Acceptability and Use of Interactive Voice Response Mobile Phone Surveys for Noncommunicable Disease Behavioral Risk Factor Surveillance in Rural Uganda: Qualitative Study.

Charles Ssemugabo,Adnan A Hyder,Dan Kajungu,George W Pariyo,Elizeus Rutebemberwa,Dustin G Gibson

doi:10.2196/15000

Abstract

BackgroundThere is need for more timely data to inform interventions that address the growing noncommunicable disease (NCD) epidemic. With a global increase in mobile phone ownership, mobile phone surveys can bridge this gap.ObjectiveThis study aimed to explore the acceptability and use of interactive voice response (IVR) surveys for surveillance of NCD behavioral risk factors in rural Uganda.MethodsThis qualitative study employed user group testing (UGT) with community members. The study was conducted at the Iganga-Mayuge Health and Demographic Surveillance Site (IM-HDSS) in Eastern Uganda. We conducted four UGTs which consisted of different categories of HDSS members: females living in urban areas, males living in urban areas, females living in rural areas, and males living in rural areas. Participants were individually sent an IVR survey, then were brought in for a group discussion using a semistructured guide. Data were analyzed thematically using directed content analysis.ResultsParticipants perceived that IVR surveys may be useful in promoting confidentiality, saving costs, and raising awareness on NCD behavioral risk factors. Due to the clarity and delivery of questions in the local language, the IVR survey was perceived as easy to use. Community members suggested scheduling surveys on specific days and sending reminders as ways to improve their use for surveillance. Social issues such as domestic violence and perceptions toward unknown calls, technological factors including poor network connections and inability to use phones, and personal issues such as lack of access to phones and use of multiple networks were identified as barriers to the acceptability and use of mobile phone surveys. However, incentives were reported to motivate people to complete the survey.ConclusionsCommunity members reflected on contextual and sociological implications of using mobile phones for surveillance of NCD behavioral risk factors. The opportunities and challenges that affect acceptability and use of IVR surveys should be considered in designing and implementing surveillance programs for NCD risk factors.

Highlights

The use of mobile phones has a huge potential to promote health in low- and middle-income countries (LMIC) [1,2,3]
In order to strengthen the health systems response to noncommunicable disease (NCD) prevention and control in Uganda, there is a need for frequent data on NCD behavioral risk factors
Surveillance of NCD behavioral risk factors in Uganda has been carried out using the World Health Organization Stepwise Approach to Surveillance (STEPS) NCD risk factor surveillance [12]

Summary

Introduction

The use of mobile phones has a huge potential to promote health in low- and middle-income countries (LMIC) [1,2,3]. There is limited literature on use of mobile phones in prevention and control of noncommunicable diseases (NCDs) such as cancer, diabetes, and cardiovascular disease. The increasing burden of NCDs in Uganda and globally is attributed partly to behavioral risk factors including tobacco use, alcohol use, dietary intake, and physical activity [11]. In order to strengthen the health systems response to NCD prevention and control in Uganda, there is a need for frequent data on NCD behavioral risk factors. Surveillance of NCD behavioral risk factors in Uganda has been carried out using the World Health Organization Stepwise Approach to Surveillance (STEPS) NCD risk factor surveillance [12]. Uganda last conducted a STEPS survey in 2014 [14]. Given the high levels of mobile phone ownership and access [15], NCD risk factor surveillance could be explored. With a global increase in mobile phone ownership, mobile phone surveys can bridge this gap

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