/11.4.418.CrossRefPubMed Seidel G: Confidentiality and HIV status in Kwazulu-Natal, South Africa: implications, resistances and challenges. Health Policy Plan. 1996, 11 (4): 418-427. 10.1093/heapol/11.4.418.CrossRefPubMed
24.
go back to reference Haberer JE, Kiwanuka J, Nansera D, Wilson IB, Bangsberg DR: Challenges in Using Mobile Phones for Collection of Antiretroviral Therapy Adherence Data in a Resource-Limited Setting. AIDS Behav. 2010, 14 (6): 1294-1301. 10.1007/s10461-010-9720-1.CrossRefPubMedPubMedCentral Haberer JE, Kiwanuka J, Nansera D, Wilson IB, Bangsberg DR: Challenges in Using Mobile Phones for Collection of Antiretroviral Therapy Adherence Data in a Resource-Limited Setting. AIDS Behav. 2010, 14 (6): 1294-1301. 10.1007/s10461-010-9720-1.CrossRefPubMedPubMedCentral
25.
go back to reference Mitchell KJ, Bull S, Kiwanuka J, Ybarra ML: Cell phone usage among adolescents in Uganda: acceptability for relaying health information. Health Educ Res. 2011, 26 (5): 770-781. 10.1093/her/cyr022.CrossRefPubMedPubMedCentral Mitchell KJ, Bull S, Kiwanuka J, Ybarra ML: Cell phone usage among adolescents in Uganda: acceptability for relaying health information. Health Educ Res. 2011, 26 (5): 770-781. 10.1093/her/cyr022.CrossRefPubMedPubMedCentral
26.
go back to reference Ssali SN, Atuyambe L, Tumwine C, Segujja E, Nekesa N, Nannungi A, Ryan G, Wagner G: Reasons for disclosure of HIV status by people living with HIV/AIDS and in HIV care in Uganda: an exploratory study. AIDS Patient Care STDS. 2010, 24 (10): 675-681. 10.1089/apc.2010.0062.CrossRefPubMedPubMedCentral Ssali SN, Atuyambe L, Tumwine C, Segujja E, Nekesa N, Nannungi A, Ryan G, Wagner G: Reasons for disclosure of HIV status by people living with HIV/AIDS and in HIV care in Uganda: an exploratory study. AIDS Patient Care STDS. 2010, 24 (10): 675-681. 10.1089/apc.2010.0062.CrossRefPubMedPubMedCentral
27.
go back to reference Kairania R, Gray RH, Kiwanuka N, Makumbi F, Sewankambo NK, Serwadda D, Nalugoda F, Kigozi G, Semanda J, Wawer MJ: Disclosure of HIV results among discordant couples in Rakai, Uganda: a facilitated couple counselling approach. AIDS Care. 2010, 22 (9): 1041-1051. 10.1080/09540121003602226.CrossRefPubMedPubMedCentral Kairania R, Gray RH, Kiwanuka N, Makumbi F, Sewankambo NK, Serwadda D, Nalugoda F, Kigozi G, Semanda J, Wawer MJ: Disclosure of HIV results among discordant couples in Rakai, Uganda: a facilitated couple counselling approach. AIDS Care. 2010, 22 (9): 1041-1051. 10.1080/09540121003602226.CrossRefPubMedPubMedCentral
Metadata
Title
High acceptability for cell phone text messages to improve communication of laboratory results with HIV-infected patients in rural Uganda: a cross-sectional survey study
Authors
Mark J Siedner
Jessica E Haberer
Mwebesa Bosco Bwana
Norma C Ware
David R Bangsberg
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2012
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/1472-6947-12-56

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