Experiences and intentions of Ugandan household tuberculosis contacts receiving test results via text message: an exploratory study
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Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
BMC public health
Abstract
The World Health Organization (WHO) recommends household contact investigation for tuberculosis
(TB) in high-burden countries. However, household contacts who complete evaluation for TB during contact
investigation may have difficulty accessing their test results. Use of automated short-messaging services (SMS) to
deliver test results could improve TB status awareness and linkage to care. We sought to explore how household
contacts experience test results delivered via SMS, and how these experiences influence follow-up intentions.
Methods: We conducted semi-structured interviews with household contacts who participated in a randomized
controlled trial evaluating home sputum collection and delivery of TB results via SMS (Pan-African Clinical Trials
Registry #201509000877140). We asked about feelings, beliefs, decisions, and behaviors in response to the SMS
results. We analyzed the content and emerging themes in relation to the Theory of Planned Behavior.
Results: We interviewed and achieved thematic saturation with ten household contacts. Nine received TB-negative
results and one a TB-positive result. Household contacts reported relief upon receiving SMS confirming their TB
status, but also said they lacked confidence in the results delivered by SMS. Some worried that negative results
were incorrect until they spoke to a lay health worker (LHW). Household contacts said their long-term intentions to
request help or seek care were influenced by perceived consequences of not observing the LHW’s instructions
related to the SMS and follow-up procedures; beliefs about the curability of TB; anticipated support from LHWs; and
perceived barriers to responding to an SMS request for further evaluation.
Conclusion: Household contacts experienced relief when they received results. However, they were less confident
about results delivered via SMS than results delivered by LHWs. Delivery of results by SMS should complement
continued interaction with LHWs, not replace them.
Description
Keywords
mHealth, Tuberculosis, Text message, Mobile phone, Community health worker
Citation
Ggita, J. M., Katahoire, A., Meyer, A. J., Nansubuga, E., Nalugwa, T., Turimumahoro, P., ... & Davis, J. L. (2020). Experiences and intentions of Ugandan household tuberculosis contacts receiving test results via text message: an exploratory study. BMC public health, 20(1), 1-10. https://doi.org/10.1186/s12889-020-8427-0