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Acceptability, feasibility and appropriateness of intensified health education, SMS/phone tracing and transport reimbursement for uptake of voluntary medical male circumcision in a sexually transmitted infections clinic in Malawi: a mixed methods study.

作者信息

Matoga Mitch M, Kudowa Evaristar, Chikuni Joachim, Tsidya Mercy, Tseka Jennifer, Ndalama Beatrice, Bonongwe Naomi, Mathiya Esther, Jere Edward, Yatina Dumbo, Kamtambe Blessings, Kapito Martin, Hosseinipour Mina C, Chasela Charles S, Jewett Sara

机构信息

University of North Carolina Project, Lilongwe, Malawi.

Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Heath Sciences, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

medRxiv. 2024 Apr 4:2024.03.27.24304985. doi: 10.1101/2024.03.27.24304985.


DOI:10.1101/2024.03.27.24304985
PMID:38633812
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11023656/
Abstract

INTRODUCTION: Uptake of voluntary medical male circumcision (VMMC) remains a challenge in many settings. Innovative implementation strategies are required to scale-up VMMC uptake. METHODOLOGY: RITe was a multi-faceted intervention comprising transport reimbursement (R), intensified health education (IHE) and SMS/Telephone tracing (Te), which increased the uptake of VMMC among uncircumcised men with sexually transmitted infections (STIs) in Malawi. Using a concurrent exploratory mixed-method approach, we assessed the intervention's acceptability, feasibility and appropriateness among men with STIs and healthcare workers (HCWs) at Bwaila District Hospital. Participants completed Likert scale surveys and participated in-depth interviews (IDIs) and focus group discussions (FGDs). We calculated percentages of responses to survey items and summarized common themes using thematic analysis. Median scores and interquartile ranges (IQR) were calculated for acceptability, feasibility and appropriateness of each strategy at baseline and end-line and compared using the Wilcoxon signed rank test. RESULTS: A total of 300 surveys, 17 IDIs and 4 FGDs were conducted with men and HCWs between baseline and end-line. The mean age for men in the survey was 29 years (SD ±8) and most were married/cohabiting (59.3%). Mean age for HCWs was 38.5 years (SD ±7), and most were female (59.1%). For acceptability, participants agreed that RITe was welcome, approvable, and likable. Despite participants agreeing that RITe was a good idea, culture and religion influenced appropriateness, particularly at baseline, which improved at end-line for Te and R. For feasibility, HCWs agreed that RITe was easy to implement, but expressed concerns that R (end-line median = 4, IQR: 2, 4) and Te (end-line median = 4, IQR: 4, 4), were resource intensive, hence unsustainable. Interviews corroborated the survey results. Participants reported that IHE provided important information, Te was a good reminder and R was attractive, but they reported barriers to R and Te such as electricity, limited access to phones and distrust in the government. CONCLUSIONS: The RITe intervention was acceptable, feasible and appropriate. However, culture/religion and structural barriers affected perceptions of appropriateness and feasibility, respectively. Continued awareness raising on VMMC and addressing setting-specific structural factors are required to overcome barriers that impede demand-creation interventions for VMMC. STUDY REGISTRATION: ClinicalTrials.gov identifier: NCT04677374. Registered on December 18, 2020.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb4c/11023656/88bb36cbce40/nihpp-2024.03.27.24304985v1-f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb4c/11023656/9b2de01c93f2/nihpp-2024.03.27.24304985v1-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb4c/11023656/cc2639e00601/nihpp-2024.03.27.24304985v1-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb4c/11023656/88bb36cbce40/nihpp-2024.03.27.24304985v1-f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb4c/11023656/9b2de01c93f2/nihpp-2024.03.27.24304985v1-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb4c/11023656/cc2639e00601/nihpp-2024.03.27.24304985v1-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb4c/11023656/88bb36cbce40/nihpp-2024.03.27.24304985v1-f0003.jpg

相似文献

[1]
Acceptability, feasibility and appropriateness of intensified health education, SMS/phone tracing and transport reimbursement for uptake of voluntary medical male circumcision in a sexually transmitted infections clinic in Malawi: a mixed methods study.

medRxiv. 2024-4-4

[2]
Acceptability, feasibility and appropriateness of intensified health education, SMS/phone tracing and transport reimbursement for uptake of voluntary medical male circumcision in a sexually transmitted infections clinic in Malawi: A mixed methods study.

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[3]
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[4]
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[5]
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East Afr Med J. 2014-11

[6]
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HIV AIDS (Auckl). 2022-9-23

[7]
Men's attitudes: A hindrance to the demand for voluntary medical male circumcision--a qualitative study in rural Mhondoro-Ngezi, Zimbabwe.

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[8]
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[9]
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[10]
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本文引用的文献

[1]
Effectiveness of an intervention to increase uptake of voluntary medical male circumcision among men with sexually transmitted infections in Malawi: a preinterventional and postinterventional study.

BMJ Open. 2023-10-3

[2]
'I understood the texting process well'. Participant perspectives on usability and acceptability of SMS-based telehealth follow-up after voluntary medical male circumcision in South Africa.

Digit Health. 2023-8-27

[3]
Key challenges to voluntary medical male circumcision uptake in traditionally circumcising settings of Machinga district in Malawi.

BMC Public Health. 2021-10-28

[4]
Effects of HIV voluntary medical male circumcision programs on sexually transmitted infections.

Curr Opin Infect Dis. 2021-2-1

[5]
Usability and acceptability of a two-way texting intervention for post-operative follow-up for voluntary medical male circumcision in Zimbabwe.

PLoS One. 2020-6-16

[6]
Service delivery interventions to increase uptake of voluntary medical male circumcision for HIV prevention: A systematic review.

PLoS One. 2020-1-13

[7]
Barriers to the Use of Mobile Health in Improving Health Outcomes in Developing Countries: Systematic Review.

J Med Internet Res. 2019-10-9

[8]
The effectiveness of demand creation interventions for voluntary male medical circumcision for HIV prevention in sub-Saharan Africa: a mixed methods systematic review.

J Int AIDS Soc. 2019-7

[9]
Systematic review of barriers and facilitators to voluntary medical male circumcision in priority countries and programmatic implications for service uptake.

Glob Public Health. 2018-4-26

[10]
Systematic review of the effect of economic compensation and incentives on uptake of voluntary medical male circumcision among men in sub-Saharan Africa.

AIDS Care. 2018-9

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