Abstract
BackgroundMobile phone ownership and access have increased rapidly across low- and middle-income countries (LMICs) within the last decade. Concomitantly, LMICs are experiencing demographic and epidemiologic transitions, where non-communicable diseases (NCDs) are increasingly becoming leading causes of morbidity and mortality. Mobile phone surveys could aid data collection for prevention and control of these NCDs but limited evidence of their feasibility exists.ObjectiveThe objective of this paper is to describe a series of sub-studies aimed at optimizing the delivery of interactive voice response (IVR) and computer-assisted telephone interviews (CATI) for NCD risk factor data collection in LMICs. These sub-studies are designed to assess the effect of factors such as airtime incentive timing, amount, and structure, survey introduction characteristics, different sampling frames, and survey modality on key survey metrics, such as survey response, completion, and attrition rates.MethodsIn a series of sub-studies, participants will be randomly assigned to receive different airtime incentive amounts (eg, 10 minutes of airtime versus 20 minutes of airtime), different incentive delivery timings (airtime delivered before survey begins versus delivery upon completion of survey), different survey introductions (informational versus motivational), different narrative voices (male versus female), and different sampling frames (random digit dialing versus mobile network operator-provided numbers) to examine which study arms will yield the highest response and completion rates. Furthermore, response and completion rates and the inter-modal reliability of the IVR and CATI delivery methods will be compared.ResultsResearch activities are expected to be completed in Bangladesh, Tanzania, and Uganda in 2017.ConclusionsThis is one of the first studies to examine the feasibility of using IVR and CATI for systematic collection of NCD risk factor information in LMICs. Our findings will inform the future design and implementation of mobile phone surveys in LMICs.
Highlights
Introduction viiIntroduction viiiThe Global Status Report on Noncommunicable Diseases is the first detailed description of the global burden of Noncommunicable diseases (NCDs), their risk factors and determinants; it highlights the immediate opportunities for tackling the epidemic in all settings through a broad focus on NCD surveillance, population-based prevention, strengthening health care and the capacities of countries to respond to the epidemic
A strategic objective in the fight against the NCD epidemic must be to ensure early detection and care using cost-effective and sustainable health-care interventions: High-risk individuals and those with established cardiovascular disease can be treated with regimens of low-cost generic medicines that significantly reduce the likelihood of death or vascular events
NCDs’ negative impact on national economies means fewer jobs and fewer people escaping poverty. It is important for achieving Millennium Development Goals (MDGs) 2, since costs for NCD health care, medicines, tobacco and alcohol consumption displace household resources that otherwise might be available for education
Summary
Noncommunicable diseases (NCDs) are the leading causes of death globally, killing more people each year than all other causes combined. Available data demonstrate that nearly 80% of NCD deaths occur in low- and middle-income countries Despite their rapid growth and inequitable distribution, much of the human and social impact caused each year by NCD-related deaths could be averted through well-understood, cost-effective and feasible interventions. The greatest effects of these risk factors fall increasingly on low- and middle-income countries, and on poorer people within all countries, mirroring the underlying socioeconomic determinants Among these populations, a vicious cycle may ensue: poverty exposes people to behavioural risk factors for NCDs and, in turn, the resulting NCDs may become an important driver to the downward spiral that leads families towards poverty. Much has been learnt about the causes, prevention and treatment of NCDs over the past three decades, as important achievements have been made in reducing mortality in many highincome countries; the evidence base for action is steadily mounting and global attention to the NCD epidemic is intensifying
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