Ggita Joseph M, Katahoire Anne, Meyer Amanda J, Nansubuga Elizabeth, Nalugwa Talemwa, Turimumahoro Patricia, Ochom Emmanuel, Ayakaka Irene, Haberer Jessica E, Katamba Achilles, Armstrong-Hough Mari, Davis J Lucian
Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda.
Child Health and Development Centre, Makerere University, Kampala, Uganda.
BMC Public Health. 2020 Mar 12;20(1):310. doi: 10.1186/s12889-020-8427-0.
The World Health Organization (WHO) recommends household contact investigation for tuberculosis (TB) in high-burden countries. However, household contacts who complete evaluation for TB during contact investigation may have difficulty accessing their test results. Use of automated short-messaging services (SMS) to deliver test results could improve TB status awareness and linkage to care. We sought to explore how household contacts experience test results delivered via SMS, and how these experiences influence follow-up intentions.
We conducted semi-structured interviews with household contacts who participated in a randomized controlled trial evaluating home sputum collection and delivery of TB results via SMS (Pan-African Clinical Trials Registry #201509000877140). We asked about feelings, beliefs, decisions, and behaviors in response to the SMS results. We analyzed the content and emerging themes in relation to the Theory of Planned Behavior.
We interviewed and achieved thematic saturation with ten household contacts. Nine received TB-negative results and one a TB-positive result. Household contacts reported relief upon receiving SMS confirming their TB status, but also said they lacked confidence in the results delivered by SMS. Some worried that negative results were incorrect until they spoke to a lay health worker (LHW). Household contacts said their long-term intentions to request help or seek care were influenced by perceived consequences of not observing the LHW's instructions related to the SMS and follow-up procedures; beliefs about the curability of TB; anticipated support from LHWs; and perceived barriers to responding to an SMS request for further evaluation.
Household contacts experienced relief when they received results. However, they were less confident about results delivered via SMS than results delivered by LHWs. Delivery of results by SMS should complement continued interaction with LHWs, not replace them.
世界卫生组织（WHO）建议在高负担国家对结核病（TB）进行家庭接触者调查。然而，在接触者调查期间完成结核病评估的家庭接触者可能难以获取其检测结果。使用自动短消息服务（SMS）来传递检测结果可以提高对结核病状况的认知并促进与医疗服务的联系。我们试图探究家庭接触者如何体验通过短信发送的检测结果，以及这些体验如何影响后续的跟进意愿。
我们对参与一项随机对照试验的家庭接触者进行了半结构化访谈，该试验评估了家庭痰液采集以及通过短信发送结核病检测结果（泛非临床试验注册编号#201509000877140）。我们询问了他们对短信结果的感受、信念、决定和行为。我们根据计划行为理论分析了内容和新出现的主题。
我们对10名家庭接触者进行了访谈并达到了主题饱和。9人收到结核病阴性结果，1人收到结核病阳性结果。家庭接触者表示收到确认其结核病状况的短信后感到宽慰，但也表示他们对通过短信发送的结果缺乏信心。一些人担心阴性结果不正确，直到他们与非专业卫生工作者（LHW）交谈。家庭接触者表示，他们寻求帮助或寻求医疗服务的长期意愿受到以下因素的影响：未遵守LHW与短信及后续程序相关指示的感知后果；对结核病可治愈性的信念；预期从LHW获得的支持；以及对回复短信要求进一步评估的感知障碍。
家庭接触者收到结果时感到宽慰。然而，他们对通过短信发送的结果比对LHW提供的结果信心更低。通过短信发送结果应补充与LHW的持续互动，而不是取代他们。
