最终用户对两种移动医疗决策支持工具的看法：马拉维北部的电子社区病例管理。

End-user perspectives of two mHealth decision support tools: Electronic Community Case Management in Northern Malawi.

机构信息

Faculty of Health Sciences, Mzuzu University, Private Bag 201, Luwinga, Mzuzu, Malawi; School of Public Health and Family Medicine, University of Malawi, College of Medicine, Blantyre, Malawi.

School of Public Health and Family Medicine, University of Malawi, College of Medicine, Blantyre, Malawi; Africa Centre of Excellence in Public Health and Herbal Medicine, University of Malawi, College of Medicine, Malawi.

出版信息

Int J Med Inform. 2021 Jan;145:104323. doi: 10.1016/j.ijmedinf.2020.104323. Epub 2020 Nov 10.

DOI:10.1016/j.ijmedinf.2020.104323

PMID:33232917

Abstract

BACKGROUND

The introduction of a paper-based Community Case Management (CCM) in Malawi has contributed to a reduction of child morbidity and mortality rates. In addition, the introduction of electronic Community Case Management (eCCM) (smartphones with built in CCM apps) may help to reduce the under-five mortality rates even further.

PURPOSE

It is not uncommon for Apps with a similar area of interest to develop different features to assist the end users. Such differences between Apps may have a significant role to play in its overall adoption and integration. The purpose of this research was to explore end users perspectives of two eCCM decision support tools developed and implemented by the Supporting LIFE project (SL eCCM App) and D-Tree International's (Mangologic eCCM App)in Northern Malawi.

METHODS

A mixed methods approach was applied, involving a survey of 109 users (106 Health Surveillance Assistants (HSAs), and 3 Integrated Management of Childhood Il6lnesses (IMCI) coordinators). This was followed up with semi-structured interviews with 34 respondents (31 HSAs, and 3 IMCI coordinators). Quantitative data was analyzed using SPSS version 20 where descriptive statistics and Chi-Squared tests were generated. Qualitative data were analyzed based on thematic analysis.

RESULTS

Participants reported that both Apps could assist the HSAs in the management of childhood illnesses. However, usability differed between the two apps where the Supporting LIFE eCCM App was found to be easier to use (61%) compared to the Mangologic eCCM App (4%). Both Apps were perceived to provide credible and accurate information.

CONCLUSION

It is essential that the quality of the data within Mobile Health (mHealth) Apps is high, however even Apps with excellent levels of data quality may not succeed if the overall usability of the App is low. Therefore it is essential that the Apps has high levels of data quality, usability and credibility. The results of this study will help inform mobile Health (mHealth) App designers in developing future eCCM Apps as well as researchers and policy makers when considering the adoption of mHealth solutions in the future in Malawi and other LMICs.

摘要

背景

马拉维引入纸质社区病例管理（CCM）有助于降低儿童发病率和死亡率。此外，引入电子社区病例管理（eCCM）（内置 CCM 应用程序的智能手机）甚至可能有助于进一步降低五岁以下儿童死亡率。

目的

具有相似兴趣领域的应用程序开发不同的功能以帮助最终用户是很常见的。这些应用程序之间的差异可能在其整体采用和集成中发挥重要作用。本研究旨在探讨支持生命项目（SL eCCM 应用程序）和 D-Tree International（Mangologic eCCM 应用程序）在马拉维北部开发和实施的两种电子社区病例管理决策支持工具的最终用户观点。

方法

采用混合方法，对 109 名用户（106 名卫生监督助理（HSA）和 3 名儿童综合管理疾病（IMCI）协调员）进行了调查。随后对 34 名受访者（31 名 HSA 和 3 名 IMCI 协调员）进行了半结构化访谈。使用 SPSS 版本 20 分析定量数据，生成描述性统计数据和卡方检验。定性数据基于主题分析进行分析。

结果

参与者报告说，两个应用程序都可以帮助 HSA 管理儿童疾病。然而，两个应用程序的可用性存在差异，其中支持生命 eCCM 应用程序被认为比 Mangologic eCCM 应用程序更容易使用（61%）。两个应用程序都被认为提供了可靠和准确的信息。

结论

移动健康（mHealth）应用程序中的数据质量至关重要，但是，如果应用程序的整体可用性较低，即使具有出色数据质量水平的应用程序也可能无法成功。因此，应用程序必须具有高水平的数据质量、可用性和可信度。这项研究的结果将有助于为移动健康（mHealth）应用程序设计师开发未来的 eCCM 应用程序提供信息，同时也为研究人员和政策制定者在未来考虑在马拉维和其他中低收入国家采用 mHealth 解决方案提供信息。