Lessons learned from a mobile technology-based intervention informed by behavioral economics to improve ART adherence among youth in Uganda. AIDS Care.
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Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
Taylor & Francis
Abstract
Evidence suggests that simple text messaging interventions may not suffice to improve ART
adherence among youth in low-resource settings. To address this shortcoming, we developed an
intervention that shared weekly real-time adherence feedback to youth in Uganda using short
message services (SMS), based on information tracked by an electronic device (Wisepill). We
present results from 7 formative and 6 exit focus groups (FGs) in Mulago and Entebbe, Uganda
with youth ages 15–24, providers, and Community Advisory Board members. Participants
consistently conveyed positive impressions of Wisepill, noting that it helped store their
medications, facilitated travel, served as a reminder, and motivated adherence. Participants raised
phone-related issues before the study; most were addressed but some remained (e.g., limited
network access, electricity for powering phones). Further, they highlighted the importance of
carefully crafting text messages (e.g., use slang rather than potentially stigmatizing words) and
viewed personalizing messages favorably but were divided on the desirability of including their
name in study-related texts. Exit FGs confirmed that sharing group adherence levels with
participants tapped into the competitive spirit common among youth. Our results suggest future
mobile technology-based interventions can be improved by providing messages that go beyond
simple reminders to provide individual and group-level adherence feedback.
Description
Keywords
Mobile technology, Behavioral economics, ART
Citation
MacCarth, S., Mendoza-Graf, A., Samba, C., Saya, U., Birungi, J., & Okobo, S. (2019). Lessons learned from a mobile technology-based intervention informed by behavioral economics to improve ART adherence among youth in Uganda.