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TitleAssessing the feasibility of eHealth and mHealth: a systematic review and analysis of initiatives implemented in Kenya.
AuthorsNjoroge, M; Zurovac, D; Ogara, EA; Chuma, J; Kirigia, D
JournalBMC research notes
Publication Date10 Feb 2017
Date Added to PubMed12 Feb 2017
AbstractThe growth of Information and Communication Technology in Kenya has facilitated implementation of a large number of eHealth projects in a bid to cost-effectively address health and health system challenges. This systematic review aims to provide a situational analysis of eHealth initiatives being implemented in Kenya, including an assessment of the areas of focus and geographic distribution of the health projects. The search strategy involved peer and non-peer reviewed sources of relevant information relating to projects under implementation in Kenya. The projects were examined based on strategic area of implementation, health purpose and focus, geographic location, evaluation status and thematic area. A total of 114 citations comprising 69 eHealth projects fulfilled the inclusion criteria. The eHealth projects included 47 mHealth projects, 9 health information system projects, 8 eLearning projects and 5 telemedicine projects. In terms of projects geographical distribution, 24 were executed in Nairobi whilst 15 were designed to have a national coverage but only 3 were scaled up. In terms of health focus, 19 projects were mainly on primary care, 17 on HIV/AIDS and 11 on maternal and child health (MNCH). Only 8 projects were rigorously evaluated under randomized control trials. This review discovered that there is a myriad of eHealth projects being implemented in Kenya, mainly in the mHealth strategic area and focusing mostly on primary care and HIV/AIDs. Based on our analysis, most of the projects were rarely evaluated. In addition, few projects are implemented in marginalised areas and least urbanized counties with more health care needs, notwithstanding the fact that adoption of information and communication technology should aim to improve health equity (i.e. improve access to health care particularly in remote parts of the country in order to reduce geographical inequities) and contribute to overall health systems strengthening.
Linkhttp://doi.org/10.1186/s13104-017-2416-0
TitleA Review of Usability Evaluation Methods and Their Use for Testing eHealth HIV Interventions.
AuthorsDavis, R; Gardner, J; Schnall, R
JournalCurrent HIV/AIDS reports
Publication Date1 Jun 2020
Date Added to PubMed12 May 2020
AbstractTo provide a comprehensive review of usability testing of eHealth interventions for HIV. We identified 28 articles that assessed the usability of eHealth interventions for HIV, most of which were published within the past 3 years. The majority of the eHealth interventions for HIV was developed on a mobile platform and focused on HIV prevention as the intended health outcome. Usability evaluation methods included eye-tracking, questionnaires, semi-structured interviews, contextual interviews, think-aloud protocols, cognitive walkthroughs, heuristic evaluations and expert reviews, focus groups, and scenarios. A wide variety of methods is available to evaluate the usability of eHealth interventions. Employing multiple methods may provide a more comprehensive assessment of the usability of eHealth interventions as compared with inclusion of only a single evaluation method.
Linkhttp://doi.org/10.1007/s11904-020-00493-3
TitlePeer Group Focused eHealth Strategies to Promote HIV Prevention, Testing, and Care Engagement.
AuthorsRonen, K; Grant, E; Copley, C; Batista, T; Guthrie, BL
JournalCurrent HIV/AIDS reports
Publication Date1 Oct 2020
Date Added to PubMed15 Aug 2020
AbstractElectronic communication platforms are increasingly used to support all steps of the HIV care cascade (an approach defined as eHealth). Most studies have employed individual-level approaches in which participants are connected with information, reminders, or a healthcare worker. Recent growth in use of social media platforms, which create digital communities, has created an opportunity to leverage virtual peer-to-peer connection to improve HIV prevention and care. In this article, we describe the current landscape of peer group eHealth interventions in the HIV field, based on a review of published literature, an online survey of unpublished ongoing work, and discussions with practitioners in the field in an in-person workshop. We identified 45 published articles and 12 ongoing projects meeting our inclusion criteria. Most reports were formative or observational; only three randomized evaluations of two interventions were reported. Studies indicated that use of peer group eHealth interventions is acceptable and has unique potential to influence health behaviors, but participants reported privacy concerns. Evaluations of health outcomes of peer group eHealth interventions show promising data, but more rigorous evaluations are needed. Development of group eHealth interventions presents unique technological, practical, and ethical challenges. Intervention design must consider privacy and data sovereignty concerns, and respond to rapid changes in platform use. Innovative development of open-source tools with high privacy standards is needed.
Linkhttp://doi.org/10.1007/s11904-020-00527-w
TitleThe Impact of COVID-19 on HIV Care Provided via Telemedicine-Past, Present, and Future.
AuthorsBudak, JZ; Scott, JD; Dhanireddy, S; Wood, BR
JournalCurrent HIV/AIDS reports
Publication Date1 Apr 2021
Date Added to PubMed23 Feb 2021
AbstractThis review summarizes HIV care delivered via telemedicine before and during the COVID-19 pandemic and highlights areas of study to inform optimal usage of telemedicine in HIV clinical practice in the future. To address barriers to care created by the COVID-19 pandemic, regulatory agencies and payors waived longstanding restrictions, which enabled rapid expansion of telemedicine across the country. Preliminary data show that providers and persons with HIV (PWH) view telemedicine favorably. Some data suggest telemedicine has facilitated retention in care, but other studies have found increasing numbers of PWH lost to follow-up and worsened virologic suppression rates despite offering video and/or telephone visits. The COVID-19 pandemic has exacerbated gaps in the HIV care continuum. To help mitigate the impact, most clinics have adopted new virtual care options and are now evaluating usage, impact, and concerns. Further research into the effects of telemedicine on HIV care and continued work towards universal access are needed.
Linkhttp://doi.org/10.1007/s11904-021-00543-4
TitleA Missing Link: HIV-/AIDS-Related mHealth Interventions for Health Workers in Low- and Middle-Income Countries.
AuthorsGimbel, S; Kawakyu, N; Dau, H; Unger, JA
JournalCurrent HIV/AIDS reports
Publication Date1 Dec 2018
Date Added to PubMed28 Sep 2018
AbstractThrough a review of the peer-reviewed and gray literature on HIV mobile health (mHealth) tools for health workers and in-depth interviews with mHealth leaders in the field, we provide a synthesis of current work and propose mHealth research priorities for HIV prevention, care, and treatment. Significant investment in implementation research and bringing together researchers capable of identifying drivers of successful implementation and industry leaders capable of bringing efficacious tools to scale are needed to move this area forward. Effective and appropriate technologies to support health systems in the prevention and treatment of HIV/AIDS in low- and middle-income countries are needed to improve the efficiency and quality of health service delivery and ultimately improve health outcomes. Although a growing number of HIV mHealth tools have been developed to support health workers, few of these tools have been rigorously evaluated and even fewer have been brought to scale.
Linkhttp://doi.org/10.1007/s11904-018-0416-x
TitleHealth Behavior Theory to Enhance eHealth Intervention Research in HIV: Rationale and Review.
AuthorsSimoni, JM; Ronen, K; Aunon, FM
JournalCurrent HIV/AIDS reports
Publication Date1 Dec 2018
Date Added to PubMed5 Dec 2018
AbstractOptimal design and evaluation of eHealth interventions requires the specification of behavioral targets and hypothesized mechanisms of action-both of which can be enhanced with the use of established health behavior theories (HBTs). In this paper, we describe the major HBTs and examine their use in studies of eHealth interventions for HIV prevention and treatment and assess the contribution of HBT in developing and evaluating eHealth interventions. Based on our review of the literature, we argue the field can benefit from more systematic selection, application, and reporting of HBT. We highlight theories specifically designed for eHealth and describe ways that HBT can be used by researchers and practitioners to improve the rigor and impact of eHealth interventions for individuals living with or at risk for HIV. This brief overview of HBTs and their application to eHealth intervention in HIV research has underscored the importance of a theoretically intentional approach. The theory should be used to inform the design of the eHealth intervention; the intervention should not determine the theory. A theory-driven iterative model of eHealth intervention development may not only improve our repertoire of effective strategies but also has the potential to expand our theoretical and empirical knowledge of health behavior change.
Linkhttp://doi.org/10.1007/s11904-018-0418-8
TitleInterest in use of mHealth technology in HIV prevention and associated factors among high-risk drug users enrolled in methadone maintenance program.
AuthorsShrestha, R; Karki, P; Copenhaver, M
JournalAIDS care
Publication Date1 Sep 2017
Date Added to PubMed10 May 2017
AbstractThe adoption of mobile technologies for health (mHealth) in healthcare has grown considerably in recent years, but systematic assessment of interest in the use of mHealth in HIV prevention efforts among people who use drugs (PWUD) is lacking. We therefore examined interest in use of mHealth technology in HIV prevention and associated individual-level factors among high-risk PWUD enrolled in methadone maintenance program. A total of 400 HIV-negative PWUD, who reported drug- and/or sex-related risk behaviors completed a standardized assessment using audio computer assisted self-interview (ACASI). Results revealed significant interest in using mHealth-based approaches for specific purposes, including: to receive medication reminders (72.3%), to receive information about HIV risk reduction (65.8%), and to assess HIV risk behaviors (76.5%). Multivariate analysis showed that interest in receiving medication reminders was associated with currently taking medication and being neurocognitively impaired, whereas interest in receiving HIV-risk reduction information was associated with being non-white, married, and perceiving the person was at high-risk for contracting HIV. Similarly, participants' interested in using mHealth for HIV risk behavior assessment was associated with having recently visited a healthcare provider and exhibiting depressive symptoms. Overall, this study demonstrated that high-risk PWUD are interested in using mHealth-based tools as a key part of an HIV prevention approach within a common type of drug treatment settings. Thus, formative research on preferences for design and functionality of mHealth-based HIV prevention tools are now needed, followed by practical development, implementation, and evaluation of these new intervention strategies.
Linkhttp://doi.org/10.1080/09540121.2017.1325439
TitleImplementation of eHealth Interventions Across the HIV Care Cascade: a Review of Recent Research.
AuthorsKemp, CG; Velloza, J
JournalCurrent HIV/AIDS reports
Publication Date1 Dec 2018
Date Added to PubMed2 Sep 2018
AbstractWe review recent implementation science focusing on eHealth interventions to improve outcomes along the HIV care cascade. We highlight several gaps in the eHealth implementation literature and propose areas for future study. We identified 17 studies conducted in North America, Europe, and sub-Saharan Africa assessing the acceptability, appropriateness, adoption, cost, feasibility, fidelity, penetration, or sustainability of eHealth interventions targeting the HIV care cascade. Most interventions used SMS messages to improve cascade outcomes. Feasibility research has demonstrated the importance of adaptability for intervention scale-up and delivery. Key gaps in the literature remain related to predictors of the adoption of eHealth interventions by health facilities and staff. In addition, no studies explored sustainability and few used theoretical frameworks for implementation research or validated measures of implementation outcomes. We propose next steps for the future of eHealth implementation research to inform the delivery, scale-up, and maintenance of eHealth interventions in the real world.
Linkhttp://doi.org/10.1007/s11904-018-0415-y
TitleExamining the Acceptability of mHealth Technology in HIV Prevention Among High-Risk Drug Users in Treatment.
AuthorsShrestha, R; Huedo-Medina, TB; Altice, FL; Krishnan, A; Copenhaver, M
JournalAIDS and behavior
Publication Date1 Nov 2017
Date Added to PubMed28 Dec 2016
AbstractDespite promising trends of the efficacy of mobile health (mHealth) based strategies to a broad range of health conditions, very few if any studies have been done in terms of the examining the use of mHealth in HIV prevention efforts among people who use drugs in treatment. Thus, the goal of this study was to gain insight into the real-world acceptance of mHealth approaches among high-risk people who use drugs in treatment. A convenience sample of 400 HIV-negative drug users, who reported drug- and/or sex-related risk behaviors, were recruited from a methadone clinic in New Haven, Connecticut. Participants completed standardized assessments of drug- and sex-related risk behaviors, neurocognitive impairment (NCI), and measures of communication technology access and utilization, and mHealth acceptance. We found a high prevalence of current ownership and use of mobile technologies, such as cell phone (91.5%) including smartphone (63.5%). Participants used mobile technologies to communicate mostly through phone calls (M = 4.25, SD = 1.24), followed by text messages (M = 4.21, SD = 1.29). Participants expressed interest in using mHealth for medication reminders (72.3%), receive information about HIV (65.8%), and to assess drug-related (72.3%) and sex-related behaviors (64.8%). Furthermore, participants who were neurocognitively impaired were more likely to use cell phone without internet and show considerable interest in using mHealth as compared to those without NCI. The findings from this study provide empirical evidence that mHealth-based programs, specifically cell phone text messaging-based health programs, may be acceptable to this high-risk population.
Linkhttp://doi.org/10.1007/s10461-016-1637-x
TitlePeople Living With Human Immunodeficiency Virus During the COVID-19 Pandemic: Experiences With Telemedicine.
AuthorsCoppock, D; Quimby, C; Nunez, J; Whitener, C; Zurlo, J
JournalHealth promotion practice
Publication Date1 May 2021
Date Added to PubMed13 Mar 2021
AbstractPreserving routine primary care for people living with human immunodeficiency virus (PLWH) has been an important challenge during the COVID-19 pandemic. Telemedicine platforms have offered novel means through which care for these individuals may be maintained. Opt-In for Life is a unique mobile health application that contains telemedicine capabilities as well as other features designed specifically for the care of PLWH. Opt-In for Life was implemented early in the pandemic at Hershey Medical Center, although the center is now using a different telemedicine platform across its health care system. Institutional decisions regarding telemedicine platforms are complex. Opt-In for Life contains features that may improve the care of PLWH where telemedicine software alone may be limited.
Linkhttp://doi.org/10.1177/15248399211001071
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