Research Unit, Elizabeth Glaser Pediatric AIDS Foundation, 1140 Connecticut Avenue NW, Suite 200, Washington, D,C, 20036, USA.
BMC Public Health. 2013 Dec 5;13:1131. doi: 10.1186/1471-2458-13-1131.
Community-based mobile phone programs can complement gaps in clinical services for prevention of mother-to-child transmission (PMTCT) of HIV in areas with poor infrastructure and personnel shortages. However, community and health worker perceptions on optimal mobile phone communication for PMTCT are underexplored. This study examined what specific content and forms of mobile communication are acceptable to support PMTCT.
Qualitative methods using focus groups and in-depth interviews were conducted in two district hospitals in Nyanza Province, Kenya. A total of 45 participants were purposefully selected, including HIV-positive women enrolled in PMTCT, their male partners, community health workers, and nurses. Semi-structured discussion guides were used to elicit participants' current mobile phone uses for PMTCT and their perceived benefits and challenges. We also examined participants' views on platform design and gender-tailored short message service (SMS) messages designed to improve PMTCT communication and male involvement.
Most participants had access to a mobile phone and prior experience receiving and sending SMS, although phone sharing was common among couples. Mobile phones were used for several health-related purposes, primarily as voice calls rather than texts. The perceived benefits of mobile phones for PMTCT included linking with health workers, protecting confidentiality, and receiving information and reminders. Men and women considered the gender-tailored SMS as a catalyst for improving PMTCT male involvement and couples' communication. However, informative messaging relayed safely to the intended recipient was critical. In addition, health workers emphasized the continual need for in-person counseling coupled with, rather than replaced by, mobile phone reinforcement. For all participants, integrated and neutral text messaging provided antenatally and postnatally was most preferred, although not all topics or text formats were equally acceptable.
Given the ubiquity of mobile phones in Kenya and current health-related uses of mobile phones, a PMTCT mobile communications platform holds considerable potential. This pre-intervention assessment of community and health worker preferences yielded valuable information on the complexities of design and implementation. An effective PMTCT mobile platform engaging men and women will need to address contexts of non-disclosure, phone sharing, and linkages with existing community and facility-based services.
在基础设施薄弱和人员短缺的地区，基于社区的移动电话项目可以弥补预防母婴传播（PMTCT）艾滋病毒临床服务的空白。然而，社区和卫生工作者对 PMTCT 最佳移动电话通信的看法尚未得到充分探索。本研究探讨了支持 PMTCT 的可接受的具体移动通讯内容和形式。
在肯尼亚 Nyanza 省的两家地区医院采用定性方法，使用焦点小组和深入访谈。共选择了 45 名参与者，包括参加 PMTCT 的 HIV 阳性妇女、她们的男性伴侣、社区卫生工作者和护士。使用半结构化讨论指南，了解参与者当前用于 PMTCT 的移动电话使用情况以及他们认为的益处和挑战。我们还研究了参与者对平台设计和针对男性的短信服务（SMS）消息的看法，这些消息旨在改善 PMTCT 沟通和男性参与度。
大多数参与者都有移动电话，并具有发送和接收短信的经验，尽管夫妻之间经常共享电话。移动电话用于几个与健康相关的目的，主要是语音通话而不是文本。移动电话在 PMTCT 中的好处包括与卫生工作者联系、保护保密性以及接收信息和提醒。男性和女性都认为针对男性的 SMS 是提高 PMTCT 男性参与度和夫妻沟通的催化剂。但是，重要的是安全地向预期收件人传达有教育意义的信息。此外，卫生工作者强调需要持续的面对面咨询，而不是取代移动电话强化。对于所有参与者来说，最希望在产前和产后提供综合且中立的文本信息，尽管并非所有主题或文本格式都同样可以接受。
鉴于肯尼亚移动电话的普及性和当前移动电话在健康方面的使用，PMTCT 移动通讯平台具有很大的潜力。对社区和卫生工作者偏好的这种干预前评估提供了有关设计和实施复杂性的宝贵信息。一个有效的 PMTCT 移动平台要吸引男女双方，就需要解决保密性问题、电话共享问题以及与现有社区和机构服务的联系问题。
