Mobile Health Technologies May Be Acceptable Tools for Providing Social Support to Tuberculosis Patients in Rural Uganda: A Parallel Mixed-Method Study

Article Author(s): Angella Musiimenta,1,2 Wilson Tumuhimbise,1 Esther C. Atukunda,1 Aaron T. Mugaba,1,2 Conrad Muzoora,1 Mari Armstrong-Hough,3,4,5,6 David Bangsberg,7 J. Lucian Davis,3,4,5 and Jessica E. Haberer8,9


Background. Social support has been shown to mitigate social barriers to medication adherence and improve tuberculosis (TB) treatment success rates. The use of mobile technology to activate social support systems among TB patients, however, has not been well explored. Moreover, studies that tie supportive SMS (Short Message Service) texts to electronic monitoring of TB medication adherence are lacking. Objective. To explore TB patientscurrent access to social support and perceptions of utilizing real-time adherence monitoring interventions to support medication adherence. Methods. We purposively selected TB patients who owned phones, had been taking TB medications for 1 month, were receiving their treatment from Mbarara Regional Referral Hospital, and reported having 1 social supporter. We interviewed these patients and their social supporters about their access to and perceptions of social support. We used STATA 13 to describe participantssociodemographic and social support characteristics. Qualitative data were analyzed using content analysis to derive categories describing accessibility and perceptions. Results. TB patients report requesting and receiving a variety of dierent forms of social support, including instrumental (e.g., money for transport and other needs and medication reminders), emotional (e.g., adherence counselling), and informational (e.g., medication side eects) support through mobile phones. Participants felt that SMS notications may motivate medication adherence by creating a personal sense of obligation to take medications regularly. Participants anticipated that limited nancial resources and relationship dynamics could constrain the provision of social support especially when patients and social supporters are not oriented about their expectations. Conclusion. Mobile telephones could provide alternative approaches to providing social support for TB medication adherence especially where patients do not stay close to their social supporters. Further eorts should focus on optimized designs of mobile phone-based applications for providing social support to TB patients and training of TB patients and social supporters to match their expectations.

Bibliographical metadata

Journal Hindawi
Related Faculties/Schools

1 Mbarara University of Science and Technology, Mbarara, Uganda

2 Angels Compassion Research and Innovations Centre, Mbarara, Uganda

3 Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda

4 Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA

5 Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut, USA

6 New York University College of Global Public Health, New York, New York, USA

7 Oregon Health & Science University-Portland State University School of Public Health, USA

8 Harvard Medical School, Boston, MA, USA

9 Massachusetts General Hospital Center for Global Health, Boston, MA, USA