FEASIBILITY, ACCEPTABILITY, AND APPROPRIATENESS OF THE PHONE BASED INTERVENTIONS UNDER NURSE GUIDANCE AFTER STROKE (PINGS) IN GHANA

Abstract

Background PINGS is a clinical trial to evaluate a nurse-led mHealth technology - centered approach to maintaining BP control among recent stroke survivors with hypertension in Ghana. PINGS involves domiciliary BP self-monitoring, mobile phone consultations, phone alerts as reminders, and patient education via text messages. We assessed the feasibility, acceptability, and appropriateness of PINGS from the perspective of health workers in general - not necessarily working in stroke rehabilitation. Methods Using an adaptation of psychometrically validated Likert-scale measures for feasibility, acceptability, and appropriateness of interventions, we deployed an online survey among health workers. Summed composite scores were obtained, dichotomized, and binary logistic regression performed using R programming software. Results There were 665 respondents; males (57%), females (43%); clinical staff (75%) and non-clinical staff (25%); and median age was 33 years (IQR 29, 37). PINGS was feasible, acceptable, and appropriate to 93%, 93% and 94% of respondents respectively. Clinical staff found PINGS feasible (OR 9.28; C.I. 4.86, 18.7; p<0.001), acceptable (OR 7.41, C.I. 3.95, 14.5; p<0.001), or appropriate (OR 7.59, C.I. 3.9, 15.5; p<0.001) compared to non-clinical staff. The measures were not significantly affected by type (including public or private), level (including tertiary or district), or regional location of the facility. Conclusion PINGS was overwhelmingly perceived as feasible, acceptable, and appropriate, with these perspectives not being significantly different across different types of facilities, levels of health care, or geographic locations in Ghana. Clinical staff however found PINGS much more feasible, acceptable, and appropriate than their non-clinical counterparts. PINGS is a clinical trial to evaluate a nurse-led mHealth technology - centered approach to maintaining BP control among recent stroke survivors with hypertension in Ghana. PINGS involves domiciliary BP self-monitoring, mobile phone consultations, phone alerts as reminders, and patient education via text messages. We assessed the feasibility, acceptability, and appropriateness of PINGS from the perspective of health workers in general - not necessarily working in stroke rehabilitation. Using an adaptation of psychometrically validated Likert-scale measures for feasibility, acceptability, and appropriateness of interventions, we deployed an online survey among health workers. Summed composite scores were obtained, dichotomized, and binary logistic regression performed using R programming software. There were 665 respondents; males (57%), females (43%); clinical staff (75%) and non-clinical staff (25%); and median age was 33 years (IQR 29, 37). PINGS was feasible, acceptable, and appropriate to 93%, 93% and 94% of respondents respectively. Clinical staff found PINGS feasible (OR 9.28; C.I. 4.86, 18.7; p<0.001), acceptable (OR 7.41, C.I. 3.95, 14.5; p<0.001), or appropriate (OR 7.59, C.I. 3.9, 15.5; p<0.001) compared to non-clinical staff. The measures were not significantly affected by type (including public or private), level (including tertiary or district), or regional location of the facility. PINGS was overwhelmingly perceived as feasible, acceptable, and appropriate, with these perspectives not being significantly different across different types of facilities, levels of health care, or geographic locations in Ghana. Clinical staff however found PINGS much more feasible, acceptable, and appropriate than their non-clinical counterparts.