mHealth Projects Research Articles

Strengthening the home-to-facility continuum of newborn and child health care through mHealth: Evidence from an intervention in rural Malawi

This paper assesses the impact of a mobile health (mHealth) project on uptake of home-based care for newborn and child health, and investigates the extent to which uptake of home-based care resulted in lessened pressure on health facilities for conditions that can be handled at the household level. It uses mixed methods consisting of cross-sectional household surveys data from a quasi-experimental pre-test post-test design as well as qualitative data. The results show a large, positive effect of the project on the aggregate home-based care for child health, and a sharp, negative impact on facility-based care seeking for fever among children whose mothers/caretakers used the services offered by the intervention. Reasons for using the services mainly relate to the potential of avoiding unnecessary trips to the health facility for care that could be provided at home. The project provides insights on mHealth and community-based programming to improve newborn and child health care delivery.

Improving care-seeking for facility-based health services in a rural, resource-limited setting: Effects and potential of an mHealth project

The aim of this paper was to investigate the impact of a toll-free hotline and mobile messaging service on care-seeking behaviors. Due to the low uptake of the services, the treatment on the treated estimate is used. For maternal health, the intervention had a strong, positive impact on antenatal care initiation and skilled birth attendance. No effect was observed for postnatal check-ups, receiving the recommended four antenatal care visits and vitamin A uptake. A negative effect was observed on tetanus toxoid coverage. For child health, no change was seen in child immunization, and a significant decrease was observed for care-seeking for children with fever. Different factors are associated with care-seeking, which may explain in part the variations seen across care-seeking behaviors and possible influence of exogenous factors. Introduction of mHealth services for demand generation require attention to local health systems to ensure adequate supply and quality are available.

Unmet Need: Improving mHealth Evaluation Rigor to Build the Evidence Base

mHealth—the use of mobile technologies for health—is a growing element of health system activity globally, but evaluation of those activities remains quite scant, and remains an important knowledge gap for advancing mHealth activities. In 2010, the World Health Organization and Columbia University implemented a small-scale survey to generate preliminary data on evaluation activities used by mHealth initiatives. The authors describe self-reported data from 69 projects in 29 countries. The majority (74%) reported some sort of evaluation activity, primarily nonexperimental in design (62%). The authors developed a 6-point scale of evaluation rigor comprising information on use of comparison groups, sample size calculation, data collection timing, and randomization. The mean score was low (2.4); half (47%) were conducting evaluations with a minimum threshold (4 + ) of rigor, indicating use of a comparison group, while less than 20% had randomized the mHealth intervention. The authors were unable to assess whether the rigor score was appropriate for the type of mHealth activity being evaluated. What was clear was that although most data came from mHealth projects pilots aimed for scale-up, few had designed evaluations that would support crucial decisions on whether to scale up and how. Whether the mHealth activity is a strategy to improve health or a tool for achieving intermediate outcomes that should lead to better health, mHealth evaluations must be improved to generate robust evidence for cost-effectiveness assessment and to allow for accurate identification of the contribution of mHealth initiatives to health systems strengthening and the impact on actual health outcomes.

Harnessing the Internet of Things for Global Development

This report explores the current use and potential of Internet of Things (IoT) technologies in tackling global development challenges, highlighting a number of specific instances where IoT interventions are helping to solve some of the world’s most pressing issues. It presents summary conclusions on what is required for the IoT to reach billions of people living in the developing world, and also to accelerate income growth and social development as a result. Information and communication technologies (ICTs) such as mobile phones, Internet use and Big Data analytics are pervasively utilized in global development projects (in a field often known as ICT for Development, or ICT4D) to improve outcomes and deliver services. Recently, this field has experienced strong growth. For example, in a recent presentation, Carolyn Woo, CEO of Catholic Relief Services (CRS), identified 157 new development assistance projects, each started by CRS between 2014 and 2015, that incorporate ICTs (primarily mobile telephony). Similarly, at Johns Hopkins University alone, as of May 2015, there were over 140 mHealth (mobile phone-enabled healthcare) projects across the developing world. And an April 2015 review at the World Bank identified at least thirty-two projects that specifically incorporate Big Data analytics. As evidenced by these examples, mobiles are highly integrated in development projects already. Connected sensors and M2M connectivity represent the next frontier in the ICT4D story.

TulaSalud: An m-health system for maternal and infant mortality reduction in Guatemala

Summary The Guatemalan NGO (Non-Governmental Organization) TulaSalud has implemented an m-health project in the Department of Alta Verapaz. This Department has 1.2 million inhabitants (78% living in rural areas and 89% from indigenous communities) and in 2012, had a maternal mortality rate of 273 for every 100,000 live births. This m-health initiative is based on the provision of a cell phone to community facilitators (CFs). The CFs are volunteers in rural communities who perform health prevention, promotion and care. Thanks to the cell phone, the CFs have become tele-CFs who able to carry out consultations when they have questions; send full epidemiological and clinical information related to the cases they attend to; receive continuous training; and perform activities for the prevention and promotion of community health through distance learning sessions in the Q’eqchí and/or Poqomchi’ languages. In this study, rural populations served by tele-CFs were selected as the intervention group while the control group was composed of the rural population served by CFs without Information and Communication Technology (ICT) tools. As well as the achievement of important process results (116,275 medical consultations, monitoring of 6,783 pregnant women, and coordination of 2,014 emergency transfers), the project has demonstrated a statistically significant decrease in maternal mortality (p < 0.05) and in child mortality (p = 0.054) in the intervention group compared with rates in the control group. As a result of the telemedicine initiative, the intervention areas, which were selected for their high maternal and infant mortality rates, currently show maternal and child mortality indicators that are not only lower than the indicators in the control area, but also lower than the provincial average (which includes urban areas).

Evaluating success of mobile health projects in the developing world.

Many mobile health (mHealth) projects, typically deploying pilot or small scale implementations, have been undertaken in developing world settings and reported with a widely varying range of claims being made on their effectiveness and benefits. As a result, there is little evidence for which aspects of such projects lead to successful outcomes. This paper describes a literature review of papers from PubMed undertaken to identify strong contributions to execution and evaluation of mHealth projects in developing world settings, and suggests a template for classifying the main success factors to assist with collating evidence in the future.

Sexual and reproductive health and rights and mHealth in policy and practice in South Africa

Information and Communications Technology (ICT) offers enormous opportunity and innovation to improve public health and health systems.This paper explores the intersections between mHealth and sexual and reproductive health and rights in both policy and practice. It is a qualitative study, informed by policy review and key informant interviews. Three case studies provide evidence of what is happening on the ground in relation to ICTs and reproductive health and rights. We argue that in terms of policy, there is little overlap between health rights and communication technology. In the area of practice, however, significant interventions address aspects of reproductive health. At present, the extent to which mHealth addresses the full range of reproductive justice and sexual and reproductive health and rights is limited, particularly in terms of government initiatives. The paper argues that mHealth projects tend to avoid contentious aspects of sexual health, while addressing favourable topics such as pregnancy and motherhood. The ways in which information is framed in mHealth mirrors current gaps within sexual and reproductive health and rights, where a limited and conservative lens predominates, and which may result in narrow programming and implementation of services.

The RAFT Telemedicine Network: Lessons Learnt and Perspectives from a Decade of Educational and Clinical Services in Low- and Middle-Incomes Countries.

Background: The objectives of this paper are to (i) provide an overview of the educational and clinical experiences of the Réseau en Afrique Francophone pour la Télémédecine (RAFT) network, (ii) analyze key challenges and lessons learnt throughout a decade of activity, and (iii) draw a vision and perspectives of its sustainability.Methods: The study was carried out following three main stages: (i) a literature review, (ii) the analysis of key documents, and (iii) discussions with key collaborators of the RAFT.Results: Réseau en Afrique Francophone pour la Télémédecine has been offering an important quantity of educational, clinical, and public health activities during the last decade. The educational activities include the weekly delivery of video-lectures for continuing and post-graduate medical education, the use of virtual patients for training in clinical decision making, research training activities using ICTs and other e-learning activities. The clinical and public health activities include tele-expertise to support health professionals in the management of difficult clinical cases, the implementation of clinical information systems in African hospitals, the deployment of mHealth projects, etc. Since 2010, the RAFT has been extended to the Altiplano in Bolivia and Nepal (in progress).Lessons Learnt and Perspectives: Important lessons have been learnt from the accumulated experiences throughout these years. These lessons concern: social and organization, human resources, technologies and data security, policy and legislation, and economy and financing. Also, given the increase of the activities and the integration of eHealth and telemedicine in the health system of most of the countries, the RAFT network faces many other challenges and perspectives such as learning throughout life, recognition, and valorization of teaching or learning activities, the impact evaluation of interventions, and the scaling up and transferability out of Africa of RAFT activities. Based on the RAFT experience, effective integration and optimum use of eHealth and telemedicine in low- and middle-income countries (LMICs) health systems should take into account the context (resources, infrastructure, and funding), the needs of key stakeholders, and the results derived from theoretical and practical experience. The relevant items highlighted to illustrate the sustainability of the RAFT network and the analyses performed in this study, should serve as discussion basis for the development of eHealth and telemedicine in LMICs.

Successfully Addressing Challenges to Implementing a Multinational SMS-based Reminder and Data Collection System in a Biomedical HIV Prevention Trial

AIDS Research and Human RetrovirusesVol. 30, No. S1 Behavioral and Social SciencesSuccessfully Addressing Challenges to Implementing a Multinational SMS-based Reminder and Data Collection System in a Biomedical HIV Prevention TrialWilliam BrownIII, Rebecca Giguere, Mobolaji Ibitoye, Alex Carballo-Diéguez, and Ross D. CranstonWilliam BrownIIIColumbia University, HIV Center for Clinical and Behavioral Studies, New York, NY, United StatesColumbia University, Biomedical Informatics, New York, NY, United StatesSearch for more papers by this author, Rebecca GiguereColumbia University, HIV Center for Clinical and Behavioral Studies, New York, NY, United StatesSearch for more papers by this author, Mobolaji IbitoyeColumbia University, HIV Center for Clinical and Behavioral Studies, New York, NY, United StatesSearch for more papers by this author, Alex Carballo-DiéguezColumbia University, HIV Center for Clinical and Behavioral Studies, New York, NY, United StatesSearch for more papers by this author, and Ross D. CranstonUniversity of Pittsburgh, Department of Medicine, Pittsburgh, PA, United StatesSearch for more papers by this authorPublished Online:30 Oct 2014https://doi.org/10.1089/aid.2014.5159.abstractAboutSectionsView articleView Full TextPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"Successfully Addressing Challenges to Implementing a Multinational SMS-based Reminder and Data Collection System in a Biomedical HIV Prevention Trial." AIDS Research and Human Retroviruses, 30(S1), p. A87FiguresReferencesRelatedDetailsCited ByAre participants concerned about privacy and security when using short message service to report product adherence in a rectal microbicide trial?24 August 2017 | Journal of the American Medical Informatics Association, Vol. 25, No. 4Brief Participant-Centered Convergence Interviews Integrate Self-Reports, Product Returns, and Pharmacokinetic Results to Improve Adherence Measurement in MTN-01726 October 2017 | AIDS and Behavior, Vol. 22, No. 3Factors Supporting and Hindering Adherence to Rectal Microbicide Gel Use with Receptive Anal Intercourse in a Phase 2 Trial19 August 2017 | AIDS and Behavior, Vol. 22, No. 2High levels of adherence to a rectal microbicide gel and to oral Pre-Exposure Prophylaxis (PrEP) achieved in MTN-017 among men who have sex with men (MSM) and transgender women27 July 2017 | PLOS ONE, Vol. 12, No. 7Scoping review and evaluation of SMS/text messaging platforms for mHealth projects or clinical interventionsInternational Journal of Medical Informatics, Vol. 101 Volume 30Issue S1Oct 2014 InformationCopyright 2014, Mary Ann Liebert, Inc.To cite this article:William BrownIII, Rebecca Giguere, Mobolaji Ibitoye, Alex Carballo-Diéguez, and Ross D. Cranston.Successfully Addressing Challenges to Implementing a Multinational SMS-based Reminder and Data Collection System in a Biomedical HIV Prevention Trial.AIDS Research and Human Retroviruses.Oct 2014.A87-A87.http://doi.org/10.1089/aid.2014.5159.abstractPublished in Volume: 30 Issue S1: October 30, 2014PDF download

Healthcare Information For All By 2015

This paper reports on the Mobile Healthcare Information For All By 2015 (mHIFA) initiative led by the Health Information For All 2015 (HIFA2015) 2012-2015 Challenge Working Group. It discusses the preliminary findings of a scoping exercise to identify global current, completed and planned projects that use mobile phones to provide healthcare information, particularly maternal, child and first-aid, in low- and middle-income countries, that appear to be aligned to the mHIFA Goal. Despite a plethora of mHealth projects on a wide range of mHealth topics, only nine projects were closely related to the mHealthcare Goal. Findings of the scoping exercise were made available on the HIFA2015 Discussion Forums to instigate feedback from key healthcare and telecom stakeholders. An assessment tool was created to help telecom providers and potential providers to assess relevance to the mHIFA Goal.

Mobile health innovations for improved access to safe abortion in Indonesia

Objectives: In recent years mobile phones have rapidly evolved as tools for health promotion and disease prevention in low-resource settings. While mobile health (mHealth) projects have successfully demonstrated improvements in sexual and reproductive health outcomes to date no full-scale mHealth project exists for improving information access or outcomes for abortion. This study aims to facilitate the development of a prototype mHealth smartphone application to provide information about and increase access to safe abortion in Indonesia. Methods: Between October 2013 and January 2014 15 in-depth interviews were conducted in collaboration with a safe abortion hotline among Indonesian women aged 18 or older who had safely self-induced abortion using misoprostol. Interviews explored four areas of interest: information needs about safe abortion including questions or concerns about misoprostol; individual mobile phone access and use patterns; comfort and literacy with mobile technologies; and desirable features of a safe abortion mHealth smartphone application. IRB approval was granted by the UCSF committee on human research. Results: Preliminary results suggest that a smartphone application providing information about safe abortion would be desirable for women in Indonesia. Suggested features include instructions on protocol and administration of misoprostol for abortion photographs and warnings about counterfeit misoprostol reminders to take pills information about normal side effects information about when to seek care and geocoded maps for local health facilities. Conclusions: Given the proliferation of smartphone use in Indonesia and elsewhere there is great promise for mobile technology to empower women seeking abortion with accurate information about and improved access to safe medical abortion. Copyright © 2014 Elsevier Inc. All rights reserved.

Review of mobile health technology for military mental health.

Mental health problems pose challenges for military veterans, returning service members, and military family members including spouses and children. Challenges to meeting mental health needs include improving access to care and improving quality of care. Mobile Health, or "mHealth," can help meet these needs in the garrison and civilian environments. mHealth brings unique capabilities to health care provision through the use of mobile device technologies. This report identifies high-priority mHealth technology development considerations in two categories. First, priority considerations specific to mental health care provision include safety, privacy, evidence-based practice, efficacy studies, and temperament. Second, priority considerations broadly applicable to mHealth include security, outcomes, ease of use, carrier compliance, hardware, provider perspectives, data volume, population, regulation, command policy, and reimbursement. Strategic planning for the advancement of these priority considerations should be coordinated with stated Department of Defense capability needs to maximize likelihood of adoption. This report also summarizes three leading, military programs focused on mHealth projects in mental health, The Telemedicine and Advanced Technology Research Center, The Military Operational Medicine Research Program, United States Army Medical Research and Materiel Command, and The National Center for Telehealth and Technology.

Strategies for mHealth research: lessons from 3 mobile intervention studies.

The capacity of Mobile Health (mHealth) technologies to propel healthcare forward is directly linked to the quality of mobile interventions developed through careful mHealth research. mHealth research entails several unique characteristics, including collaboration with technologists at all phases of a project, reliance on regional telecommunication infrastructure and commercial mobile service providers, and deployment and evaluation of interventions "in the wild", with participants using mobile tools in uncontrolled environments. In the current paper, we summarize the lessons our multi-institutional/multi-disciplinary team has learned conducting a range of mHealth projects using mobile phones with diverse clinical populations. First, we describe three ongoing projects that we draw from to illustrate throughout the paper. We then provide an example for multidisciplinary teamwork and conceptual mHealth intervention development that we found to be particularly useful. Finally, we discuss mHealth research challenges (i.e. evolving technology, mobile phone selection, user characteristics, the deployment environment, and mHealth system "bugs and glitches"), and provide recommendations for identifying and resolving barriers, or preventing their occurrence altogether.

Systematic review on what works, what does not work and why of implementation of mobile health (mHealth) projects in Africa

BackgroundAccess to mobile phone technology has rapidly expanded in developing countries. In Africa, mHealth is a relatively new concept and questions arise regarding reliability of the technology used for health outcomes. This review documents strengths, weaknesses, opportunities, and threats (SWOT) of mHealth projects in Africa.MethodsA systematic review of peer-reviewed literature on mHealth projects in Africa, between 2003 and 2013, was carried out using PubMed and OvidSP. Data was synthesized using a SWOT analysis methodology. Results were grouped to assess specific aspects of project implementation in terms of sustainability and mid/long-term results, integration to the health system, management process, scale-up and replication, and legal issues, regulations and standards.ResultsForty-four studies on mHealth projects in Africa were included and classified as: “patient follow-up and medication adherence” (n = 19), “staff training, support and motivation” (n = 2), “staff evaluation, monitoring and guidelines compliance” (n = 4), “drug supply-chain and stock management” (n = 2), “patient education and awareness” (n = 1), “disease surveillance and intervention monitoring” (n = 4), “data collection/transfer and reporting” (n = 10) and “overview of mHealth projects” (n = 2). In general, mHealth projects demonstrate positive health-related outcomes and their success is based on the accessibility, acceptance and low-cost of the technology, effective adaptation to local contexts, strong stakeholder collaboration, and government involvement. Threats such as dependency on funding, unclear healthcare system responsibilities, unreliable infrastructure and lack of evidence on cost-effectiveness challenge their implementation. mHealth projects can potentially be scaled-up to help tackle problems faced by healthcare systems like poor management of drug stocks, weak surveillance and reporting systems or lack of resources.ConclusionsmHealth in Africa is an innovative approach to delivering health services. In this fast-growing technological field, research opportunities include assessing implications of scaling-up mHealth projects, evaluating cost-effectiveness and impacts on the overall health system.

MHealth in Africa: challenges and opportunities

Over the past decade, Africa has experi- enced an incredible boom in mobile phone use. In 1998, there were fewer than 4 million mobile subscriptions on the continent, but today, there are more than 800 million subscriptions, and this is pro- jected to reach 1.12 billion subscriptions by 2017.1 Various studies2,3 on pilot pro- jects implemented in Africa support the claim that mobile technologies have the potential to transform the face of health- care by serving as vehicles for delivering specific health interventions. This form of health service delivery, known as mHealth, is seen as a complementary strategy for strengthening health systems and achiev- ing the health-related Millennium Development Goals (MDGs) in low- income countries.DEFINING mHEALTHThe term mHealth was coined by Professor Robert Istepanian, who described it broadly as the use of 'emerging mobile communications and network technologies for healthcare'.4 Essentially, mHealth is the use in medi- cine and public health of mobile commu- nication devices 'such as mobile phones, patient monitoring devices, personal digi- tal assistants (PDAs), and other wireless devices,'5 to 'enhance access to health information, improve distribution of rou- tine and emergency health services, or provide diagnostic services'.6mHealth platforms operate on the premise that technology integration with the health sector has the potential to improve health outcomes.7 Today, countries such as Ethiopia, Kenya, Nigeria and South Africa are leading the way in using mHealth solutions for health service delivery,8 and this is driven by the convergence of a myriad of factors - expanding penetration of mobile net- works in rural communities, reduced costs of mobile handsets, general increase in non-food expenditure and innovative technologies that integrate mobile applications with traditional health service delivery models. mHealth has found applications in treatment compli- ance, data collection and disease surveil- lance, health informa- tion dissemination, point-of-care support for health workers, health promotion, emergency medical response, as well as drug supply-chain management.OPPORTUNITIESmHealth implementa- tion in Africa has the potential to improve health outcomes in many ways. The portability and 'always on' features of mobile phones, along with their increasing capability to carry and transfer data, make them unique for relaying health information.9 In addition, the functional and structural properties, namely, low start cost, text messaging and flexible data plans make mobile phones attractive for use in healthcare interventions.10In pilot projects across the continent, the short messaging service (SMS) appli- cation has been successfully used to remind patients to take drugs and attend appointments. Studies on the use of SMS as a drug use reminder, conducted in Kenya and Uganda, showed improved adherence to antiretroviral therapy (ART) without additional counselling among HIV positive clients.2,3 While most of these projects have focused more on infectious disease treatment adherence, chronic disease management applica- tions will become more relevant as epi- demiological shifts to chronic disease accelerate on the continent. However, poor or inconsistent access to health services and drug supplies may frustrate mHealth implementation in the context of treatment compliance in some areas; thus, strengthening health systems is important for successful implementation.10mHealth projects that focus on data collection and dis- ease surveillance leverage on mobile phones' abilities to collect and transmit data in real time. While studies have shown that mobile phones and PDAs are more effective in data collection compared with traditional pen and paper data collection methods, there is very little evidence that they improve health outcomes.10-13 However, one primary benefit of projects utilising mobile phones' data gathering and storage capabilities is that they could actually save government money. …

The Mobile is Part of a Whole

A challenge with mHealth in developing countries is that implementations are frequently treated as standalone solutions. Implementations fail because they are not sufficiently aligned with existing health information infrastructures (II). An interesting tool for evaluating implementation efforts in the context of the overall health II strategy, and thus potentially useful for identifying and mitigating risks, is the Bootstrap strategy. Bootstrapping is concerned with addressing take-off challenges facing novel solution implementations through incremental progression, resource maximization, mutual learning, and complexity mitigation. Although the strategy has been previously employed in retrospect to explain how implementation take-off challenges can be alleviated, less is known about its effectiveness as a tool for real time implementation risk assessment. Drawing on an action research mHealth project in Malawi, the study confirms bootstrapping as an effective tool for risk assessment, although the case also reveals that it may not always be easy to mitigate risks identified.

Profiling e-health projects in Africa: trends and funding patterns

There is a severe shortage of healthcare provision in Africa. e-Health, the use of Information and Communication Technologies (ICT) to support healthcare, may help to ease this problem. e-Health projects support a wide range of applications ranging from telemedicine to global research collaborations made possible via e-Infrastructures, worldwide systems of integrated advanced high performance networking and computing ICT. To try to understand the state of e-Health in Africa, this paper aims to create a picture and to present an analytical review of some of these initiatives in Africa. A review framework composed of multiple search methods is developed and applied to yield a broad coverage of e-Health projects over the African continent. Seven quantitative analyses on the projects are presented. Major observations include that there is a tendency for e-Health projects to grow in number in some African countries over time; that African countries with larger Gross National Incomes tend to attract more e-Health projects; that e-Health projects in Africa focus on telemedicine, health education and health-related research; that there is a wide range of funding bodies, some of which have a geographical focus, and that the number of m-Health projects has been rising sharply.

Bridging the Human Resource Gap in Primary Health Care Delivery Systems of Developing Countries With mHealth: Narrative Literature Review.

BackgroundMobile health (mHealth) has the potential to solve human resource issues in the health care sector. mHealth is of particular interest in developing countries, where widespread mobile networks and access to devices are connecting people like never before.ObjectiveThe aim of this paper was to review published and unpublished literature, field projects, and pilot studies on mHealth usage in overcoming shortage of human health resources in developing countries.MethodsA narrative literature review was undertaken using an iterative approach in extracting literature focused on mHealth and human health resources of low-income countries, especially India. The present review has undertaken comprehensive coverage of the work on related field projects that have been either published, accepted for publication, or pilot tested.ResultsThis review presented the use of mHealth across various dimensions of primary health care, including data collection, disease surveillance, health education, supervision, monitoring, and feedback. Field studies of fast, error-free data collection and transmission using mHealth were also documented. New apps for supervision, monitoring, and utilization of innovative health education tools were documented in the current review. Practical limitations of mHealth and challenges set forth in developing countries included issues of data security, cost constraints, health provider privacy, and technical barriers.ConclusionsIn the present review, we have documented a few mHealth projects that contribute to the proficient use of human resources. These projects pave the path for the efficient utilization of mHealth, offering solutions to emerging human resource challenges and simultaneously revamping the health care delivery in resource-limited settings.

MHealth Series: mHealth project in Zhao County, rural China – Description of objectives, field site and methods

BackgroundWe set up a collaboration between researchers in China and the UK that aimed to explore the use of mHealth in China. This is the first paper in a series of papers on a large mHealth project part of this collaboration. This paper included the aims and objectives of the mHealth project, our field site, and the detailed methods of two studies.Field siteThe field site for this mHealth project was Zhao County, which lies 280 km south of Beijing in Hebei Province, China.MethodsWe described the methodology of two studies: (i) a mixed methods study exploring factors influencing sample size calculations for mHealth–based health surveys and (ii) a cross–over study determining validity of an mHealth text messaging data collection tool. The first study used mixed methods, both quantitative and qualitative, including: (i) two surveys with caregivers of young children, (ii) interviews with caregivers, village doctors and participants of the cross–over study, and (iii) researchers’ views. We combined data from caregivers, village doctors and researchers to provide an in–depth understanding of factors influencing sample size calculations for mHealth–based health surveys. The second study, a cross–over study, used a randomised cross–over study design to compare the traditional face–to–face survey method to the new text messaging survey method. We assessed data equivalence (intrarater agreement), the amount of information in responses, reasons for giving different responses, the response rate, characteristics of non–responders, and the error rate.ConclusionsThis paper described the objectives, field site and methods of a large mHealth project part of a collaboration between researchers in China and the UK. The mixed methods study evaluating factors that influence sample size calculations could help future studies with estimating reliable sample sizes. The cross–over study comparing face–to–face and text message survey data collection could help future studies with developing their mHealth tools.

Mobile technology-enabled healthcare service delivery systems for community health workers in Kenya: a technology-to-performance chain perspective

Mobile technology-enabled healthcare service delivery systems for community health workers in Kenya: a technology-to-performance chain perspective