18
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      mHealth use for non-communicable diseases care in primary health: patients’ perspective from rural settings and refugee camps

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Non-communicable diseases (NCDs) account for 85% of deaths in Lebanon and contribute to remarkable morbidity and mortality among refugees and underserved populations. This study assesses the perspectives of individuals with hypertension and/or diabetes in rural areas and Palestinian refugee camps towards a population based mHealth intervention called ‘eSahha’.

          Methods

          The study employs a mixed-methods design to evaluate the effectiveness of SMSs on self-reported perceptions of lifestyle modifications. Quantitative data was collected through phone surveys, and qualitative data through focus group discussions. Descriptive statistics and bivariate analysis were performed.

          Results

          About 93.9% ( n = 1000) of respondents perceived the SMSs as useful and easy to read and understand. About 76.9% reported compliance with SMSs through daily behavioral modifications. Women ( P = 0.007), people aged ≥76 years ( P < 0.001), unemployed individuals ( P < 0.001), individuals who only read and write ( P < 0.001) or those who are illiterate ( P < 0.001) were significantly more likely to receive and not read the SMSs. Behavior change across settings was statistically significant ( P < 0.001).

          Conclusion

          While SMS-based interventions targeting individuals with hypertension and/or diabetes were generally satisfactory among those living in rural areas and Palestinian refugee camps in Lebanon, a more tailored approach for older, illiterate and unemployed individuals is needed.

          Keywords

          e-health, refugees

          RESUMEN

          Contexto

          En el Líbano, las enfermedades no transmisibles (ENT) representan el 85 % de las muertes y agravan los altos niveles de morbilidad y mortalidad entre los refugiados y los grupos de población subatendidos. Este estudio evalúa las opiniones de personas con hipertensión y/o diabetes que viven en zonas rurales y en campos de refugiados palestinos con respecto a una intervención de salud móvil basada en la población denominada ‘eSahha’.

          Métodos

          El estudio emplea un diseño de métodos mixtos para evaluar la eficacia de los SMS sobre los cambios en el estilo de vida, según los perciben los propios interesados. Se obtuvieron datos cuantitativos mediante encuestas telefónicas y datos cualitativos a través de debates en grupos de sondeo. Se realizaron estadísticas descriptivas y un análisis bivariante.

          Resultados

          Alrededor del 93,9 % ( n = 1000) de los encuestados opinaron que los SMS son útiles y fáciles de leer y comprender. Un 76,9 % manifestó cumplir con los SMS mediante modificaciones en su comportamiento cotidiano. Las mujeres ( P = 0,007), las personas mayores de 76 años ( P < 0,001), las personas desempleadas ( P < 0,001), las personas que solo sabían leer y escribir ( P < 0,001) o aquellas que eran analfabetas ( P < 0,001) tenían muchas más probabilidades de recibir y no leer los SMS. Los cambios de comportamiento en los distintos entornos tuvieron una importancia estadística ( P < 0,001).

          Conclusión

          Aunque, en general, las intervenciones por SMS orientadas a personas con hipertensión y/o diabetes fueron satisfactorias entre quienes vivían en zonas rurales y en campos de refugiados palestinos del Líbano, se necesita un enfoque más ajustado para las personas mayores, analfabetas y desempleadas.

          Palabras clave

          cibersalud, refugiados

          RÉSUMÉ

          Contexte

          Les maladies non transmissibles sont à l’origine de 85 p. 100 des décès au Liban et contribuent à une morbidité et une mortalité graves chez les réfugiés et les populations mal desservies. Cette étude analyse le point de vue des personnes souffrant d’hypertension ou de diabète dans les régions rurales et dans les camps de réfugiés palestiniens en ce qui a trait à une intervention en santé mobile axée sur la population appelée « eSahha ».

          Méthodes

          L’étude a recours à un modèle regroupant plusieurs méthodes pour évaluer l’efficacité des messages textes sur la façon dont les personnes disent percevoir la modification de leur mode de vie. Des données quantitatives ont été recueillies par des sondages téléphoniques, et des données qualitatives par des discussions thématiques de groupe. L’étude comprend la réalisation de statistiques descriptives et d’analyses bivariées.

          Résultats

          Près de 93,9 p. 100 ( n = 1000) des personnes interrogées perçoivent les messages textes comme utiles et faciles à lire et à comprendre. Environ 76,9 p. 100 ont déclaré se conformer aux messages textes en modifiant chaque jour leur comportement. Les femmes ( P = 0,007), les personnes âgées ≥76 ans ( P < 0,001), les personnes sans emploi ( P < 0,001), les personnes qui ne savent que lire et écrire ( P < 0,001) ou celles qui sont analphabètes ( P < 0,001) sont beaucoup plus disposées à recevoir, mais à ne pas lire les messages textes. Une modification de comportement tous environnements confondus était statistiquement significative ( P < 0,001).

          Conclusion

          Les interventions par messages textes qui ciblent les personnes qui souffrent d’hypertension ou de diabète étaient en général satisfaisantes pour les personnes vivant dans les régions rurales et dans les camps de réfugiés palestiniens au Liban; toutefois, il faut une approche plus adaptée pour les personnes âgées, analphabètes et sans emploi.

          Mots clés

          cybersanté, réfugiés

          Related collections

          Most cited references28

          • Record: found
          • Abstract: found
          • Article: not found

          Prevention and management of chronic disease: a litmus test for health-systems strengthening in low-income and middle-income countries.

          National health systems need strengthening if they are to meet the growing challenge of chronic diseases in low-income and middle-income countries. By application of an accepted health-systems framework to the evidence, we report that the factors that limit countries' capacity to implement proven strategies for chronic diseases relate to the way in which health systems are designed and function. Substantial constraints are apparent across each of the six key health-systems components of health financing, governance, health workforce, health information, medical products and technologies, and health-service delivery. These constraints have become more evident as development partners have accelerated efforts to respond to HIV, tuberculosis, malaria, and vaccine-preventable diseases. A new global agenda for health-systems strengthening is arising from the urgent need to scale up and sustain these priority interventions. Most chronic diseases are neglected in this dialogue about health systems, despite the fact that non-communicable diseases (most of which are chronic) will account for 69% of all global deaths by 2030 with 80% of these deaths in low-income and middle-income countries. At the same time, advocates for action against chronic diseases are not paying enough attention to health systems as part of an effective response. Efforts to scale up interventions for management of common chronic diseases in these countries tend to focus on one disease and its causes, and are often fragmented and vertical. Evidence is emerging that chronic disease interventions could contribute to strengthening the capacity of health systems to deliver a comprehensive range of services-provided that such investments are planned to include these broad objectives. Because effective chronic disease programmes are highly dependent on well-functioning national health systems, chronic diseases should be a litmus test for health-systems strengthening. Copyright © 2010 Elsevier Ltd. All rights reserved.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Effectiveness of mobile phone messaging in prevention of type 2 diabetes by lifestyle modification in men in India: a prospective, parallel-group, randomised controlled trial.

            Type 2 diabetes can often be prevented by lifestyle modification; however, successful lifestyle intervention programmes are labour intensive. Mobile phone messaging is an inexpensive alternative way to deliver educational and motivational advice about lifestyle modification. We aimed to assess whether mobile phone messaging that encouraged lifestyle change could reduce incident type 2 diabetes in Indian Asian men with impaired glucose tolerance. We did a prospective, parallel-group, randomised controlled trial between Aug 10, 2009, and Nov 30, 2012, at ten sites in southeast India. Working Indian men (aged 35-55 years) with impaired glucose tolerance were randomly assigned (1:1) with a computer-generated randomisation sequence to a mobile phone messaging intervention or standard care (control group). Participants in the intervention group received frequent mobile phone messages compared with controls who received standard lifestyle modification advice at baseline only. Field staff and participants were, by necessity, not masked to study group assignment, but allocation was concealed from laboratory personnel as well as principal and co-investigators. The primary outcome was incidence of type 2 diabetes, analysed by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00819455. We assessed 8741 participants for eligibility. 537 patients were randomly assigned to either the mobile phone messaging intervention (n=271) or standard care (n=266). The cumulative incidence of type 2 diabetes was lower in those who received mobile phone messages than in controls: 50 (18%) participants in the intervention group developed type 2 diabetes compared with 73 (27%) in the control group (hazard ratio 0·64, 95% CI 0·45-0·92; p=0·015). The number needed to treat to prevent one case of type 2 diabetes was 11 (95% CI 6-55). One patient in the control group died suddenly at the end of the first year. We recorded no other serious adverse events. Mobile phone messaging is an effective and acceptable method to deliver advice and support towards lifestyle modification to prevent type 2 diabetes in men at high risk. The UK India Education and Research Initiative, the World Diabetes Foundation. Copyright © 2013 Elsevier Ltd. All rights reserved.
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              Collecting data on patient experience is not enough: they must be used to improve care.

                Bookmark

                Author and article information

                Contributors
                Role: Professor of Health Systems and Financing, Founding Director
                Role: Project Coordinator
                Role: Research Officer and Refugee Health Program Coordinator
                Role: Associate Professor
                Role: Assistant Professor and Health Informatics Certificate Coordinator
                Role: Professor, Dalla Lana School of Public Health, Bloomberg Faculty of Nursing
                Role: Director General
                Role: Head of the Social Health and the Primary Health Care department
                Role: Associate Professor, Senior Director of Strategy and Institutional Excellence and Associate Professor of Health Policy
                Journal
                J Public Health (Oxf)
                J Public Health (Oxf)
                pubmed
                Journal of Public Health (Oxford, England)
                Oxford University Press
                1741-3842
                1741-3850
                December 2018
                11 October 2018
                11 October 2018
                : 40
                : Suppl 2 , Advancing health equity and gender equality: Digital health in the Global South
                : ii52-ii63
                Affiliations
                [1 ]Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Riad El Solh, Beirut, Lebanon
                [2 ]Global Health Institute, American University of Beirut, Riad El Solh, Beirut, Lebanon
                [3 ]Department of Pharmaceutical Sciences, School of Pharmacy, Lebanese American University, Beirut, Lebanon
                [4 ]School of Health Policy & Management, Faculty of Health, School of Health Policy and Management, York University, 4700 Keele St., Toronto ON, Canada
                [5 ]Social & Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
                [6 ]Ministry of Public Health, Ministry of Public Health, Beirut, Lebanon
                [7 ]Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates
                Author notes
                Address correspondence to Mohamad Alameddine, E-mail: ma164@ 123456aub.edu.lb
                Article
                fdy172
                10.1093/pubmed/fdy172
                6294037
                30307516
                c8e093b3-224c-463f-8012-87ab247ce256
                © The Author(s) 2018. Published by Oxford University Press on behalf of Faculty of Public Health.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 11 April 2018
                : 14 August 2018
                : 11 September 2018
                Page count
                Pages: 12
                Categories
                Digital health in LMICs: Unpacking health equity and gender dimensions

                Public health
                Public health

                Comments

                Comment on this article