Establishing an independent mobile health program for chronic disease self-management support in bolivia.
No Thumbnail Available
Date
2014-08-28
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
BACKGROUND Mobile health m health work in low and middle income countries LMICs mainly consists of small pilot programs with an unclear path to scaling and dissemination We describe the deployment and testing of an m health platform for non communicable disease NCD self management support in Bolivia METHODS Three hundred sixty four primary care patients in La Paz with diabetes or hypertension completed surveys about their use of mobile phones health and access to care One hundred sixty five of those patients then participated in a 12 week demonstration of automated telephone monitoring and self management support Weekly interactive voice response IVR calls were made from a platform established at a university in La Paz under the direction of the regional health ministry RESULTS Thirty seven percent of survey respondents spoke indigenous languages at home and 38 had six or fewer years of education Eighty two percent had a mobile phone 45 used text messaging with a standard phone and 9 had a smartphone Smartphones were least common among patients who were older spoke indigenous languages or had less education IVR program participants completed 1007 self management support calls with an overall response rate of 51 IVR call completion was lower among older adults but was not related to patients ethnicity health status or healthcare access IVR health and self care reports were consistent with information reported during in person baseline interviews Patients likelihood of reporting excellent very good or good health versus fair or poor health via IVR increased during program participation and was associated with better medication adherence Patients completing follow up interviews were satisfied with the program with 19 20 95 reporting that they would recommend it to a friend CONCLUSION By collaborating with LMICs m health programs can be transferred from higher resource centers to LMICs and implemented in ways that improve access to self management support among people with NCDs