دورية أكاديمية
Bridging community and clinic through digital health: Community-based adaptation of a mobile phone-based heart failure program for remote communities in Uganda.
| العنوان: | Bridging community and clinic through digital health: Community-based adaptation of a mobile phone-based heart failure program for remote communities in Uganda. |
|---|---|
| المؤلفون: | Wali S; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada.; Centre for Digital Therapeutics, Toronto General Hospital, University Health Network, R. Fraser Elliott Building, 4th floor, 190 Elizabeth St, Toronto, ON M5G 2C4 Canada., Ssinabulya I; Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda.; Uganda Heart Institute, MulagoNational Referral Hospital, Kampala, Uganda., Muhangi CN; Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda., Kamarembo J; Gulu Regional Referral Hospital, Gulu, Uganda., Atala J; Lira Regional Referral Hospital, Lira, Uganda., Nabadda M; Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda., Odong F; Gulu Regional Referral Hospital, Gulu, Uganda., Akiteng AR; Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda.; Uganda Heart Institute, MulagoNational Referral Hospital, Kampala, Uganda., Ross H; Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON Canada.; Institute of Medical Sciences, Faculty of Medicine, University of Toronto, Toronto, ON Canada.; Peter Munk Cardiac Centre, University Health Network, Toronto, ON Canada., Mashford-Pringle A; Dalla Lana School of Public Health, Waakebiness-Bryce Institute for Indigenous Health, University of Toronto, Toronto, ON Canada., Cafazzo JA; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada.; Centre for Digital Therapeutics, Toronto General Hospital, University Health Network, R. Fraser Elliott Building, 4th floor, 190 Elizabeth St, Toronto, ON M5G 2C4 Canada.; Institute of Biomedical Engineering, University of Toronto, Toronto, ON Canada.; Department of Computer Science, University of Toronto, Toronto, ON Canada., Schwartz JI; Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda.; Section of General Internal Medicine, Yale University School of Medicine, New Haven, USA. |
| المصدر: | BMC digital health [BMC Digit Health] 2023; Vol. 1 (1), pp. 20. Date of Electronic Publication: 2023 Jun 16. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BioMed Central Ltd Country of Publication: England NLM ID: 9918663887506676 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2731-684X (Electronic) Linking ISSN: 2731684X NLM ISO Abbreviation: BMC Digit Health Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: [London] : BioMed Central Ltd., [2023]- |
| مستخلص: | Background: In Uganda, limited healthcare access has created a significant burden for patients living with heart failure. With the increasing use of mobile phones, digital health tools could offer an accessible platform for individualized care support. In 2016, our multi-national team adapted a mobile phone-based program for heart failure self-care to the Ugandan context and found that patients using the system showed improvements in their symptoms and quality of life. With approximately 84% of Ugandans residing in rural communities, the Medly Uganda program can provide greater benefit for communities in rural areas with limited access to care. To support the implementation of this program within rural communities, this study worked in partnership with two remote clinics in Northern Uganda to identify the cultural and service level requirements for the program. Methods: Using the principles from community-based research and user-centered design, we conducted a mixed-methods study composed of 4 participatory consensus cycles, 60 semi-structured interviews (SSI) and 8 iterative co-design meetings at two remote cardiac clinics. Patient surveys were also completed during each SSI to collect data related to cell phone access, community support, and geographic barriers. Qualitative data was analyzed using inductive thematic analysis. The Indigenous method of two-eyed seeing was also embedded within the analysis to help promote local perspectives regarding community care. Results: Five themes were identified. The burden of travel was recognized as the largest barrier for care, as patients were travelling up to 19 km by motorbike for clinic visits. Despite mixed views on traditional medicine, patients often turned to healers due to the cost of medication and transport. With most patients owning a non-smartphone ( n = 29), all participants valued the use of a digital tool to improve equitable access to care. However, to sustain program usage, integrating the role of village health teams (VHTs) to support in-community follow-ups and medication delivery was recognized as pivotal. Conclusion: The use of a mobile phone-based digital health program can help to reduce the barrier of geography, while empowering remote HF self-care. By leveraging the trusted role of VHTs within the delivery of the program, this will help enable more culturally informed care closer to home. Supplementary Information: The online version contains supplementary material available at 10.1186/s44247-023-00020-5. Competing Interests: Competing interestsThe authors declare no competing interests. (© The Author(s) 2023.) |
| References: | Glob Heart. 2018 Dec;13(4):347-354. (PMID: 29685638) Ann Glob Health. 2021 Aug 19;87(1):86. (PMID: 34458110) J Hum Hypertens. 2023 Mar;37(3):213-219. (PMID: 35246602) Int J Equity Health. 2021 Jan 18;20(1):38. (PMID: 33461568) BMC Med Res Methodol. 2018 Dec 12;18(1):167. (PMID: 30541471) BMC Res Notes. 2017 May 25;10(1):184. (PMID: 28545502) Int J Equity Health. 2017 Jul 20;16(1):129. (PMID: 28728553) Global Health. 2014 Nov 19;10:77. (PMID: 25406738) Circ Cardiovasc Qual Outcomes. 2017 Nov;10(11):. (PMID: 29133472) PLoS One. 2021 Aug 6;16(8):e0255918. (PMID: 34358281) PLoS One. 2020 Dec 23;15(12):e0241555. (PMID: 33362249) J Med Internet Res. 2020 Feb 8;22(2):e16538. (PMID: 32027309) Ther Innov Regul Sci. 2018 Jan;52(1):62-69. (PMID: 29714608) Ann Glob Health. 2020 Jul 28;86(1):85. (PMID: 32832383) JMIR Mhealth Uhealth. 2019 Oct 7;7(10):e14275. (PMID: 31593547) Lancet Glob Health. 2017 Jul;5(7):e665-e672. (PMID: 28476564) Can J Cardiol. 2017 Feb;33(2):219-231. (PMID: 27956043) J Card Fail. 2009 Aug;15(6):508-16. (PMID: 19643362) Int J Cardiol. 2014 Oct 20;176(3):1233-4. (PMID: 25127332) Implement Sci. 2015 May 04;10:64. (PMID: 25935849) JMIR Mhealth Uhealth. 2019 Feb 26;7(2):e13259. (PMID: 30806625) Digit Health. 2022 Sep 27;8:20552076221129064. (PMID: 36185389) JMIR Res Protoc. 2020 Jan 22;9(1):e15753. (PMID: 32012116) J R Soc Med. 2013 Apr;106(4):130-42. (PMID: 23564897) Contemp Nurse. 2013 Dec;46(1):13-7. (PMID: 24716757) Glob Health Action. 2019;12(1):1684070. (PMID: 31694487) Am J Public Health. 2010 Nov;100(11):2094-102. (PMID: 20864728) Am J Public Health. 2015 Jun;105(6):1149-54. (PMID: 25880963) Int J Telemed Appl. 2013;2013:482324. (PMID: 24369460) Afr Health Sci. 2009 Oct;9 Suppl 2:S49-51. (PMID: 20589106) J Am Coll Cardiol. 2007 Oct 23;50(17):1688-93. (PMID: 17950152) Biomed Instrum Technol. 2012 Fall;Suppl:49-56. (PMID: 23039777) |
| فهرسة مساهمة: | Keywords: community-based research; digital health; heart failure; two-eyed seeing; user-centered design |
| تواريخ الأحداث: | Date Created: 20240527 Latest Revision: 20240528 |
| رمز التحديث: | 20240528 |
| مُعرف محوري في PubMed: | PMC11116269 |
| DOI: | 10.1186/s44247-023-00020-5 |
| PMID: | 38800672 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2731-684X |
|---|---|
| DOI: | 10.1186/s44247-023-00020-5 |