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Sin WM, Tse MMY, Chung JWY, Choi SPP. A feasibility study of mindfulness-based interventions for children. Pilot Feasibility Stud 2024; 10:58. [PMID: 38589971 PMCID: PMC11000349 DOI: 10.1186/s40814-024-01488-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/26/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Children's overall psychological well-being is a concern for parents and adults worldwide. Mindfulness appears to be a promising intervention for enhancing children's psychological well-being, and its effectiveness has been well-documented. However, there is a paucity of data on the feasibility and acceptability of implementing mindfulness-based interventions (MBIs) for children; this is a crucial factor in determining whether MBIs can be utilized to benefit children. The aim of this study was to determine the feasibility and acceptability of implementing MBIs among Hong Kong children. METHODS Seventy-eight children (mean age = 9.06, SD = .375) were recruited from a primary school in Hong Kong and received MBIs in a single session that lasted about 2 h. The intervention's feasibility was determined in terms of retention rates, while acceptability was based on qualitative feedback from the children. RESULTS The results show that there were high retention rates (96%). Qualitative analyses of children's feedback revealed that they experienced enhanced well-being, and enjoyed and benefited from the interventions. CONCLUSIONS This study shows the high feasibility of MBIs in children, supporting the conduct of an efficacy trial to examine the effects of MBIs among children. Support from school teachers and measures to raise and maintain children's interest in mindfulness could facilitate the conduct of a study.
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Affiliation(s)
- Wai Man Sin
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Kowloon, Hong Kong
| | - Mimi Mun Yee Tse
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Kowloon, Hong Kong.
| | - Joanne Wai Yee Chung
- Guangzhou Medical University, Guangzhou, China
- Kiang Wu Nursing College of Macau, Macao, China
| | - Sandy Pin Pin Choi
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Kowloon, Hong Kong
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Hovadick ACDA, Cardoso MA. Family-Based WhatsApp Intervention to Promote Healthy Eating Behaviors Among Amazonian School Children: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e54446. [PMID: 38373039 PMCID: PMC10912988 DOI: 10.2196/54446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Stunting and micronutrient deficiencies have persistently affected children in the Brazilian Amazon for decades. However, in recent years, a notable increase in childhood overweight prevalence has been observed, particularly in the context of heightened food insecurity exacerbated by the COVID-19 pandemic. Despite the limited number of effective solutions proposed to tackle this problem, digital interventions have shown great promise worldwide in preventing obesity and promoting healthy diets. OBJECTIVE This study aims to describe the protocol of a family-based WhatsApp intervention, specifically designed to investigate the efficacy of multimedia messaging in preventing excessive weight gain and improving healthy eating practices among school-aged children in the Amazon region. METHODS This study protocol outlines a theory-driven randomized controlled trial based on the cognitive theory of multimedia learning and the social cognitive theory. A total of 240 parents or caregivers of children enrolled in the Maternal and Child Health and Nutrition Cohort Study in Acre (MINA-Brazil) will be recruited by phone and social media. The intervention group will receive persuasive multimedia messages through WhatsApp over 19 weeks, while the waitlist control group will remain in the usual care. The primary outcome is a change in children's BMI in z score. Secondary outcomes are changes in dietary intake and biochemical indicators of the children. Outcome measures will be assessed at baseline and 5 months after randomization in comparison to usual care. The analysis will use an intent-to-treat approach and will be conducted using the statistical package Stata (version 18.0), with a significance level set at P<.05. Paired and unpaired 2-tailed t tests will be applied to compare mean changes in the outcomes. RESULTS Data collection started in June 2023, and final measurements are scheduled to be completed in December 2023. The results of the main analysis are expected to be available in 2024. CONCLUSIONS This innovative multimedia message intervention holds significant potential for fostering behavioral changes among Amazonian children. TRIAL REGISTRATION Brazilian Clinical Trials Registry RBR-5zdnw6t; https://ensaiosclinicos.gov.br/rg/RBR-5zdnw6t. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54446.
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Affiliation(s)
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
- Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa (UNL), Lisbon, Portugal
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Ayieko S, Jaoko W, Opiyo RO, Orang’o EO, Messiah SE, Baker K, Markham C. Knowledge, Attitudes, and Subjective Norms Associated with COVID-19 Vaccination among Pregnant Women in Kenya: An Online Cross-Sectional Pilot Study Using WhatsApp. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:98. [PMID: 38248561 PMCID: PMC10815556 DOI: 10.3390/ijerph21010098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
COVID-19 vaccination during pregnancy has been recommended, but the perceptions related to uptake remain unexplored. This pilot study aimed to explore how perceptions influence COVID-19 vaccine uptake among a sample of 115 pregnant women in Kenya, recruited via WhatsApp. Data were collected using an adapted online questionnaire between May and October 2022. Logistic analyses assessed the relationship between COVID-19 vaccination uptake and the Theory of Reasoned Action (TRA) constructs: attitudes and subjective norms. COVID-19 vaccination coverage was 73%, with vaccine hesitancy estimated at 41.4% among the unvaccinated group. Most participants had completed college education and had good knowledge of COVID-19 vaccines. There was no significant effect of enrollment in WhatsApp pregnancy groups on attitudes toward COVID-19 vaccination. Pregnant women were concerned about vaccine effectiveness (31.1%), and almost one-half (47.3%) were discouraged from receiving COVID-19 vaccines. Positive attitudes towards vaccination were associated with COVID-19 vaccination (aOR 2.81; 95% CI 1.12-7.04; p = 0.027), but no significant relationship was found between COVID-19 vaccination and strong subjective norms (influences to get COVID-19 vaccines). Our findings suggest that strategies to improve vaccination should consider targeting attitudes and proximal social networks (friends/family) to facilitate vaccination decision-making. WhatsApp can be used for research distribution and enhance the dissemination of accurate information.
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Affiliation(s)
- Sylvia Ayieko
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX 77030, USA; (K.B.); (C.M.)
| | - Walter Jaoko
- Department of Medical Microbiology, University of Nairobi, P.O Box 19676, Nairobi 00202, Kenya;
- KAVI-Institute of Clinical Research, University of Nairobi, P.O. Box 19676, Nairobi 00202, Kenya
| | - Rose Okoyo Opiyo
- Department of Public and Global Health, University of Nairobi, P.O. Box 19676, Nairobi 00202, Kenya;
| | | | - Sarah E. Messiah
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Dallas, TX 75207, USA;
- Center for Pediatric Population Health, University of Texas Health Science Center at Houston School of Public Health, Dallas, TX 75207, USA
- Department of Pediatrics, McGovern Medical School, Houston, TX 77030, USA
| | - Kimberly Baker
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX 77030, USA; (K.B.); (C.M.)
| | - Christine Markham
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX 77030, USA; (K.B.); (C.M.)
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Amaro JS, Pessalli MRTFB, da Cunha LB, Betrán AP, Torloni MR, Siaulys MM. The Godmother Project: A Virtual Initiative to Support Pregnant and Postpartum Women in Brazil During the COVID-19 Pandemic. GLOBAL HEALTH, SCIENCE AND PRACTICE 2023; 11:e2200500. [PMID: 37116933 PMCID: PMC10141421 DOI: 10.9745/ghsp-d-22-00500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/15/2023] [Indexed: 04/30/2023]
Abstract
BACKGROUND The COVID-19 pandemic increased maternal distress and demand for social support and educational services, while restriction measures decreased the availability of these services. PROJECT DESCRIPTION The Godmother Project, a person-centered, WhatsApp-based support and health education initiative, was created after all in-person perinatal educational activities offered at 3 Brazilian hospitals were canceled in 2020. The project was developed in response to pregnant/postpartum women who called the hospitals with questions for health care professionals (HCPs). Health education nurses teamed up with staff from the communication department to design a project to (1) provide a direct communication channel between women and HCPs to answer health-related questions, (2) offer reliable virtual health education material, (3) identify women in need of additional assessment/referrals, (4) offer each woman continuous support from a specific nurse educator (Godmother), and (5) offer a virtual forum where women going through similar experiences could interact. PROJECT DEVELOPMENT AND ROLLOUT The project provides direct communication between WhatsApp groups of 25-30 pregnant/postpartum women and a Godmother. It also offers access to a virtual library of educational materials prepared in response to women's needs/demands. The project, which began in July 2020 with 1 WhatsApp group of 5 women and 1 Godmother, currently has 305 groups, 6,942 active participants, and 4 Godmothers. Enrollments and WhatsApp groups continued to increase despite reestablishment of in-person educational activities in 2022. The vast majority of 232 participants surveyed in December 2021 were very satisfied with the project, the Godmothers, and the educational materials. CONCLUSIONS Our findings suggest that WhatsApp groups of pregnant/postpartum women led by dedicated nurse educators can be an important tool to educate and support women during the perinatal period. This type of initiative may be especially important in contexts of physical distancing requirements or situations where social support is unavailable.
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Affiliation(s)
- Juliana S Amaro
- Communication and Marketing Department, Grupo Santa Joana, São Paulo, Brazil
| | | | - Lissandra B da Cunha
- Department of Health Education and Training, Grupo Santa Joana, São Paulo, Brazil
| | - Ana Pilar Betrán
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Montenegro JLZ, da Costa CA, da Rosa Righi R, Farias ER, Matté LB. Development and Validation of Conversational Agent to Pregnancy Safe-education. J Med Syst 2023; 47:7. [PMID: 36626106 DOI: 10.1007/s10916-022-01903-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 12/14/2022] [Indexed: 01/11/2023]
Abstract
Pregnant women constantly need some information to support nutritional decisions during pregnancy, and many do not receive such assistance at all. This study aims to present a conversational agent to provide reliable information to pregnant women, focusing on nutritional education and evaluating the perception of pregnant women and health professionals about the agent. As a scientific contribution, this article developed and implemented a conversational agent in a real environment capable of generating reliable responses on the basis of a set of health documents. We proposed an intervention study with 25 women and 10 healthcare providers through a survey to measure the perceptions of these groups towards conversational agents. The results show that the intended design could ensure positive support for pregnant women, clarify certain issues for the public, and remove some knowledge barriers. The results showed no significant difference between the groups (p-value = 0.713). Depending on the perception of the pregnant group, the conversational agent model can teach new knowledge during the prenatal period (Mean = 4.56). The model presented for health professionals could already be indicated as a support tool for pregnant women (Mean = 4.7).
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Affiliation(s)
- João Luis Zeni Montenegro
- Software Innovation Laboratory - SOFTWARELAB, Programa de Pós-Graduação em Computação Aplicada, Universidade do Vale do Rio dos Sinos - Unisinos, Av. Unisinos 950, São Leopoldo, RS, 93022-000, Brazil
| | - Cristiano André da Costa
- Software Innovation Laboratory - SOFTWARELAB, Programa de Pós-Graduação em Computação Aplicada, Universidade do Vale do Rio dos Sinos - Unisinos, Av. Unisinos 950, São Leopoldo, RS, 93022-000, Brazil.
| | - Rodrigo da Rosa Righi
- Software Innovation Laboratory - SOFTWARELAB, Programa de Pós-Graduação em Computação Aplicada, Universidade do Vale do Rio dos Sinos - Unisinos, Av. Unisinos 950, São Leopoldo, RS, 93022-000, Brazil
| | - Elson Romeu Farias
- School of Public Health of the State Health Secretariat of RS, Universidade Luterana do Brasil - Ulbra, Canoas, Brazil
| | - Lara Balen Matté
- Software Innovation Laboratory - SOFTWARELAB, Programa de Pós-Graduação em Computação Aplicada, Universidade do Vale do Rio dos Sinos - Unisinos, Av. Unisinos 950, São Leopoldo, RS, 93022-000, Brazil
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Malmström N, Lydell M, Carlsson IM. “Womanhood,” a shared experience of participating in a lifestyle intervention with a focus on integration and physical activity to promote health among pregnant women: perspectives from pregnant women, midwives, and cultural interpreter doulas. Int J Qual Stud Health Well-being 2022; 17:2043527. [PMID: 35212612 PMCID: PMC8925914 DOI: 10.1080/17482631.2022.2043527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose Migrating women, have an overall increased risk of adverse outcomes and poorer health during pregnancy and childbirth. In addition, they do not participate in planned antenatal care to the same extent as natives. These disparities among migrants and native pregnant women point to the need for interventions to improve equal health and care during pregnancy and childbirth. This study aimed to explore the experiences of participating in a lifestyle intervention, named “Dancing for birth,” focusing on integration and physical activity, from the perspectives of the participating pregnant women, midwives, and cultural interpreter doulas. Method Qualitative interviews were conducted from March 2019 to December 2020, with ten women who participated in a lifestyle intervention in Sweden: four pregnant women, three midwives, and three cultural interpreter doulas. Thematic analysis was used to analyse the data. Results The lifestyle intervention ”Dancing for birth” provided positive shared Health-promoting experiences among the participants with social inclusivness and a commitment to supporting each other. This seemed to encourage the sense of strength as a woman- a strengthboth for the individual woman and as a kind of women´s power. Conclusions Interventions targeting physical activity, social inclusiveness, and health literacy are of utmost importance in promoting positive pregnancy experiences and equal healthcare during pregnancy. Further research is needed on how to implement antenatal education that includes all women in society.
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Affiliation(s)
- Nina Malmström
- Department of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Marie Lydell
- Department of Health and Welfare, Halmstad University, Halmstad, Sweden
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Owen MD, Ismail HM, Goodman D, Batakji M, Kim SM, Olufolabi A, Srofenyoh EK. Use of WhatsApp messaging technology to strengthen obstetric referrals in the Greater Accra Region, Ghana: Findings from a feasibility study. PLoS One 2022; 17:e0266932. [PMID: 35482758 PMCID: PMC9049345 DOI: 10.1371/journal.pone.0266932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 03/30/2022] [Indexed: 11/18/2022] Open
Abstract
In Ghana, the high-risk obstetric referral system is inadequate. Delay is common and patients often arrive to receiving hospitals in compromised states. An effective referral system should include an adequately resourced referral hospital, communication across sectors, accountability, transport, monitoring capability and policy support, which are currently lacking. A pilot program was undertaken to facilitate communication between hospital staffs. Additionally, data was collected to better understand and characterize obstetric referrals in Accra. Thirteen institutions were selected based on referral volume to implement the use of pre-referral treatment guidelines and WhatsApp as a mobile technology communication platform (Platform). Participants included healthcare workers from 8 health centers, 4 district hospitals, the Greater Accra Regional Hospital (GARH), administrators, doctors from other tertiary hospitals in Accra and medical consultants abroad. Facilities were provided smartphones and guidelines on using WhatsApp for advice on patient care or referral. Data were collected on WhatsApp communications among participants (March-August 2017). During this period, 618 cases were posted on the Platform and users increased from 69 to 81. The median response time was 17 min, a receiving hospital was identified 511 (82.7%) times and pre-referral treatment was initiated in 341 (55.2%). Subsequently, data collected on 597 referrals to GARH (September-November 2017) included 319 (53.4%) from Platform and 278 (46.6%) from non-Platform hospitals. Of these, 515 (86.3%) were urgent referrals; the median (interquartile range) referral to arrival time was 293 (111–1887) minutes without variation by facility grouping. Taxis were utilized for transportation in 80.2%; however, referral time shortened when patients arrived by ambulance and with a midwife. Only 23.5% of urgent referrals arrived within two hours. This project demonstrates that WhatsApp can be used as a communication tool for high-risk obstetric referrals and highlights the need to continue to improve urban referral processes due to identified delays which may contribute to poor outcomes.
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Affiliation(s)
- Medge D. Owen
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Hebah M. Ismail
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
- * E-mail:
| | - David Goodman
- Winnie Palmer Hospital for Women and Babies, Orlando, FL, United States of America
| | - Mariam Batakji
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Sung Min Kim
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Adeyemi Olufolabi
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States of America
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Yurtsal B, Hasdemir O. "Effects of the whatsapp midwife breastfeeding support line on early postpartum breastfeeding process of mothers". Health Care Women Int 2022; 43:1433-1448. [DOI: 10.1080/07399332.2021.1972303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Burcu Yurtsal
- Faculty of Health Science Midwifery Department, Cumhuriyet University, Sivas, Turkey
- Presidency of Public Health, Provincial Health Directorate, Sivas, Turkey
| | - Oznur Hasdemir
- Faculty of Health Science Midwifery Department, Cumhuriyet University, Sivas, Turkey
- Presidency of Public Health, Provincial Health Directorate, Sivas, Turkey
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Sowon K, Maliwichi P, Chigona W. The Influence of Design and Implementation Characteristics on the Use of Maternal Mobile Health Interventions in Kenya: Systematic Literature Review. JMIR Mhealth Uhealth 2022; 10:e22093. [PMID: 35084356 PMCID: PMC8832263 DOI: 10.2196/22093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/16/2021] [Accepted: 11/27/2021] [Indexed: 12/03/2022] Open
Abstract
Background The growth of mobile technology in developing countries, coupled with pressing maternal health care challenges, has led to a widespread implementation of maternal mobile health (mHealth) innovations. However, reviews generating insights on how the characteristics of the interventions influence use are scarce. Objective This study aims to review maternal mHealth interventions in Kenya to explore the influence of intervention design and implementation characteristics on use by maternal health clients. We also provide a starting inventory for maternal mHealth interventions in the country. Methods Using a systematic approach, we retrieved a total of 1100 citations from both peer-reviewed and gray sources. Articles were screened on the basis of an inclusion and exclusion criterion, and the results synthesized by categorizing and characterizing the interventions presented in the articles. The first phase of the literature search was conducted between January and April 2019, and the second phase was conducted between April and June 2021. Results A total of 16 articles were retrieved, comprising 13 maternal mHealth interventions. The study highlighted various mHealth design and implementation characteristics that may influence the use of these interventions. Conclusions In addition to elaborating on insights that would be useful in the design and implementation of future interventions, this study contributes to a local inventory of maternal mHealth interventions that may be useful to researchers and implementers in mHealth. This study highlights the need for explanatory studies to elucidate maternal mHealth use, while complementing existing evidence on mHealth effectiveness.
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Affiliation(s)
- Karen Sowon
- University of Cape Town, Department of Information Systems, Cape Town, South Africa
| | - Priscilla Maliwichi
- University of Cape Town, Department of Information Systems, Cape Town, South Africa
- Department of Computer Science and Information Technology, Malawi University of Science and Technology, Limbe, Malawi
| | - Wallace Chigona
- University of Cape Town, Department of Information Systems, Cape Town, South Africa
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10
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Development and psychometric testing of a new measure of the determinants that influence the adoption of WhatsApp in hospitals. PLoS One 2021; 16:e0262003. [PMID: 34969058 PMCID: PMC8717971 DOI: 10.1371/journal.pone.0262003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 12/16/2021] [Indexed: 11/19/2022] Open
Abstract
Background Healthcare contexts are witnessing a growing use of applications to support clinical processes and to communicate between peers and with patients. An increasing number of hospital professionals use instant-messaging applications such as WhatsApp in their daily work. Previous research has mainly focused on the advantages and risks of WhatsApp usage in different clinical settings, but limited evidence is available about whether and how individual and organizational determinants can influence the use of WhatsApp in hospitals. Moreover, instruments to explore this phenomenon are lacking. A theoretical four-factor model based on the ‘Technology Acceptance Model’ and the Institutional Theory, guided the development of a new measure of the individual and institutional determinants of WhatsApp usage in hospitals. Aim To develop and psychometrically test the questionnaire ‘Digital Innovation Adoption in Hospitals’. Method A panel of researchers and clinical experts generated an initial pool of 35 items by identifying and adapting items from existing measures. These items were assessed for content and face validity by fourteen experts. The final 28-item ‘Digital Innovation Adoption in Hospitals’ questionnaire comprising four sections (Perceived risks, Perceived usefulness, Regulative factors and Normative factors) was administered online to nurses and physicians. Construct validity was tested through confirmatory factor analysis. Results The sample included 326 hospital nurses and physicians. The theoretical four-factors model was confirmed and the confirmatory factor analysis yielded acceptable fit indexes. The correlations between the factors were significant and ranged from -0.284 to 0.543 (p < .01). Reliability in terms of internal consistency was satisfactory with Cronbach’s alpha coefficient ranging from 0.918–0.973. Conclusion This study is the first to provide a validated tool to evaluate the use of WhatsApp in hospitals. The new instrument shows reasonable psychometric properties and is a promising and widely applicable measure of factors that influence the use of WhatsApp in hospitals.
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Trude ACB, Martins RC, Martins-Silva T, Blumenberg C, Carpena MX, Del-Ponte B, Loret de Mola C. A WhatsApp-Based Intervention to Improve Maternal Social Support and Maternal-Child Health in Southern Brazil: The Text-Message Intervention to Enhance Social Support (TIES) Feasibility Study. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2021; 58:469580211048701. [PMID: 34619999 PMCID: PMC8504647 DOI: 10.1177/00469580211048701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Participatory learning and action cycles with women’s groups have been recommended by the WHO to promote maternal and newborn health, but few studies have tested its feasibility and acceptability in mobile health (mHealth) interventions among mothers of toddlers. This was a mixed-method feasibility assessment of an 8-week WhatsApp-based maternal support group for mothers of toddlers (12–18 months of age) enrolled in a birth cohort study in Southern Brazil. Daily messages and weekly activities were sent by moderators to promote maternal–child outcomes: child nutrition, child sleep, nurturing care, and maternal psychosocial well-being (assessed pre- and post-intervention via self-reported questionnaire). The implementation and engagement of the mothers in the program were assessed by message extraction. Acceptability was evaluated through in-depth interviews (n = 5) and open-ended surveys (n = 10). 1481 messages were exchanged in 3 WhatsApp groups (n = 30 mothers). Mothers were most active on weekdays (68.6% of messages sent on Tuesdays and 72.6% on Thursdays), afternoons (2:00–4:00pm), and evenings (9:00–11:00 pm). Engagement was higher at weeks 1–4. Mothers enjoyed and considered topics relevant. Group interaction was perceived as low, which influenced their participation. The prevalence of depression symptoms decreased from pre- to post-intervention (9% to 5%; P = .04). A moderated mobile-based support group for mothers of toddlers was feasible. mHealth services to promote maternal support are a promising strategy to improve maternal–child outcomes, but engagement and use of the service remains a challenge. Program managers should work with community members to identify ways to support engagement and participation throughout the intervention.
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Affiliation(s)
- Angela C B Trude
- Growth and Nutrition Division, Department of Pediatrics, School of Medicine, 12264University of Maryland Baltimore, Baltimore, MD, USA
| | - Rafaela Costa Martins
- Post-graduation Program in Epidemiology, 37902Federal University of Pelotas, Pelotas, Brazi.,Innovation in Health Research Group, 67820Federal University of Rio Grande (FURG), Rio Grande, Brazil.,Human Development and Violence Research Centre (DOVE), 37902Federal University of Pelotas, Pelotas, Brazil
| | - Thais Martins-Silva
- Post-graduation Program in Epidemiology, 37902Federal University of Pelotas, Pelotas, Brazi.,Innovation in Health Research Group, 67820Federal University of Rio Grande (FURG), Rio Grande, Brazil.,Human Development and Violence Research Centre (DOVE), 37902Federal University of Pelotas, Pelotas, Brazil
| | - Cauane Blumenberg
- Post-graduation Program in Epidemiology, 37902Federal University of Pelotas, Pelotas, Brazi.,Innovation in Health Research Group, 67820Federal University of Rio Grande (FURG), Rio Grande, Brazil
| | - Marina X Carpena
- Innovation in Health Research Group, 67820Federal University of Rio Grande (FURG), Rio Grande, Brazil.,Post-graduation Program in Developmental Disorder, Presbyterian University Mackenzie, Sao Paulo, Brazil
| | - Bianca Del-Ponte
- Post-graduation Program in Epidemiology, 37902Federal University of Pelotas, Pelotas, Brazi
| | - Christian Loret de Mola
- Innovation in Health Research Group, 67820Federal University of Rio Grande (FURG), Rio Grande, Brazil.,Post-graduation Program in Public Health, 67820FURG, Rio Grande, Brazil
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Suárez-Obando F, Gómez-Restrepo C, Castro-Diaz S, Paez-Rojas P, Uribe-Restrepo JM, Naslund JA, Torrey WC, Cubillos L, Bartels SM, Williams MJ, Marsch LA. Patterns of digital information and communication technology use among patients at primary health care centres in Colombia: Phase I of the DIADA project. REVISTA COLOMBIANA DE PSIQUIATRÍA (ENGLISH ED.) 2021; 50 Suppl 1:116-132. [PMID: 34257055 DOI: 10.1016/j.rcpeng.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 06/14/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Assess the prevalence and types of digital technology use, as well as the extent to which patients use the internet and mobile devises. Evaluate the socioeconomic characteristics of patients and the possible relation to patterns of technology use in Colombia. Understand the nature of patient technology use in primary care for finding medical information. METHODS A survey was applied to adult patients who attended primary health care centers systems in 6 Colombian cities. The survey inquired about demographic characteristics, insurance, access to services, cell phone use, internet access, and the use of such technology to access health-related services and information. Data was collected and managed using REDCap. Summary statistics on each survey item were calculated and the differences between discrete variables were analyzed using chi-square. Multivariate analyses were performed using logistic regression analysis for binary dependent variables. RESULTS A total of 1580 patients were surveyed across the six study sites. 93% of the patients reported they have a cell phone. Patients from urban healthcare centers showed a higher use of the Internet on their phone than less urban settings. Around half of the surveyed patients reported Internet use (49.7%). Among Internet users, 65% of participants use the Internet looking for health care information. Around one-third of patients use cellphones to arrange clinic visits. Around 24% of participants answered positively for both Whooley's questions. Of those who screened positive on the Whooley questions, 43% reported being moderately anxious, 47% reported being very anxious. 51% reported having moderate pain; 52% reported having severe pain. CONCLUSIONS The patterns of technology use identified in this study are essential for developing future health interventions based on ICT. The design of ICT clinical interventions must take into account the cellphone payment plans, availability of internet connection, advantages, and disadvantages of messenger services, including SMS as a possible alternative to people who do not have smartphones.
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Affiliation(s)
- Fernando Suárez-Obando
- Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Pontificia Universidad Javeriana, Colombia.
| | - Carlos Gómez-Restrepo
- Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Pontificia Universidad Javeriana, Colombia
| | - Sergio Castro-Diaz
- Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Pontificia Universidad Javeriana, Colombia
| | | | - José M Uribe-Restrepo
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, USA
| | - John A Naslund
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, USA
| | - William C Torrey
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, USA
| | - Leonardo Cubillos
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, USA
| | - Sophia M Bartels
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, USA
| | - Makeda J Williams
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Lisa A Marsch
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, USA
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"Whatsapping" the continuity of postpartum care in Switzerland: A socio-anthropological study. Women Birth 2021; 35:e263-e274. [PMID: 34226154 DOI: 10.1016/j.wombi.2021.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Digital media such as Apps, Internet and social networks have become integral parts of the maternity experience for more than a decade. These media can support or undermine women's experiences as has been shown in digital sociology research. Using Immediate Messaging Applications to provide information and support to women during the perinatal period is an emerging practice. AIM This article analyses how health and social care professionals - with a focus on community midwives - and women communicate between postpartum home visits through Immediate Message Applications in Switzerland. METHODS A socio-anthropological study that relied on qualitative methods including semi-directed interviews with midwives and health and social care professionals (n = 30) and immigrant women (n = 20). FINDINGS Since the introduction of Immediate Messaging Applications, women and their carer converse more regularly between post-partum home visits. Women send questions, pictures and videos to them, often allowing swift responses to their concerns. Midwives encounter difficulties answering women's questions when they cannot be solved through quick communication (e.g. infant crying). To them, texting frequency forms a clinical clue to women's mental health. Not all women contact their carer through digital messages; immigrant women are less likely to know and use this service. DISCUSSION AND CONCLUSION Immediate Messaging Applications form a promising communication tool, complementary to home visits, and contribute to woman-centered care and continuity of care. As an emergent practice, it has not been framed by a guideline yet. Policy makers and practitioners should ensure that its use does not contribute to unequal access to care.
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Digital Educational Support Groups Administered through WhatsApp Messenger Improve Health-Related Knowledge and Health Behaviors of New Adolescent Mothers in the Dominican Republic: A Multi-Method Study. INFORMATICS (MDPI) 2021; 7. [PMID: 33747831 PMCID: PMC7971517 DOI: 10.3390/informatics7040051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: In limited-resource settings such as the Dominican Republic, many factors contribute to poor health outcomes experienced by adolescent mothers, including insufficient support and/or health knowledge. In response, we designed a digital educational support group, administered through WhatsApp Messenger, for new adolescent mothers. The purpose of this study was to assess if participation in this digital support group could improve health outcomes and health behaviors. Methods: Participants completed questionnaires with a health literacy screener, demographic items, knowledge questions, the Index of Autonomous Functioning, and five Patient Reported Outcomes Measurement Information System scales before and after the moderator-led intervention. Differences between pre- and post-intervention scores were calculated and perceptions of the intervention were explored through in-depth interviews analyzed with content analysis. Participants’ well-baby visit attendance and contraceptive use were compared to that of controls and a national sample. Results: Participants’ (N = 58) knowledge scores increased (p < 0.05). Participants were 6.58 times more likely to attend well-baby visits than controls (95% CI: 2.23–19.4) and their contraceptive use was higher than that of the national sample (p < 0.05). Participants indicated the intervention was enjoyable and beneficial. Conclusion: This adolescent-centered digital intervention is a promising method to improve health outcomes and health behaviors of young mothers in limited-resource settings.
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Stonbraker S, Haight E, Soriano L, Guijosa L, Davison E, Bushley D, Messina L, Halpern M. Establishing content for a digital educational support group for new adolescent mothers in the Dominican Republic: a user-centered design approach. Int J Adolesc Med Health 2020; 34:219-232. [PMID: 32857722 DOI: 10.1515/ijamh-2020-0054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/24/2020] [Indexed: 11/15/2022]
Abstract
Background As digital interventions to improve health become widespread globally, it is critical to include target end-users in their design. This can help ensure interventions are maximally beneficial among intended populations. Objectives To generate the content of a digital educational support group, administered through WhatsApp, for new adolescent mothers and establish participants' cellular access and WhatsApp use. Participants Adolescent mothers with new babies. Methods We completed a two-phase user-centered design process. In phase I design sessions, participants discussed their postpartum experiences and completed an activity to elucidate their health and wellbeing information needs. In phase II sessions, participants individually identified which health information topics were important to them, then all topics were prioritized as a group. Phase II participants also completed a brief survey on cell phone access and WhatsApp use. Results Phase I included 24 participants, 21 of whom completed phase II. Priority health and wellbeing information topics in the postpartum period were identified as: child growth and development, understanding your baby, common childhood illnesses, breastfeeding, childhood nutrition, family planning, and self-care. Of phase II participants, 45% had cellular phone access and none had a data plan. Cellular service was inconsistently obtained with data packages or Wi-Fi. 30% of participants had no experience using WhatsApp. Conclusions Participants identified numerous health information needs, which will serve as the content for our planned digital support group and provides valuable insight for health care providers globally. Less than half of participants had consistent cellular phone access, and none had reliable access to cellular service.
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Affiliation(s)
- Samantha Stonbraker
- Columbia University School of Nursing, New York, NY, USA
- Clínica de Familia La Romana, La Romana, Dominican Republic
| | - Elizabeth Haight
- Planned Parenthood of the Great Northwest and the Hawaiian Islands, Seattle, WA, USA
| | - Leidy Soriano
- Clínica de Familia La Romana, La Romana, Dominican Republic
| | - Linda Guijosa
- Planned Parenthood of the Great Northwest and the Hawaiian Islands, Seattle, WA, USA
| | - Eliza Davison
- Planned Parenthood of the Great Northwest and the Hawaiian Islands, Seattle, WA, USA
| | - Diane Bushley
- Planned Parenthood of the Great Northwest and the Hawaiian Islands, Seattle, WA, USA
| | - Luz Messina
- Clínica de Familia La Romana, La Romana, Dominican Republic
| | - Mina Halpern
- Clínica de Familia La Romana, La Romana, Dominican Republic
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Singh JK, Acharya D, Paudel R, Gautam S, Adhikari M, Kushwaha SP, Park JH, Yoo SJ, Lee K. Effects of Female Community Health Volunteer Capacity Building and Text Messaging Intervention on Gestational Weight Gain and Hemoglobin Change Among Pregnant Women in Southern Nepal: A Cluster Randomized Controlled Trial. Front Public Health 2020; 8:312. [PMID: 32766199 PMCID: PMC7379845 DOI: 10.3389/fpubh.2020.00312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/09/2020] [Indexed: 11/29/2022] Open
Abstract
Introduction: Public health interventions such as text messaging are commonly evaluated in high-income countries and that the evaluation reports of the effectiveness of community health volunteers in low-income countries like Nepal is scarce. This study aimed to determine whether female community health volunteer (FCHV) capacity building and text messaging to expectant mother increases gestational weights and hemoglobin levels of pregnant women living in southern Nepal. Methods: A cluster randomized control trial was carried out in 52 clusters of 6 Village Development Committees in southern Nepal between July 2015 and March 2016. A total of 413 pregnant mothers of gestation age between 13 and 28 weeks (214 in the intervention group and 199 in the control group) were included in the analysis. Intervention consisted of FCHV capacity building followed by regular supervision and monitoring and mobile phone text messaging to expectant mothers. Regression analysis, controlled for confounders, was conducted to assess gestational weight gains and changes in hemoglobin levels. Results: At the end of the pregnancy, the mean weight gain difference between the intervention and control groups was 1.1 kg (95% CI: 1.0, 1.9). Rates of weight increases in the intervention and control groups were 0.504 kg/week (95% CI: 0.371, 0.528), and 0.399 kg/week (95% CI: 0.362, 0.465), respectively. Similarly, the mean inter group difference in hemoglobin levels was 0.11 gm/dl (95% CI: 0.09, 0.15), and rates of hemoglobin increases (gm/dl/week) in the intervention and control groups were 0.02 gm/dl (95% CI: 0.01, 0.09) and 0.004 gm/dl (95% CI: 0.02, 0.12), respectively. Conclusions: The study shows that FCHV capacity building and mobile text messaging have a positive effect on the gestational weights and hemoglobin levels of expectant mothers. Our findings suggest that mobile text messaging coupled with FCHV capacity building services should be supported and would usefully expand in resource poor settings. Trial registration: ISRCTN60684155.
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Affiliation(s)
- Jitendra Kumar Singh
- Department of Community Medicine, Janaki Medical College, Tribhuvan University, Janakpur, Nepal
| | - Dilaram Acharya
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju-si, South Korea.,Department of Community Medicine, Devdaha Medical College and Research Institute, Kathmandu University, Dhulikhel, Nepal
| | - Rajan Paudel
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Salila Gautam
- Department of Public Health, Sanjeevani College of Medical Sciences, Biratnagar, Nepal
| | | | | | - Ji-Hyuk Park
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju-si, South Korea
| | - Seok-Ju Yoo
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju-si, South Korea
| | - Kwan Lee
- Department of Preventive Medicine, College of Medicine, Dongguk University, Gyeongju-si, South Korea
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Odendaal WA, Anstey Watkins J, Leon N, Goudge J, Griffiths F, Tomlinson M, Daniels K. Health workers' perceptions and experiences of using mHealth technologies to deliver primary healthcare services: a qualitative evidence synthesis. Cochrane Database Syst Rev 2020; 3:CD011942. [PMID: 32216074 PMCID: PMC7098082 DOI: 10.1002/14651858.cd011942.pub2] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Mobile health (mHealth), refers to healthcare practices supported by mobile devices, such as mobile phones and tablets. Within primary care, health workers often use mobile devices to register clients, track their health, and make decisions about care, as well as to communicate with clients and other health workers. An understanding of how health workers relate to, and experience mHealth, can help in its implementation. OBJECTIVES To synthesise qualitative research evidence on health workers' perceptions and experiences of using mHealth technologies to deliver primary healthcare services, and to develop hypotheses about why some technologies are more effective than others. SEARCH METHODS We searched MEDLINE, Embase, CINAHL, Science Citation Index and Social Sciences Citation Index in January 2018. We searched Global Health in December 2015. We screened the reference lists of included studies and key references and searched seven sources for grey literature (16 February to 5 March 2018). We re-ran the search strategies in February 2020. We screened these records and any studies that we identified as potentially relevant are awaiting classification. SELECTION CRITERIA We included studies that used qualitative data collection and analysis methods. We included studies of mHealth programmes that were part of primary healthcare services. These services could be implemented in public or private primary healthcare facilities, community and workplace, or the homes of clients. We included all categories of health workers, as well as those persons who supported the delivery and management of the mHealth programmes. We excluded participants identified as technical staff who developed and maintained the mHealth technology, without otherwise being involved in the programme delivery. We included studies conducted in any country. DATA COLLECTION AND ANALYSIS We assessed abstracts, titles and full-text papers according to the inclusion criteria. We found 53 studies that met the inclusion criteria and sampled 43 of these for our analysis. For the 43 sampled studies, we extracted information, such as country, health worker category, and the mHealth technology. We used a thematic analysis process. We used GRADE-CERQual to assess our confidence in the findings. MAIN RESULTS Most of the 43 included sample studies were from low- or middle-income countries. In many of the studies, the mobile devices had decision support software loaded onto them, which showed the steps the health workers had to follow when they provided health care. Other uses included in-person and/or text message communication, and recording clients' health information. Almost half of the studies looked at health workers' use of mobile devices for mother, child, and newborn health. We have moderate or high confidence in the following findings. mHealth changed how health workers worked with each other: health workers appreciated being more connected to colleagues, and thought that this improved co-ordination and quality of care. However, some described problems when senior colleagues did not respond or responded in anger. Some preferred face-to-face connection with colleagues. Some believed that mHealth improved their reporting, while others compared it to "big brother watching". mHealth changed how health workers delivered care: health workers appreciated how mHealth let them take on new tasks, work flexibly, and reach clients in difficult-to-reach areas. They appreciated mHealth when it improved feedback, speed and workflow, but not when it was slow or time consuming. Some health workers found decision support software useful; others thought it threatened their clinical skills. Most health workers saw mHealth as better than paper, but some preferred paper. Some health workers saw mHealth as creating more work. mHealth led to new forms of engagement and relationships with clients and communities: health workers felt that communicating with clients by mobile phone improved care and their relationships with clients, but felt that some clients needed face-to-face contact. Health workers were aware of the importance of protecting confidential client information when using mobile devices. Some health workers did not mind being contacted by clients outside working hours, while others wanted boundaries. Health workers described how some community members trusted health workers that used mHealth while others were sceptical. Health workers pointed to problems when clients needed to own their own phones. Health workers' use and perceptions of mHealth could be influenced by factors tied to costs, the health worker, the technology, the health system and society, poor network access, and poor access to electricity: some health workers did not mind covering extra costs. Others complained that phone credit was not delivered on time. Health workers who were accustomed to using mobile phones were sometimes more positive towards mHealth. Others with less experience, were sometimes embarrassed about making mistakes in front of clients or worried about job security. Health workers wanted training, technical support, user-friendly devices, and systems that were integrated into existing electronic health systems. The main challenges health workers experienced were poor network connections, access to electricity, and the cost of recharging phones. Other problems included damaged phones. Factors outside the health system also influenced how health workers experienced mHealth, including language, gender, and poverty issues. Health workers felt that their commitment to clients helped them cope with these challenges. AUTHORS' CONCLUSIONS Our findings propose a nuanced view about mHealth programmes. The complexities of healthcare delivery and human interactions defy simplistic conclusions on how health workers will perceive and experience their use of mHealth. Perceptions reflect the interplay between the technology, contexts, and human attributes. Detailed descriptions of the programme, implementation processes and contexts, alongside effectiveness studies, will help to unravel this interplay to formulate hypotheses regarding the effectiveness of mHealth.
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Affiliation(s)
- Willem A Odendaal
- South African Medical Research CouncilHealth Systems Research UnitCape TownWestern CapeSouth Africa
- Stellenbosch UniversityDepartment of PsychiatryCape TownSouth Africa
| | | | - Natalie Leon
- South African Medical Research CouncilHealth Systems Research UnitCape TownWestern CapeSouth Africa
- Brown UniversitySchool of Public HealthProvidenceRhode IslandUSA
| | - Jane Goudge
- University of the WitwatersrandCentre for Health Policy, School of Public Health, Faculty of Health SciencesJohannesburgSouth Africa
| | - Frances Griffiths
- University of WarwickWarwick Medical SchoolCoventryUK
- University of the WitwatersrandCentre for Health Policy, School of Public Health, Faculty of Health SciencesJohannesburgSouth Africa
| | - Mark Tomlinson
- Stellenbosch UniversityInstitute for Life Course Health Research, Department of Global HealthCape TownSouth Africa
- Queens UniversitySchool of Nursing and MidwiferyBelfastUK
| | - Karen Daniels
- South African Medical Research CouncilHealth Systems Research UnitCape TownWestern CapeSouth Africa
- University of Cape TownHealth Policy and Systems Division, School of Public Health and Family MedicineCape TownWestern CapeSouth Africa7925
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Affiliation(s)
- Laura Martinengo
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Pier Spinazze
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Global Digital Health Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, UK
| | - Josip Car
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Global Digital Health Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, UK
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Kaur J, Suri V. WhatsApp in obstetrics and gynaecology: necessary evil or blessing in disguise? J OBSTET GYNAECOL 2020; 41:164-165. [PMID: 32068470 DOI: 10.1080/01443615.2019.1710481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Japleen Kaur
- Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Vanita Suri
- Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Lee S, Begley CE, Morgan R, Chan W, Kim SY. Addition of mHealth (mobile health) for family planning support in Kenya: disparities in access to mobile phones and associations with contraceptive knowledge and use. Int Health 2020; 11:463-471. [PMID: 30576546 DOI: 10.1093/inthealth/ihy092] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 08/27/2018] [Accepted: 11/06/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Recently mobile health (mHealth) has been implemented in Kenya to support family planning. Our objectives were to investigate disparities in mobile phone ownership and to examine the associations between exposure to family planning messages through mHealth (stand-alone or combined with other channels such as public forums, informational materials, health workers, social media and political/religious/community leaders' advocacy) and contraceptive knowledge and use. METHODS Logistic and Poisson regression models were used to analyze the 2014 Kenya Demographic and Health Survey. RESULTS Among 31 059 women, 86.7% had mobile phones and were more likely to have received higher education, have children ≤5 y of age and tended to be wealthier or married. Among 7397 women who were sexually active, owned a mobile phone and received family planning messages through at least one channel, 89.8% had no exposure to mHealth. mHealth alone was limited in improving contraceptive knowledge and use but led to intended outcomes when used together with four other channels compared with other channels only (knowledge: incidence rate ratio 1.084 [95% confidence interval {CI} 1.063-1.106]; use: odds ratio 1.429 [95% CI 1.026-1.989]). CONCLUSIONS Socio-economic disparities existed in mobile phone ownership, and mHealth alone did not improve contraceptive knowledge and use among Kenyan women. However, mHealth still has potential for family planning when used with existing channels.
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Affiliation(s)
- Seohyun Lee
- Department of Management, Policy and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Charles E Begley
- Department of Management, Policy and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Robert Morgan
- Department of Management, Policy and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Wenyaw Chan
- Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Sun-Young Kim
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
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Griauzde DH, Kieffer EC, Domoff SE, Hess K, Feinstein S, Frank A, Pike D, Pesch MH. The influence of social media on child feeding practices and beliefs among Hispanic mothers: A mixed methods study. Eat Behav 2020; 36:101361. [PMID: 31923649 PMCID: PMC8005295 DOI: 10.1016/j.eatbeh.2019.101361] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 11/22/2019] [Accepted: 12/23/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES (1) To identify factors that influence child feeding practices and beliefs among Hispanic mothers in a low-income community; (2) to describe the use of social media, other internet websites, and text messaging among Hispanic mothers; and (3) to explore mothers' perceptions of social media and/or text messaging interventions to prevent childhood obesity. METHODS Mixed methods descriptive study with a sequential explanatory design. Hispanic mothers (N = 66) from Detroit, Michigan with children between 6 and 36 months of age completed surveys regarding their child feeding practices, the source (s) influencing these practices, and their use of social media, internet, and text messaging. During qualitative interviews (N = 19), we explored mothers' use of social media and internet websites to find child health information as well as mothers' perspectives on social media/internet/text messaging interventions to promote child health. RESULTS Most survey respondents were between the ages of 20 and 39 years. One-third of mothers breastfed their child for >6 months; 68% did not introduce solids until their child was older than 6 months. The majority (96%) owned a cellphone; 75% used social media at least once daily. Few mothers indicated that social media and other internet websites influenced their child feeding decisions. During qualitative interviews (N = 19), almost all mothers expressed interest in social media and/or text messaging as a tool to communicate information regarding child health and feeding. CONCLUSIONS Hispanic mothers had high rates of social media use and most desired social media/internet/text messaging interventions to promote child health.
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Affiliation(s)
- Dina H Griauzde
- Ann Arbor VA Health System, Ann Arbor, MI, USA; Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
| | - Edith C Kieffer
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Sarah E Domoff
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
| | - Kristen Hess
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | | | - Amy Frank
- Community Health and Social Services (CHASS) Center, Detroit, MI, USA
| | - Denise Pike
- Community Health and Social Services (CHASS) Center, Detroit, MI, USA
| | - Megan H Pesch
- Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
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Reiss K, Andersen K, Pearson E, Biswas K, Taleb F, Ngo TD, Hossain A, Barnard S, Smith C, Carpenter J, Menzel J, Footman K, Keenan K, Douthwaite M, Reena Y, Mahmood HR, Tabbassum T, Colombini M, Bacchus L, Church K. Unintended Consequences of mHealth Interactive Voice Messages Promoting Contraceptive Use After Menstrual Regulation in Bangladesh: Intimate Partner Violence Results From a Randomized Controlled Trial. GLOBAL HEALTH: SCIENCE AND PRACTICE 2019; 7:386-403. [PMID: 31558596 PMCID: PMC6816818 DOI: 10.9745/ghsp-d-19-00015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 05/21/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mobile phones for health (mHealth) hold promise for delivering behavioral interventions. We evaluated the effect of automated interactive voice messages promoting contraceptive use with a focus on long-acting reversible contraceptives (LARCs) among women in Bangladesh who had undergone menstrual regulation (MR), a procedure to "regulate the menstrual cycle when menstruation is absent for a short duration." METHODS We recruited MR clients from 41 public- and private-sector clinics immediately after MR. Eligibility criteria included having a personal mobile phone and consenting to receive messages about family planning by phone. We randomized participants remotely to an intervention group that received at least 11 voice messages about contraception over 4 months or to a control group (no messages). The primary outcome was LARC use at 4 months. Adverse events measured included experience of intimate partner violence (IPV). Researchers recruiting participants and 1 analyst were blinded to allocation groups. All analyses were intention to treat. The trial is registered with ClinicalTrials.gov (NCT02579785). RESULTS Between December 2015 and March 2016, 485 women were allocated to the intervention group and 484 to the control group. We completed follow-up on 389 intervention and 383 control participants. Forty-eight (12%) participants in the intervention group and 59 (15%) in the control group reported using a LARC method at 4 months (adjusted odds ratio [aOR] using multiple imputation=0.95; 95% confidence interval [CI]=0.49 to 1.83; P=.22). Reported physical IPV was higher in the intervention group: 42 (11%) intervention versus 25 (7%) control (aOR=1.97; 95% CI=1.12 to 3.46; P=.03) when measured using a closed question naming acts of violence. No violence was reported in response to an open question about effects of being in the study. CONCLUSIONS The intervention did not increase LARC use but had an unintended consequence of increasing self-reported IPV. Researchers and health program designers should consider possible negative impacts when designing and evaluating mHealth and other reproductive health interventions. IPV must be measured using closed questions naming acts of violence.
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Affiliation(s)
- Kate Reiss
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK.
| | | | | | | | | | | | - Altaf Hossain
- Association for Prevention of Septic Abortion, Bangladesh, Dhaka, Bangladesh
| | - Sharmani Barnard
- School of Population Health and Environmental Sciences, King's College, London, UK
| | - Chris Smith
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - James Carpenter
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Katherine Keenan
- School of Geography and Sustainable Development, University of St. Andrews, St. Andrews, UK
| | | | | | | | | | - Manuela Colombini
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Loraine Bacchus
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
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