O'Connor Cara, Leyritana Katerina, Doyle Aoife M, Birdthistle Isolde, Lewis James J, Gill Randeep, Salvaña Edsel Maurice
Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Sustained Health Initiatives of the Philippines, Mandaluyong, Philippines.
JMIR Form Res. 2022 Aug 12;6(8):e37163. doi: 10.2196/37163.
The Philippines HIV epidemic is one of the fastest growing epidemics globally, and infections among men who have sex with men are increasing at an alarming rate. Connect for Life Philippines is a mobile health (mHealth) intervention that supports antiretroviral therapy (ART) adherence in this key population through individualized voice calls and SMS text messages.
The objective of this process evaluation is to assess the intervention reach, dose delivered and received, fidelity, and acceptability and to describe contextual factors affecting the implementation of an mHealth adherence support intervention for patients on ART in a clinic in Metro Manila, Philippines.
A mixed methods process evaluation approach was used in an observational cohort study. Quantitative data sources for the process evaluation were call and SMS text message logs obtained from the mHealth platform and questionnaires collected at 12-, 24-, and 48-week study visits. Qualitative data were collected from process reports and through a series of focus group discussions conducted with a subset of participants during the intervention development phase, after an initial 8-week pilot phase, and at the end of the study.
The 462 study participants received 31,095 interactive voice calls and 8234 SMS text messages during the study. Owing to technical issues, intervention fidelity was low, with only 22.1% (102/462) of the participants receiving reminders via voice calls and others (360/462, 77.9%) receiving only SMS text messages during the intervention. After 48 weeks in the study, 63.5% (293/462) of the participants reported that they would be quite likely or very likely to recommend the program to a friend, and 53.8% (249/462) of the participants reported that they benefited quite a bit or very much from the intervention. Participants who were on ART for <6 months at the beginning of the study and those who received the daily or weekly pill reminders were more likely to report that they benefited from the intervention (P=.02 and P=.01, respectively).
The Connect for Life intervention had high participant satisfaction and acceptability, especially among those who received high dose of the intervention. However, poor reliability of local telecommunication networks had a large impact on the intervention's usability, fidelity, and dose received.
菲律宾的艾滋病病毒疫情是全球增长最快的疫情之一，男男性行为者中的感染率正以惊人的速度上升。菲律宾“携手生命”项目是一项移动健康（mHealth）干预措施，通过个性化语音通话和短信支持这一关键人群坚持抗逆转录病毒疗法（ART）。
本过程评估的目的是评估干预的覆盖范围、提供和接收的剂量、保真度及可接受性，并描述影响菲律宾马尼拉大都会一家诊所中针对接受抗逆转录病毒治疗患者的移动健康依从性支持干预措施实施的背景因素。
在一项观察性队列研究中采用了混合方法过程评估方法。过程评估的定量数据来源是从移动健康平台获取的通话和短信日志，以及在研究的第12周、24周和48周访视时收集的问卷。定性数据从过程报告中收集，并通过在干预开发阶段、最初8周试点阶段结束后以及研究结束时与一部分参与者进行的一系列焦点小组讨论收集。
在研究期间，462名研究参与者共收到31095次交互式语音通话和8234条短信。由于技术问题，干预保真度较低，在干预期间，只有22.1%（102/462）的参与者通过语音通话收到提醒，其他参与者（360/462，77.9%）仅收到短信。研究48周后，63.5%（293/462）的参与者表示他们很可能或非常可能会向朋友推荐该项目，53.8%（249/462）的参与者表示他们从干预中受益匪浅或获益良多。在研究开始时接受抗逆转录病毒治疗不到6个月的参与者以及收到每日或每周服药提醒的参与者更有可能表示他们从干预中受益（分别为P = 0.02和P = 0.01）。
“携手生命”干预措施获得了参与者较高的满意度和可接受性，尤其是在那些接受高剂量干预的参与者中。然而，当地电信网络可靠性差对干预的可用性、保真度和接收剂量产生了很大影响。
