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      An mHealth Framework to Improve Birth Outcomes in Benue State, Nigeria: A Study Protocol

      research-article
      , MD, MPH, FAAP, FIDA 1 , , , MBBS, MPH 1 , , MBBS, MSc 2 , , PhD 3 , , PhD 4 , , MSc 5 , , MSc 6 , , RN, MSN, PNP 1 , , MBBS, MPH, PhD 6
      (Reviewer), (Reviewer)
      JMIR Research Protocols
      JMIR Publications
      mHealth, smart card, HIV, hepatitis B, sickle cell disease, mobile health technology, Nigeria

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          Abstract

          Background

          The unprecedented coverage of mobile technology across the globe has led to an increase in the use of mobile health apps and related strategies to make health information available at the point of care. These strategies have the potential to improve birth outcomes, but are limited by the availability of Internet services, especially in resource-limited settings such as Nigeria.

          Objective

          Our primary objective is to determine the feasibility of developing an integrated mobile health platform that is able to collect data from community-based programs, embed collected data into a smart card, and read the smart card using a mobile phone-based app without the need for Internet access. Our secondary objectives are to determine (1) the acceptability of the smart card among pregnant women and (2) the usability of the smart card by pregnant women and health facilities in rural Nigeria.

          Methods

          We will leverage existing technology to develop a platform that integrates a database, smart card technology, and a mobile phone-based app to read the smart cards. We will recruit 300 pregnant women with one of the three conditions—HIV, hepatitis B virus infection, and sickle cell trait or disease—and four health facilities in their community. We will use Glasgow’s Reach, Effectiveness, Adoption, Implementation, and Maintenance framework as a guide to assess the implementation, acceptability, and usability of the mHealth platform.

          Results

          We have recruited four health facilities and 300 pregnant women with at least one of the eligible conditions. Over the course of 3 months, we will complete the development of the mobile health platform and each participant will be offered a smart card; staff in each health facility will receive training on the use of the mobile health platform.

          Conclusions

          Findings from this study could offer a new approach to making health data from pregnant women available at the point of delivery without the need for an Internet connection. This would allow clinicians to implement evidence-based interventions in real time to improve health outcomes.

          Trial Registration

          ClinicalTrials.gov NCT03027258; https://clinicaltrials.gov/ct2/show/NCT03027258 (Archived by WebCite at http://www.webcitation.org/6owR2D0kE)

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          Most cited references39

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          Heuristic evaluation of user interfaces

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            Point-of-care tests for diagnosing infections in the developing world.

            Infectious diseases continue to cause an enormous burden of death and disability in developing countries. Increasing access to appropriate treatment for infectious diseases could have a major impact on disease burden. Some common infections can be managed syndromically without the need for diagnostic tests, but this is not appropriate for many infectious diseases, in which a positive diagnostic test is needed before treatment can be given. Since many people in developing countries do not have access to laboratory services, diagnosis depends on the availability of point of care (POC) tests. Historically there has been little investment in POC tests for diseases that are common in developing countries, but that is now changing. Lack of regulation of diagnostic tests in many countries has resulted in the widespread use of sub-standard POC tests, especially for malaria, making it difficult for manufacturers of reliable POC tests to compete. In recent years increased investment, technological advances, and greater awareness about the importance of reliable diagnostic tests has resulted in rapid progress. Rapid, reliable and affordable POC tests, requiring no equipment and minimal training, are now available for HIV infection, syphilis and malaria, but POC tests for other infections are urgently needed. Many countries do not have established criteria for licensing and introducing new diagnostic tests, and many clinicians in developing countries have become disillusioned with diagnostic tests and prefer to rely on clinical judgment. Continuing advocacy and training in the use of POC tests are needed, and systems for quality control of POC tests need to be developed if they are to achieve their maximum potential.
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              Quality and rigor of the concept mapping methodology: a pooled study analysis.

              The use of concept mapping in research and evaluation has expanded dramatically over the past 20 years. Researchers in academic, organizational, and community-based settings have applied concept mapping successfully without the benefit of systematic analyses across studies to identify the features of a methodologically sound study. Quantitative characteristics and estimates of quality and rigor that may guide for future studies are lacking. To address this gap, we conducted a pooled analysis of 69 concept mapping studies to describe characteristics across study phases, generate specific indicators of validity and reliability, and examine the relationship between select study characteristics and quality indicators. Individual study characteristics and estimates were pooled and quantitatively summarized, describing the distribution, variation and parameters for each. In addition, variation in the concept mapping data collection in relation to characteristics and estimates was examined. Overall, results suggest concept mapping yields strong internal representational validity and very strong sorting and rating reliability estimates. Validity and reliability were consistently high despite variation in participation and task completion percentages across data collection modes. The implications of these findings as a practical reference to assess the quality and rigor for future concept mapping studies are discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                Journal
                JMIR Res Protoc
                JMIR Res Protoc
                ResProt
                JMIR Research Protocols
                JMIR Publications (Toronto, Canada )
                1929-0748
                May 2017
                26 May 2017
                : 6
                : 5
                : e100
                Affiliations
                [1] 1Global Health Initiative School of Community Health Sciences University of Nevada Las Vegas, NVUnited States
                [2] 2Catholic Caritas Foundation of Nigeria AbujaNigeria
                [3] 3Department of Kinesiology and Community Health University of Illinois Urbana-Champaign, ILUnited States
                [4] 4Center for Minority Health and Health Disparities Research and Education Xavier University Louisiana, LAUnited States
                [5] 5Vitira LLC Arlington, VAUnited States
                [6] 6University of Nigeria NsukkaNigeria
                Author notes
                Corresponding Author: Echezona Edozie Ezeanolue echezona.ezeanolue@ 123456unlv.edu
                Author information
                http://orcid.org/0000-0002-6294-9479
                http://orcid.org/0000-0003-2048-2943
                http://orcid.org/0000-0001-6732-1042
                http://orcid.org/0000-0002-8424-0807
                http://orcid.org/0000-0003-2094-3041
                http://orcid.org/0000-0003-3591-9204
                http://orcid.org/0000-0002-8282-1173
                http://orcid.org/0000-0002-6790-6769
                http://orcid.org/0000-0002-3328-1887
                Article
                v6i5e100
                10.2196/resprot.7743
                5466701
                28550003
                8e72b8f6-4e11-4712-9f2c-fe0346f04949
                ©Echezona Edozie Ezeanolue, Semiu Olatunde Gbadamosi, John Olajide Olawepo, Juliet Iwelunmor, Daniel Sarpong, Chuka Eze, Amaka Ogidi, Dina Patel, Chima Onoka. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 26.05.2017.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.

                History
                : 22 March 2017
                : 20 April 2017
                : 25 April 2017
                : 27 April 2017
                Categories
                Protocol
                Protocol

                mhealth,smart card,hiv,hepatitis b,sickle cell disease,mobile health technology,nigeria

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