Anybody out there? A process evaluation of SMS sent to household TB contacts in Kampala, Uganda

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dc.contributor.authorAmanda, J. Meyer
dc.contributor.authorBabirye, Diana
dc.contributor.authorArmstrong-Hough, Mari
dc.contributor.authorMark, David
dc.contributor.authorAyakaka, Irene
dc.contributor.authorKatamba, Achilles
dc.contributor.authorHaberer, Jessica E.
dc.contributor.authorDavis, J. Lucian
dc.date.accessioned2023-01-17T18:29:35Z
dc.date.available2023-01-17T18:29:35Z
dc.date.issued2018
dc.description.abstractPrevious studies have reported inconsistent effectiveness of SMS (short-messaging services) for improving health outcomes, but few have examined to what degree the quality, or “fidelity”, of implementation may explain study results. Objective: We sought to determine the fidelity of a one-time SMS intervention to promote uptake of TB evaluation services among household contacts of index TB patients. Methods: From February to June 2017, we nested a process evaluation of SMS delivery within the intervention arm of a randomized controlled trial of TB contact investigation in Kampala, Uganda. Because mobile service providers in Uganda do not provide delivery confirmations, we asked household TB contacts to confirm receipt of a one-time TB-related SMS by sending an SMS reply via a toll-free “short code.” Two weeks later, a research officer followed-up by telephone to confirm receipt of the one-time SMS and administer a survey. We considered participants lost-to-follow-up after three unsuccessful call attempts on three separate days over a one-week period. Results: Of 206 consecutive household contacts, 119 had an SMS initiated from the server. Thirty-nine (33%) were children aged 5-14, including 24 (20%) girls and 15 (13%) boys. Twenty-one (18%) were adolescents or young adults, including 14 (12%) young women and seven (6%) young men. Fifty-nine (50%) were adults, including 31 (26%) women and 28 (24%) men. Of 107 (90%) participants for whom we were able to ascertain SMS receipt status, 67% (n=72) confirmed SMS receipt, including 22% (n=24) by reply SMS and 45% (n=48) during the follow-up telephone survey. There were no significant clinical or demographic differences between those who did and did not report receiving the SMS message. 52% (n=56) reported ever reading the SMS. The cumulative likelihood of an SMS reaching its target and being read and retained by a participant was 19%. Conclusions: The fidelity of a one-time SMS intervention to increase uptake of household TB contact investigation and linkage to care was extremely low, a fact only discoverable through a detailed process evaluation. Our findings suggest the need for systematic process monitoring and reporting of implementation fidelity in both research studies and programmatic interventions employing mobile communications to improve health.en_US
dc.identifier.citationMeyer, A. J., Babirye, D., Armstrong-Hough, M., Mark, D., Ayakaka, I., Katamba, A., ... & Davis, J. L. Anybody out there? A process evaluation of SMS sent to household TB contacts in Kampala, Uganda. https://www.researchgate.net/profile/Diana-Babirye/publication/327577834_Anybody_out_there_A_process_evaluation_of_SMS_sent_to_household_TB_contacts_in_Kampala_Uganda_Preprint/links/5f38c90b299bf13404c8574b/Anybody-out-there-A-process-evaluation-of-SMS-sent-to-household-TB-contacts-in-Kampala-Uganda-Preprint.pdfen_US
dc.identifier.other10.2196/10239
dc.identifier.urihttps://www.researchgate.net/profile/Diana-Babirye/publication/327577834_Anybody_out_there_A_process_evaluation_of_SMS_sent_to_household_TB_contacts_in_Kampala_Uganda_Preprint/links/5f38c90b299bf13404c8574b/Anybody-out-there-A-process-evaluation-of-SMS-sent-to-household-TB-contacts-in-Kampala-Uganda-Preprint.pdf
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/6989
dc.language.isoenen_US
dc.publisherResearchGateen_US
dc.subjectProcess evaluationen_US
dc.subjectSMSen_US
dc.subjectHousehold TB contactsen_US
dc.titleAnybody out there? A process evaluation of SMS sent to household TB contacts in Kampala, Ugandaen_US
dc.typeArticleen_US
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