University of Michigan Medical School, 1301 Catherine St, Ann Arbor, MI, 48109, United States of America.
Department of Pediatrics, University of São Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP, 01246-903, Brazil.
Hum Resour Health. 2017 Sep 29;15(1):71. doi: 10.1186/s12960-017-0245-9.
Mobile health (m-health) tools are a promising strategy to facilitate the work of community health workers (CHWs) in low- and middle-income countries (LMICs). Despite their potential value, little is known about CHWs' experiences working with m-health tools in their outreach activities with community members.
To understand the benefits of and barriers to using m-health tools for CHWs, we conducted semi-structured interviews with 57 CHWs employed in six primary care centers in São Paulo, Brazil. All CHWs had experience using a cell phone application called Geohealth for collecting health and demographic data of community members. We assessed their experiences using Geohealth and recommendations for improvements.
CHWs described key benefits of using Geohealth as helping them save time with bureaucratic paperwork, organizing the data that they needed to collect, and by replacing sheaves of paper, reducing the weight that they carried in the field. However, there were many technical and social barriers to the successful adoption of the m-health tool. Key among these were poor quality hardware, faulty software programs, and negative community member perceptions of the m-health program. The CHWs provided valuable input as to how Geohealth could be improved to fit their needs.
m-health tools have the potential to facilitate the work of CHWs in LMICs. However, such tools must be designed and implemented thoughtfully. Technical barriers related to both hardware and software must be anticipated and addressed to maximize their efficiency and successful adoption. CHW input on the design of the tool should be sought to maximize its utility and minimize barriers to use.
移动医疗（m-health）工具是一种很有前途的策略，可以帮助中低收入国家（LMICs）的社区卫生工作者（CHWs）开展工作。尽管它们具有潜在的价值，但对于 CHWs 在与社区成员的外展活动中使用 m-health 工具的经验，人们知之甚少。
为了了解 CHWs 使用 m-health 工具的好处和障碍，我们对巴西圣保罗六个初级保健中心的 57 名 CHWs 进行了半结构化访谈。所有 CHWs 都有使用名为 Geohealth 的手机应用程序收集社区成员健康和人口数据的经验。我们评估了他们使用 Geohealth 的经验，并提出了改进建议。
CHWs 描述了使用 Geohealth 的主要好处，包括帮助他们节省繁琐的文书工作时间、组织他们需要收集的数据，以及通过取代一叠叠文件，减少他们在实地携带的重量。然而，成功采用 m-health 工具存在许多技术和社会障碍。其中最重要的是硬件质量差、软件程序故障以及社区成员对 m-health 计划的负面看法。CHWs 就如何改进 Geohealth 以满足他们的需求提供了宝贵的意见。
m-health 工具有可能为 LMICs 的 CHWs 提供便利。然而，此类工具必须经过深思熟虑的设计和实施。必须预测和解决与硬件和软件相关的技术障碍，以最大限度地提高其效率和成功采用率。应征求 CHW 对工具设计的意见，以最大限度地提高其效用并最大限度地减少使用障碍。
