Willingness to Receive mHealth Services Among Patients with Diabetes on Chronic Follow-up in Public Hospitals in Eastern Ethiopia: Multicenter Mixed-Method Study.

Abstract

Management of diabetes requires a long-term care strategy, including support for adherence to a healthy lifestyle and treatment. Exploring the willingness of patients with diabetes to receive mHealth services is essential for designing efficient and effective services. This study aimedto determine willingness to receive mHealth services and associated factors, as well as explore the barriers to receive mHealth services among patients with diabetes. A multicenter mixed-method study was employed from September 1 to November 30, 2022. For the quantitative part, a total of 365 patients with diabetes receiving chronic follow-up at three public hospitals were enrolled. Data were gathered using structured questionnaires administered by interviewers, entered into Epi-data version 4.6, and analyzed using Stata version 17. A binary and multivariable logistic regression model was computed to identify the associated factors. For qualitative, eight key informants and seven in-depth interviews were conducted. After verbatim transcription and translation, the data were thematically analyzed using ATLAS.ti V. 7.5. Overall, 77.3% had access to a mobile phone, and 74.5% of them were willing to receive mHealth services. Higher odds of willingness to receive mHealth services were reported among patients with an age below 35 years [AOR = 4.11 (1.15-14.71)], attended formal education [AOR = 2.63 (1.19-5.77)], without comorbidity [AOR = 3.6 (1.54-8.41)], <1-hour travel to reach a health facility [AOR = 3.57 (1.03-12.36)], answered unknown calls [AOR = 2.3 (1.04-5.13)], and were satisfied with health-care provider service [AOR = 2.44 (1.04-5.72)]. In the qualitative part, infrastructure, health facilities, socioeconomic factors, and patients' behavioral factors were major identified barriers to receiving mHealth services. In this study, the willingness to receive mHealth services for those who have access to mobile phones increased. Additionally, the study highlighted common barriers to receiving mHealth services.