A Framework for the Study of Complex mHealth Interventions in Diverse Cultural Settings
| Autor: | Nancy Perkins, Lisa Boesch, Marion Maar, Jessica Sleeth, Peter Liu, Diane Hua-Stewart, Karen Yeates, Sheldon W. Tobe |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Knowledge management
020205 medical informatics health care texting Psychological intervention DREAM-GLOBAL Participatory action research Community-based participatory research Health Informatics 02 engineering and technology Telehealth Information technology Tanzania 03 medical and health sciences 0302 clinical medicine Participatory evaluation Health care 0202 electrical engineering electronic engineering information engineering Medicine protocol 030212 general & internal medicine mobile health mHealth community-based participatory research Original Paper business.industry Consolidated Standards of Reporting Trials T58.5-58.64 process evaluation 3. Good health process assessment (health care) SMS Public aspects of medicine RA1-1270 business health services Indigenous |
| Zdroj: | JMIR mHealth and uHealth, Vol 5, Iss 4, p e47 (2017) JMIR mHealth and uHealth |
| ISSN: | 2291-5222 |
| Popis: | BackgroundTo facilitate decision-making capacity between options of care under real-life service conditions, clinical trials must be pragmatic to evaluate mobile health (mHealth) interventions under the variable conditions of health care settings with a wide range of participants. The mHealth interventions require changes in the behavior of patients and providers, creating considerable complexity and ambiguity related to causal chains. Process evaluations of the implementation are necessary to shed light on the range of unanticipated effects an intervention may have, what the active ingredients in everyday practice are, how they exert their effect, and how these may vary among recipients or between sites. ObjectiveBuilding on the CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile HEalth Applications and onLine TeleHealth) statement and participatory evaluation theory, we present a framework for the process evaluations for mHealth interventions in multiple cultural settings. We also describe the application of this evaluation framework to the implementation of DREAM-GLOBAL (Diagnosing hypertension—Engaging Action and Management in Getting Lower BP in Indigenous and LMIC [low- and middle-income countries]), a pragmatic randomized controlled trial (RCT), and mHealth intervention designed to improve hypertension management in low-resource environments. We describe the evaluation questions and the data collection processes developed by us. MethodsOur literature review revealed that there is a significant knowledge gap related to the development of a process evaluation framework for mHealth interventions. We used community-based participatory research (CBPR) methods and formative research data to develop a process evaluation framework nested within a pragmatic RCT. ResultsFour human organizational levels of participants impacted by the mHealth intervention were identified that included patients, providers, community and organizations actors, and health systems and settings. These four levels represent evaluation domains and became the core focus of the evaluation. In addition, primary implementation themes to explore in each of the domains were identified as follows: (1) the major active components of the intervention, (2) technology of the intervention, (3) cultural congruence, (4) task shifting, and (5) unintended consequences. Using the four organizational domains and their interaction with primary implementation themes, we developed detailed evaluation research questions and identified the data or information sources to best answer our questions. ConclusionsUsing DREAM-GLOBAL to illustrate our approach, we succeeded in developing an uncomplicated process evaluation framework for mHealth interventions that provide key information to stakeholders, which can optimize implementation of a pragmatic trial as well as inform scale up. The human organizational level domains used to focus the primary implementation themes in the DREAM-GLOBAL process evaluation framework are sufficiently supported in our research, and the literature and can serve as a valuable tool for other mHealth process evaluations. Trial RegistrationClinicalTrials.gov NCT02111226; https://clinicaltrials.gov/ct2/show/NCT02111226 (Archived by WebCite at http://www.webcitation.org/6oxfHXege) |
| Databáze: | OpenAIRE |
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