"We have been so patient because we know where we are coming from" Exploring the acceptability and feasibility of a mobile electronic medical record system designed for community-based antiretroviral therapy in Lilongwe, Malawi.
| العنوان: | "We have been so patient because we know where we are coming from" Exploring the acceptability and feasibility of a mobile electronic medical record system designed for community-based antiretroviral therapy in Lilongwe, Malawi. |
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| المؤلفون: | Kiruthu-Kamamia C; United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology, Maastricht, Netherlands.; Lighthouse Trust, Lilongwe, Malawi.; International Training and Education Center for Health, Seattle, Washington, USA., Berner-Rodoreda A; Heidelberg University, Heidelberg, Germany., O'Bryan G; International Training and Education Center for Health, Seattle, Washington, USA.; Department of Epidemiology, University of Washington, Seattle, Washington, USA.; Department of Global Health, University of Washington, Seattle, Washington, USA., Sande O; Lighthouse Trust, Lilongwe, Malawi., Huwa J; Lighthouse Trust, Lilongwe, Malawi., Thawani A; Lighthouse Trust, Lilongwe, Malawi., Tweya H; International Training and Education Center for Health, Seattle, Washington, USA.; Department of Global Health, University of Washington, Seattle, Washington, USA., Groot W; United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology, Maastricht, Netherlands., Pavlova M; Department of Health Services Research, CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands., Feldacker C; International Training and Education Center for Health, Seattle, Washington, USA.; Department of Epidemiology, University of Washington, Seattle, Washington, USA.; Department of Global Health, University of Washington, Seattle, Washington, USA. |
| المصدر: | MedRxiv : the preprint server for health sciences [medRxiv] 2024 Apr 24. Date of Electronic Publication: 2024 Apr 24. |
| نوع المنشور: | Preprint |
| اللغة: | English |
| بيانات الدورية: | Country of Publication: United States NLM ID: 101767986 Publication Model: Electronic Cited Medium: Internet NLM ISO Abbreviation: medRxiv Subsets: PubMed not MEDLINE |
| مستخلص: | Background: Mobile health (mHealth) is reshaping healthcare delivery, especially in HIV management. The World Health Organization advocates for mHealth to provide healthcare workers (HCWs) with real-time data, enhancing patient care. However, in Malawi's Lighthouse Trust antiretroviral therapy (ART) clinic, the nurse-led community-based ART (NCAP) program faces hurdles with data management due to lack of access to electronic medical records systems (EMRS) in the community setting. EMRS is not typically available in differentiated service delivery settings where reliable power and internet are often unavailable. We used human-centered design (HCD) processes to create a mobile EMRS prototype, the Community-based ART Retention and Suppression (CARES) app. We explore progress to simplify workflow for HCWs and improve client care. Methods: To evaluate the CARES app's feasibility and acceptability among NCAP HCWs, we conducted in-depth interviews among 15 NCAP HCWs. We used a rapid qualitative analysis approach guided by the extended Technology Acceptance Model. The study complied with the Consolidated Criteria for Reporting Qualitative Research (COREQ). Results: As a likely result of HCD, HCWs demonstrated high expectations for the CARES app to improve healthcare delivery and data management. However, challenges such as app performance, data integration, and system navigation were significant barriers to acceptance or feasibility. Despite challenges, HCWs remained optimistic about the potential for CARES to enhance NCAP clinical decision-making and data flow. HCWs emphasized the need for continuous training and stakeholder engagement, improved infrastructure, data security protections, and establishing the CARES app and EMRS integration to facilitate CARES' longterm success at scale. Conclusion: The study's findings underscore the importance of HCD for mHealth buy-in. As HCWs were invested in CARES success, they remained optimistic that the app could enhance NCAP services if user experience and app performance improved. Incorporation of HCW feedback would help deliver beyond the promise of CARES. |
| معلومات مُعتمدة: | R21 MH127992 United States MH NIMH NIH HHS |
| تواريخ الأحداث: | Date Created: 20240507 Latest Revision: 20240513 |
| رمز التحديث: | 20240513 |
| مُعرف محوري في PubMed: | PMC11071565 |
| DOI: | 10.1101/2024.04.23.24306213 |
| PMID: | 38712297 |
| قاعدة البيانات: | MEDLINE |
| DOI: | 10.1101/2024.04.23.24306213 |
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