背景:尽管数字粘附技术(DAT)的使用越来越多,如结核病药物依从性的实时监控和短信提醒,据报道,患者对各种DAT的参与欠佳。此外,财务限制可能会限制DAT的效用。与结核病药物管理的移动货币财务激励措施相关的DAT的感知有用性和设计机制仍不清楚。
目的:本研究的目的是描述一种名为MyMobileWallet的DAT干预措施的感知有用性和设计机制,它由实时依从性监测器组成,短信提醒,和移动资金激励措施,以支持低收入环境中的结核病药物依从性。
方法:本研究在Mbarara地区转诊医院结核病诊所招募的结核病患者中使用了混合方法。我们有目的地抽取了21名18岁及以上的肺结核患者,拥有手机并能够使用SMS短信干预措施的人。我们还招募了9名在我们之前的研究中使用DAT的参与者。我们与30名参与者进行了焦点小组讨论,以征求对MyMobileWallet干预的初始版本的看法,然后按照以用户为中心的设计方法迭代地改进干预的后续版本,直到开发出适合他们需求的干预的测试版。还进行了调查,以获取有关参与者手机使用情况和对干预措施的看法的信息。内容分析用于归纳分析定性数据,以得出描述干预措施感知有用性的类别,关注,和设计机制。Stata(版本13;StataCorp)用于分析调查数据。
结果:参与者表达了“我的手机钱包”干预措施在被提醒服药方面的有效性,支持运送到诊所,以及支付其他结核病药物相关费用的资金,所有这些都被认为意味着关心,这可以创造一种与医护人员的联系感。因此,这可能会导致参与者产生自我感知的需求,以证明他们对照顾他们的医护人员的坚持承诺,从而激发药物依从性。由于担心意外的结核病状况披露,20名(67%)参与者建议使用保密的短信语言-不容易与结核病相关。为了减少将资金用于其他竞争性需求的可能性,25(83%)的参与者更喜欢在预约前1-2天发送钱,以限制收到钱和访问诊所之间的时间间隔。
结论:与移动货币金融激励措施相结合的DAT可能会提供可接受的提醒方法,支持,并激励患者坚持服用结核病药物。
背景:ClinicalTrials.govNCT05656287;https://clinicaltrials.gov/ct2/show/NCT05656287。
BACKGROUND: Although there is an increasing use of digital adherence technologies (DATs), such as real-time monitors and SMS reminders in tuberculosis medication adherence, suboptimal patient engagement with various DATs has been reported. Additionally, financial constraints can limit DAT\'s utility. The perceived usefulness and the design mechanisms of DATs linked to mobile money financial incentives for tuberculosis medication management remain unclear.
OBJECTIVE: The aim of this study is to describe the perceived usefulness and design mechanisms for a DAT intervention called My Mobile Wallet, which is composed of real-time adherence monitors, SMS reminders, and mobile money incentives to support tuberculosis medication adherence in a low-income setting.
METHODS: This study used mixed methods approaches among persons with tuberculosis recruited from the Tuberculosis Clinic in the Mbarara Regional Referral Hospital. We purposively sampled 21 persons with tuberculosis aged 18 years and older, who owned cell phones and were able to use SMS text messaging interventions. We also enrolled 9 participants who used DATs in our previous study. We used focus group discussions with the 30 participants to solicit perceptions about the initial version of the My Mobile Wallet intervention, and then iteratively refined subsequent versions of the intervention following a user-centered design approach until the beta version of the intervention that suited their needs was developed. Surveys eliciting information about participants\' cell phone use and perceptions of the intervention were also administered. Content analysis was used to inductively analyze qualitative data to derive categories describing the perceived usefulness of the intervention, concerns, and design mechanisms. Stata (version 13; StataCorp) was used to analyze survey data.
RESULTS: Participants expressed the perceived usefulness of the My Mobile Wallet intervention in terms of being reminded to take medication, supported with transport to the clinic, and money to meet other tuberculosis medication-related costs, all of which were perceived to imply care, which could create a sense of connectedness to health care workers. This could consequently cause participants to develop a self-perceived need to prove their commitment to adherence to health care workers who care for them, thereby motivating medication adherence. For fear of unintended tuberculosis status disclosure, 20 (67%) participants suggested using SMS language that is confidential-not easily related to tuberculosis. To reduce the possibilities of using the money for other competing demands, 25 (83%) participants preferred sending the money 1-2 days before the appointment to limit the time lag between receiving the money and visiting the clinic.
CONCLUSIONS: DATs complemented with mobile money financial incentives could potentially provide acceptable approaches to remind, support, and motivate patients to adhere to taking their tuberculosis medication.
BACKGROUND: ClinicalTrials.gov NCT05656287; https://clinicaltrials.gov/ct2/show/NCT05656287.