2016-08-17
Protocol for a randomized controlled trial evaluating mobile text messaging to promote retention and adherence to antiretroviral therapy for people living with HIV in Burkina Faso
Publication
Publication
JMIR Research Protocols , Volume 5
Background: Retention in care and adherence to antiretroviral therapy (ART) among people living with human immunodeficiency
virus (PLHIV) is a critical challenge in many African countries including Burkina Faso. Delivering text messaging (short message
service, SMS) interventions through mobile phones may help facilitate health service delivery and improve patient health. Despite
this potential, no evaluations have been delivered for national scale settings to demonstrate the impact of mobile health (mHealth)
for PLHIV.
Objectives: This study aims to test the impact of SMS text messaging reminders for PLHIV in Burkina Faso, who are under
ART. The evaluation identifies whether patients who receive SMS text messages are more likely to (1) retain in care (measured
as a dichotomous variable), (2) adhere to antiretroviral regimens (measured as the number of doses missed in the past 7 days),
and (3) experience slower disease progression (measured with T-lymphocytes cells). The second objective is to assess its effects
on the frequency of health center visits, physical and psychosocial health, nutrition and whether the type of message (text vs
image) and frequency (weekly vs semiweekly) have differential impacts including the possibility of message fatigue over time.
Methods: This 24-month, wide-scale intervention implements a randomized controlled trial (RCT) to evaluate the impact of
four variants of a mHealth intervention versus a control group. Our sample comprises adult patients (>15 years of age) undergoing
antiretroviral therapy with access to mobile phone services. Multivariate regression analysis will be used to analyze the effect of
the intervention on the study population. Data collection is done at baseline and three follow-up waves 6, 12, and 24 months after
the intervention starts.
Results: The targeted 3800 patients were recruited between February 2015 and May 2015. But political uncertainty delayed the
launch of the intervention until October 2015. Data analysis has not yet started. The first follow-up data collection started in April
2016. To the best of our knowledge, this is the first research that explores the effects of mobile message reminders using a
wide-spread sample across an entire nation over a 2-year horizon, especially in a Francophone African country.
Conclusions: We hypothesize that the interventions have a positive impact on retention in care and adherence to ART schemes
and that a more sluggish disease progression will be observed in the short run. However, these benefits may fade out in the long
run. The study expects to advance the research on how long mHealth interventions remain effective and when fatigue sets in the
context of wide-scale interventions. This information will be useful in designing future wide-scale mHealth interventions in
developing countries.
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doi.org/10.2196/resprot.5823, hdl.handle.net/1765/112756 | |
JMIR Research Protocols | |
Organisation | International Institute of Social Studies of Erasmus University (ISS) |
Wagner, N., Ouedraogo, D., Artavia-Mora, L., Bedi, A. S., & Thiombiano, B. A. (2016). Protocol for a randomized controlled trial evaluating mobile text messaging to promote retention and adherence to antiretroviral therapy for people living with HIV in Burkina Faso. JMIR Research Protocols, 5. doi:10.2196/resprot.5823 |