DiAndreth Lisa, Krishnan Nandita, Elf Jessica L, Cox Sarah, Tilchin Carla, Nthulana Munei, Jarrett Brooke, Kronis Nadya, Dupuis Elisa, Motlhaoleng Katlego, Chon Sandy, Martinson Neil, Golub Jonathan E
Johns Hopkins School of Nursing, Baltimore, MD, USA.
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
AIDS Care. 2020 Jun;32(6):744-748. doi: 10.1080/09540121.2019.1640850. Epub 2019 Jul 12.
In South Africa, high attrition rates throughout the care continuum present major barriers to controlling the HIV epidemic. Mobile health (mHealth) interventions may provide innovative opportunities for efficient healthcare delivery and improving retention in care. In this formative research, we interviewed 11 patients and 28 healthcare providers in North West Province, South Africa, to identify perceived benefits, concerns and suggestions for a future mHealth program to deliver HIV Viral Load and CD4 Count test results directly to patients via mobile phone. Thematic analysis found that reduced workload for providers, reduced wait times for patients, potential expanded uses and patient empowerment were the main perceived benefits of an mHealth program. Perceived concerns included privacy, disseminating distressing results through text messages and patients' inability to interpret results. Participants felt that an mHealth program should complement face-to-face interactions and educational information to interpret results is needed. Providers identified logistical considerations and suggested protocols be developed. An mHealth program to deliver HIV test results directly to patients could mitigate multiple barriers to care but needs to be tested for efficacy. Concerns identified by patients and providers must be addressed in designing the program to successfully integrate with health facility workflow and ensure its sustainability.
在南非，整个护理连续过程中的高流失率成为控制艾滋病毒疫情的主要障碍。移动健康（mHealth）干预措施可能为高效医疗服务提供和提高护理留存率带来创新机遇。在这项形成性研究中，我们采访了南非西北省的11名患者和28名医疗服务提供者，以确定对于未来一个通过手机直接向患者提供艾滋病毒载量和CD4细胞计数检测结果的移动健康项目的感知益处、担忧及建议。主题分析发现，对医疗服务提供者而言工作量减少、对患者而言等待时间缩短、潜在的用途扩展以及患者赋权是移动健康项目的主要感知益处。感知到的担忧包括隐私问题、通过短信传播令人苦恼的结果以及患者无法解读检测结果。参与者认为移动健康项目应补充面对面互动，且需要提供解读结果的教育信息。医疗服务提供者指出了后勤方面的考虑因素，并建议制定相关规程。一个直接向患者提供艾滋病毒检测结果的移动健康项目可以减轻护理的多重障碍，但需要对其疗效进行测试。在设计该项目时，必须解决患者和医疗服务提供者所确定的担忧，以便成功融入医疗机构工作流程并确保其可持续性。
