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Impact of a mHealth Intervention for Peer Health Workers on AIDS Care in Rural Uganda: A Mixed Methods Evaluation of a Cluster-Randomized Trial

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Abstract

Mobile phone access in low and middle-income countries is rapidly expanding and offers an opportunity to leverage limited human resources for health. We conducted a mixed methods evaluation of a cluster-randomized trial exploratory substudy on the impact of a mHealth (mobile phone) support intervention used by community-based peer health workers (PHW) on AIDS care in rural Uganda. 29 PHWs at 10 clinics were randomized by clinic to receive the intervention or not. PHWs used phones to call and text higher level providers with patient-specific clinical information. 970 patients cared for by the PHWs were followed over a 26 month period. No significant differences were found in patients’ risk of virologic failure. Qualitative analyses found improvements in patient care and logistics and broad support for the mHealth intervention among patients, clinic staff, and PHWs. Key challenges identified included variable patient phone access, privacy concerns, and phone maintenance.

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Acknowledgments

We thank the patients and staff of the Rakai Health Sciences Program for their dedication, support, and compassion. We thank Jeremiah Mulamba and the Rakai Qualitative Research Team led by Neema Nakyanjo for their contributions to successful study implementation. This study was funded by the Doris Duke Charitable Foundation, The Division of Intramural Research, The National Institute for Allergy and Infectious Diseases, National Institutes of Health, and National Institutes of Health Training (2T32-AI07291) and Career Development (1K23MH086338-01A2) Grants.

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Correspondence to Larry W. Chang.

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Chang, L.W., Kagaayi, J., Arem, H. et al. Impact of a mHealth Intervention for Peer Health Workers on AIDS Care in Rural Uganda: A Mixed Methods Evaluation of a Cluster-Randomized Trial. AIDS Behav 15, 1776–1784 (2011). https://doi.org/10.1007/s10461-011-9995-x

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