216. Evaluation of the PIERS on the MOVE mobile health tool for pre-eclampsia triage: The users’ perspective

Abstract

Background The PIERS on the Move (POM) mobile health (mHealth) application was implemented as part of a complex community health system intervention in the CLIP (Community Level Interventions for Pre-eclampsia; NCT01911494) Trials. In this context, community health workers (CHWs) were trained to use the app and to take on new clinical skills, such as measuring blood pressure and assessing symptoms. Objective To evaluate the perceived impact on pre-eclampsia knowledge, self-efficacy and CHW role from use of the POM app. Method This study used mixed methods including closed and open-ended survey questions and focus group discussions (FGDs) based on the SALT (Stimulate, Appreciate, Learn, Transfer) approach. All health care workers who participated in the CLIP Trials in Pakistan and India were eligible to participate. A random sample, stratified by age and years of experience, was drawn to target participants for qualitative evaluation after completion of recruitmentfor the Trials. Survey results were summarized and qualitative data analyzed using grounded theory. Results In India, 24 CHWs completed the survey and were interviewed. In Pakistan, 219 CHWs completed the survey and 18 participated in 3 follow-up FGDs. CHWs in both countries reported a high level of pre-eclampsia knowledge and self-efficacy. Qualitative data analyzed from the interviews in India and FGDs in Pakistan indicate a high level of job satisfaction with themes emerging related to positive ability to manage pregnancy complications; happiness with supporting healthy pregnancy and birth and satisfaction with new knowledge and responsibilities. Challenges reported included initial difficulties learning to use a smart phone and technical issues with the device itself (battery life and screen size). Conclusions This study supports the ability and desire of community health workers to use mobile health tools such as the PIERS on the Move app to support their performance of clinical tasks related to pre-eclampsia care.