Montaner Andrés, Mumbalanga Mulundu, Umuhoza Marie-Chantal, Kinge Constance Wose, Okonji Emeka, Ligenda Godfrey, Mothibi Eula, Chirwa Ben, Pisa Pedro, Chasela Charles
Right to Care, Centurion, South Africa.
Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
PLoS One. 2025 Jun 5;20(6):e0312646. doi: 10.1371/journal.pone.0312646. eCollection 2025.
BACKGROUND: As more people living with HIV are identified and prescribed antiretroviral treatment in Zambia, detecting new HIV infections to complete the last mile of epidemic control is challenging. To address this, innovative targeted testing strategies are essential. Therefore, Right to Care Zambia developed and implemented a novel digital health surveillance application, Lynx, in three Zambian provinces-Northern, Luapula, and Muchinga in 2018. Lynx offers real-time HIV testing data with geo-spatial analysis for targeted testing, and has proven effective in enhancing HIV testing yield. This cross-sectional mixed methods study assessed the acceptability of Lynx among HIV testing healthcare workers in Zambia. METHODS: A quantitative Likert scale (1-5) survey was administered to 176 healthcare workers to gauge Lynx's acceptability. Additionally, six qualitative key person interviews and five focus group discussions were conducted to gain an in-depth understanding of acceptability, and identify relevant barriers and facilitators. Quantitative data were analysed by averaging survey responses and running descriptive statistics. Qualitative data were transcribed and analysed in thematic coding. Data triangulation was utilised between the data sources to verify findings. RESULTS: Overall, the average survey score of perceived ease of use was 3.926 (agree), perceived usefulness was 4.179 (strongly agree) and perceived compatibility was 3.574 (agree). Survey questions related to network requirements, resource availability, and IT support had the most "strongly disagree" responses. The qualitative data collection revealed that Lynx was perceived as useful, and easy to use. Training for staff and regular updates were identified as facilitators, while conflicting work priorities and inconsistent IT support were identified barriers. CONCLUSION: Lynx was identified as acceptable by health workers due to its perceived usefulness, staff trainings, and regular updates. For a mobile health intervention to be embraced in rural Zambian settings, key facilitators include robust IT support, comprehensive training, user feedback-based updates, and consideration of facility staff priorities.
背景：随着赞比亚越来越多的艾滋病毒感染者被确诊并接受抗逆转录病毒治疗，检测新的艾滋病毒感染以完成疫情控制的最后一公里具有挑战性。为解决这一问题，创新的针对性检测策略至关重要。因此，赞比亚关爱权利组织于2018年在赞比亚的三个省份——北部、卢阿普拉和穆钦加开发并实施了一种新型数字健康监测应用程序Lynx。Lynx提供带有地理空间分析的实时艾滋病毒检测数据，用于针对性检测，并已证明在提高艾滋病毒检测率方面有效。这项横断面混合方法研究评估了Lynx在赞比亚艾滋病毒检测医护人员中的可接受性。 方法：对176名医护人员进行了定量李克特量表（1 - 5）调查，以评估Lynx的可接受性。此外，进行了六次定性关键人物访谈和五次焦点小组讨论，以深入了解可接受性，并确定相关障碍和促进因素。定量数据通过对调查回复进行平均并运行描述性统计进行分析。定性数据进行转录并通过主题编码进行分析。在数据源之间采用数据三角测量法来验证研究结果。 结果：总体而言，感知易用性的平均调查得分是3.926（同意），感知有用性是4.179（强烈同意），感知兼容性是3.574（同意）。与网络要求、资源可用性和信息技术支持相关的调查问题得到的“强烈不同意”回复最多。定性数据收集表明，Lynx被认为是有用且易于使用的。工作人员培训和定期更新被确定为促进因素，而相互冲突的工作优先级和不一致的信息技术支持被确定为障碍。 结论：由于其感知有用性、工作人员培训和定期更新，Lynx被医护人员认为是可接受的。要使移动健康干预在赞比亚农村地区得到接受，关键促进因素包括强大的信息技术支持、全面培训、基于用户反馈的更新以及对机构工作人员优先级的考虑。
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