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Short message service (SMS)-based intervention to improve treatment adherence among HIV-positive youth in Uganda: focus group findings.

Rana Y, Haberer J, Huang H, Kambugu A, Mukasa B, Thirumurthy H, Wabukala P, Wagner GJ, Linnemayr S - PLoS ONE (2015)

Bottom Line: Youth strongly felt that the success of this intervention hinged on ensuring confidentiality about their HIV-positive status.Participants felt that the intervention would improve their adherence by providing them with needed reminders and social support.Youths' suggestions about intervention logistics related to content, frequency, timing and two-way messages will be helpful to practitioners in the field.

View Article: PubMed Central - PubMed

Affiliation: RAND Health, RAND Corporation, Santa Monica, California, United States of America.

ABSTRACT
This paper presents one of the first qualitative studies to discuss programmatic barriers to SMS-based interventions for HIV-positive youth and discusses pathways through which youth perceive them to work. We conducted six focus groups with 20 male and 19 female HIV-positive youths in two clinics in Kampala, Uganda. We find that youth commonly use SMS as over 90% of this study's youths knew how to read, write and send messages and almost three-fourths of them had phones. Youth strongly felt that the success of this intervention hinged on ensuring confidentiality about their HIV-positive status. Key programmatic challenges discussed where restrictions on phone use and phone sharing that could exclude some youth. Participants felt that the intervention would improve their adherence by providing them with needed reminders and social support. Youths' suggestions about intervention logistics related to content, frequency, timing and two-way messages will be helpful to practitioners in the field.

No MeSH data available.


IMB model adapted to RATA intervention.
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pone.0125187.g001: IMB model adapted to RATA intervention.

Mentions: While SMS-based interventions have shown potential to improve adherence, it is much less clear through which channels (some of which were discussed above) they work. We use the information, motivation and behavioral skills (IMB) model of health as our theoretical framework as it allows us to systematically lay out these channels. The IMB model posits that information is necessary to alter behavior and behavioral skills are needed for more complex tasks, but motivation, both personal and social, is what determines whether an individual acts on that information[18, 19]. As per this model, we hypothesize that SMS messages are likely to positively influence adherence in three important ways (Fig 1). First, at the most basic level, SMS messages may serve as a pure reminder function to address forgetfulness. Second, the message content can provide social support through encouragement (e.g., “stay healthy”; “you can do it”), which we theorize will increase motivation through increased social support and self-efficacy especially during a period of turbulent emotional changes, based on the IMB theory model underlying this analysis. Third, messages can also make the need for and benefits of drug adherence more salient and tangible (e.g., “take your drugs now and be healthy and successful in life”) to counter the pronounced present-biased tendencies of youth.


Short message service (SMS)-based intervention to improve treatment adherence among HIV-positive youth in Uganda: focus group findings.

Rana Y, Haberer J, Huang H, Kambugu A, Mukasa B, Thirumurthy H, Wabukala P, Wagner GJ, Linnemayr S - PLoS ONE (2015)

IMB model adapted to RATA intervention.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400100&req=5

pone.0125187.g001: IMB model adapted to RATA intervention.
Mentions: While SMS-based interventions have shown potential to improve adherence, it is much less clear through which channels (some of which were discussed above) they work. We use the information, motivation and behavioral skills (IMB) model of health as our theoretical framework as it allows us to systematically lay out these channels. The IMB model posits that information is necessary to alter behavior and behavioral skills are needed for more complex tasks, but motivation, both personal and social, is what determines whether an individual acts on that information[18, 19]. As per this model, we hypothesize that SMS messages are likely to positively influence adherence in three important ways (Fig 1). First, at the most basic level, SMS messages may serve as a pure reminder function to address forgetfulness. Second, the message content can provide social support through encouragement (e.g., “stay healthy”; “you can do it”), which we theorize will increase motivation through increased social support and self-efficacy especially during a period of turbulent emotional changes, based on the IMB theory model underlying this analysis. Third, messages can also make the need for and benefits of drug adherence more salient and tangible (e.g., “take your drugs now and be healthy and successful in life”) to counter the pronounced present-biased tendencies of youth.

Bottom Line: Youth strongly felt that the success of this intervention hinged on ensuring confidentiality about their HIV-positive status.Participants felt that the intervention would improve their adherence by providing them with needed reminders and social support.Youths' suggestions about intervention logistics related to content, frequency, timing and two-way messages will be helpful to practitioners in the field.

View Article: PubMed Central - PubMed

Affiliation: RAND Health, RAND Corporation, Santa Monica, California, United States of America.

ABSTRACT
This paper presents one of the first qualitative studies to discuss programmatic barriers to SMS-based interventions for HIV-positive youth and discusses pathways through which youth perceive them to work. We conducted six focus groups with 20 male and 19 female HIV-positive youths in two clinics in Kampala, Uganda. We find that youth commonly use SMS as over 90% of this study's youths knew how to read, write and send messages and almost three-fourths of them had phones. Youth strongly felt that the success of this intervention hinged on ensuring confidentiality about their HIV-positive status. Key programmatic challenges discussed where restrictions on phone use and phone sharing that could exclude some youth. Participants felt that the intervention would improve their adherence by providing them with needed reminders and social support. Youths' suggestions about intervention logistics related to content, frequency, timing and two-way messages will be helpful to practitioners in the field.

No MeSH data available.