Department of Family Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA.
Global Health Innovations, Dallas, TX, USA.
AIDS Behav. 2019 Nov;23(11):3093-3102. doi: 10.1007/s10461-019-02579-5.
The HIV Infant Tracking System (HITSystem) is an eHealth intervention to improve early infant diagnosis (EID) through alerts to providers and text messages to mothers. This study explored mothers' experiences receiving standard and HITSystem-enhanced EID services to assess perceived intervention benefits, acceptability, and opportunities for improvement. This qualitative study was embedded within a cluster-randomized control trial to evaluate the HITSystem at six Kenyan government hospitals (3 intervention, 3 control). We conducted semi-structured interviews with 137 mothers attending EID follow-up visits. Compared to control sites, participants at HITSystem sites described enhanced EID quality; HITSystem-generated texts informed them of result availability and retesting needs, provided cues-to-action for clinic attendance, and engendered opportunities for patient support. They described improved EID efficiency through shorter waiting periods for results and fewer hospital visits. Participants reported high satisfaction with EID and acceptability of text messages; however, modifications to ensure text delivery, increase repeat testing reminders, include low literacy content options, and provide encouraging messages were suggested. These user experience data suggest improvements in EID at HITSystem sites when compared with control sites.
艾滋病毒婴儿追踪系统 (HITSystem) 是一种电子健康干预措施,通过向提供者发出警报和向母亲发送短信来改善早期婴儿诊断 (EID)。本研究探讨了母亲接受标准和 HITSystem 增强型 EID 服务的经验,以评估感知到的干预措施的益处、可接受性和改进机会。这项定性研究是嵌入在一项评估 HITSystem 的集群随机对照试验中进行的,该试验在肯尼亚的六家政府医院(3 家干预组,3 家对照组)进行。我们对 137 名参加 EID 随访的母亲进行了半结构化访谈。与对照组相比,HITSystem 组的参与者描述了增强型 EID 的质量;HITSystem 生成的文本告知他们结果的可用性和重新检测的需求,为就诊提供行动提示,并为患者提供支持机会。他们描述了通过缩短结果等待时间和减少医院就诊次数来提高 EID 效率。参与者对 EID 和短信的可接受性表示高度满意;然而,建议进行一些修改,以确保短信的传递、增加重复检测提醒、包括低识字内容选项以及提供鼓励性信息。这些用户体验数据表明,与对照组相比,HITSystem 组的 EID 得到了改善。