Browsing by Author "Tomlinson, Mark"
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- ItemAntenatal depression case finding by community health workers in South Africa: feasibility of a mobile phone application.(2014-09-17) Tsai, Alexander C; Tomlinson, Mark; Dewing, Sarah; le Roux, Ingrid M; Harwood, Jessica M; Chopra, Mickey; Rotheram-Borus, Mary JaneRandomized controlled trials conducted in resource limited settings have shown that once women with depressed mood are evaluated by specialists and referred for treatment lay health workers can be trained to effectively administer psychological treatments We sought to determine the extent to which community health workers could also be trained to conduct case finding using short and ultrashort screening instruments programmed into mobile phones Pregnant Xhosa speaking women were recruited independently in two cross sectional studies N 1 144 and N 361 conducted in Khayelitsha South Africa and assessed for antenatal depression In the smaller study community health workers with no training in human subject research were trained to administer the Edinburgh Postnatal Depression Scale EPDS during the routine course of their community based outreach We compared the operating characteristics of four short and ultrashort versions of the EPDS with the criterion standard of probable depression defined as an EPDS 10 13 The prevalence of probable depression 475 1144 42 and 165 361 46 was consistent across both samples The 2 item subscale demonstrated poor internal consistency Cronbach s ranged from 0 55 to 0 58 All four subscales demonstrated excellent discrimination with area under the receiver operating characteristic curve AUC values ranging from 0 91 to 0 99 Maximal discrimination was observed for the 7 item depressive symptoms subscale at the conventional screening threshold of 10 it had 0 97 sensitivity and 0 76 specificity for detecting probable antenatal depression The comparability of the findings across the two studies suggests that it is feasible to use community health workers to conduct case finding for antenatal depression
- ItemDiabetes buddies: peer support through a mobile phone buddy system.(2012-05-15) Rotheram-Borus, Mary Jane; Tomlinson, Mark; Gwegwe, Margaret; Comulada, W Scott; Kaufman, Neal; Keim, MarionPURPOSE The purpose of this study is to test the feasibility and acceptability of a mobile phone based peer support intervention among women in resource poor settings to self manage their diabetes Secondary goals were to evaluate the intervention s effectiveness to motivate diabetes related health choices METHODS Women with diabetes n 22 in Cape Town South Africa participated in a 12 week program focused on providing and applying knowledge of health routines to manage diabetes Women were linked with a buddy via a mobile phone for support and were questioned daily about a health behavior via text message Women were assessed at recruitment and then 3 and 6 months later by a trained interviewer using a mobile phone for data collection The women were evaluated on technology uptake reduction of body mass index blood glucose levels and increases in positive coping and general health seeking behaviors RESULTS Women exchanged 16 739 text messages to buddies and received 3144 texts from the project Women responded to 29 of texted questions n 1321 14 582 Women attended at least 9 of 12 possible intervention sessions a third attended all 12 sessions n 8 22 Between baseline and 3 months women increased their sleep and reported a higher level of positive action and social support coping yet blood glucose increased by 3 3 points From 3 to 6 months spiritual hope decreased and diastolic blood pressure increased One year later the 22 women continue to attend meetings CONCLUSIONS Mobile phones are an easy and reliable way to provide peer support and disseminate health messages Both positive and negative changes were observed in this pilot study
- ItemPoint of care in your pocket: a research agenda for the field of m-health.(2012-05-16) van Heerden, Alastair; Tomlinson, Mark; Swartz, Leslie
- ItemProject Masihambisane: a cluster randomised controlled trial with peer mentors to improve outcomes for pregnant mothers living with HIV.(2011-01-19) Rotheram-Borus, Mary-Jane; Richter, Linda; Van Rooyen, Heidi; van Heerden, Alastair; Tomlinson, Mark; Stein, Alan; Rochat, Tamsen; de Kadt, Julia; Mtungwa, Nonhle; Mkhize, Lungile; Ndlovu, Lindo; Ntombela, Lungile; Comulada, W Scott; Desmond, Katherine A; Greco, ErinBACKGROUND Pregnant women living with HIV WLH face daily challenges maintaining their own and their babies health and mental health Standard Prevention of Maternal to Child Transmission PMTCT programs are not designed to address these challenges METHODS DESIGN As part of a cluster randomized controlled trial WLH are invited to attend four antenatal and four postnatal small group sessions led by a peer WLH a Peer Mentor The WLH and their babies are assessed during pregnancy and at one week six months and twelve months post birth Mobile phones are used to collect routine information complete questionnaires and remain in contact with participants over time Pregnant WLH N 1200 are randomly assigned by clinic N 8 clinics to an intervention program called Masihambisane n 4 clinics n 600 WLH or a standard care PMTCT control condition n 4 clinics n 600 WLH DISCUSSION Data collection with cellular phones are innovative and effective in low resource settings Standard PMTCT programs are not designed to address the daily challenges faced by WLH Peer Mentors may be useful in supporting WLH to cope with these challenges TRIAL REGISTRATION ClinicalTrials gov registration NCT00972699
- ItemScaling up mHealth: where is the evidence?(2013-02-20) Tomlinson, Mark; Rotheram-Borus, Mary Jane; Swartz, Leslie; Tsai, Alexander C
- ItemThe use of mobile phones as a data collection tool: a report from a household survey in South Africa.(2010-01-26) Tomlinson, Mark; Solomon, Wesley; Singh, Yages; Doherty, Tanya; Chopra, Mickey; Ijumba, Petrida; Tsai, Alexander C; Jackson, DebraBACKGROUND To investigate the feasibility the ease of implementation and the extent to which community health workers with little experience of data collection could be trained and successfully supervised to collect data using mobile phones in a large baseline survey METHODS A web based system was developed to allow electronic surveys or questionnaires to be designed on a word processor sent to and conducted on standard entry level mobile phones RESULTS The web based interface permitted comprehensive daily real time supervision of CHW performance with no data loss The system permitted the early detection of data fabrication in combination with real time quality control and data collector supervision CONCLUSIONS The benefits of mobile technology combined with the improvement that mobile phones offer over PDA s in terms of data loss and uploading difficulties make mobile phones a feasible method of data collection that needs to be further explored
- ItemValue of a mobile information system to improve quality of care by community health workers.(2014-08-22) Tomlinson, Mark; Rotheram-Borus, Mary Jane; Doherty, Tanya; Swendeman, Dallas; Tsai, Alexander C; Ijumba, Petrida; le Roux, Ingrid; Jackson, Debra; Stewart, Jackie; Friedman, Andi; Colvin, Mark; Chopra, MickeyINTRODUCTION We will be unable to achieve sustained impact on health outcomes with community health worker CHW based interventions unless we bridge the gap between small scale efficacy studies and large scale interventions Effective strategies to support the management of CHWs are central to bridging the gap Mobile phones are broadly available particularly in low and middle income countries LAMIC s where the penetration rate approaches 100 In this article we describe how mobile phones may be combined with mobile web based technology to assist in the management of CHWs in two projects in South Africa METHODS This paper is a descriptive one drawing lessons from two Randomised Controlled Trials RCT s outlining how a mobile phone information system can be utilized to enhance the quality of health interventions We organized our comprehensive management and supervision system around a previously published management framework The system is composed of mobile phones utilized by CHWs and a web based interface utilized by CHW supervisors Computerized algorithms were designed with intervention and assessment protocols to aid in the real time supervision and management of CHWs RESULTS CHWs used mobile phones to initiate intervention visits and trigger content to be delivered during the course of intervention visits Supervisors used the web based interface for real time monitoring of the location timing and content of intervention visits Additional real time support was provided through direct support calls in the event of crises in the field CONCLUSION Mobile phone based information system platforms offer significant opportunities to improve CHW delivered interventions The extent to which these efficiency gains can be translated into realized health gains for communities is yet to be tested