The HAART cell phone adherence trial (WelTel Kenya1): a randomized controlled trial protocol
Open accessAbstract
BACKGROUND: The objectives are to compare the effectiveness of cell phone-supported SMS messaging to standard care on adherence, quality of life, retention, and mortality in a population receiving antiretroviral therapy (ART) in Nairobi, Kenya. METHODS AND DESIGN: A multi-site randomized controlled open-label trial. A central randomization centre provided opaque envelopes to allocate treatments. Patients initiating ART at three comprehensive care clinics in Kenya will be randomized to receive either a structured weekly SMS ('short message system' or text message) slogan (the intervention) or current standard of care support mechanisms alone (the control). Our hypothesis is that using a structured mobile phone protocol to keep in touch with patients will improve adherence to ART and other patient outcomes. Participants are evaluated at baseline, and then at six and twelve months after initiating ART. The care providers keep a weekly study log of all phone based communications with study participants. Primary outcomes are self-reported adherence to ART and suppression of HIV viral load at twelve months scheduled follow-up. Secondary outcomes are improvements in health, quality of life, social and economic factors, and retention on ART. Primary analysis is by 'intention-to-treat'. Sensitivity analysis will be used to assess per-protocol effects. Analysis of covariates will be undertaken to determine factors that contribute or deter from expected and determined outcomes. DISCUSSION: This study protocol tests whether a novel structured mobile phone intervention can positively contribute to ART management in a resource-limited setting.
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Seven randomized controlled trials testing effects of SMS communication on various health outcomes reported positive effects.
“For the seven randomised controlled trials testing effects of SMS communication on various health outcomes had reported positive effects [16, 20, 32, 33, 44–49], while the remaining trial showed no effect of mobile alarm devices on treatment adherence for HIV patients [15].”
From Assessing the feasibility of eHealth and mHealth: a systematic review and analysis of initiatives implemented in Kenya (2017) · cites this paper as [20]
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Is it ok 2 txt? Reaching out to adolescents about sexual and reproductive health
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van der Kop, M. L., Muhula, S., Ekström, A., Jongbloed, K., Smillie, K., Abunah, B., Kinagwi, K., Kyomuhangi, L., Gelmon, L., Ojakaa, D., et al. (2016) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x16643457 · Cited by 10 · see citing works
“The WelTel intervention is based on a model of patienthealthcare provider mobile phone communication used in the original WelTel Kenya1 trial.(12,13) Participants randomised to the intervention arm are registered to receive the WelTel mHealth intervention for 12 months, where every Monday morning, customised computer…”
MethodSelf-citationDavey, J., Nguimfack, A., Hares, S., Ponce, W., Sousa, C., & Traca, D. (2012) · 7th International Conference on Appropriate Healthcare Technologies for Developing Countries · doi:10.1049/cp.2012.1466 · Cited by 9 · see citing works
Predicting adoption of mHealth technology in resource constrained environments
Maiga, G., & Namagembe, F. (2014) · IST-Africa Conference (IST-Africa) · doi:10.1109/istafrica.2014.6880628 · Cited by 8 · see citing works
Zafar, S., Hazlewood, G., Dhiman, K., Charlton, A., Then, K. L., Dempsey, E., Lester, R., Hoens, A. M., Lacaille, D., Barnabe, C., et al. (2024) · ACR Open Rheumatology · doi:10.1002/acr2.11652 · Cited by 9 · see citing works
Self-citationTegegne, A. S. (2021) · Scientific African · doi:10.1016/j.sciaf.2021.e00820 · Cited by 6 · see citing works
Hodges, J., Caldwell, S., Cohn, W. F., Flickinger, T., Waldman, A. L., Dillingham, R., Castel, A. D., & Ingersoll, K. S. (2022) · JMIR Research Protocols · doi:10.2196/37748 · Cited by 6 · see citing works
“Mobile health (mHealth) interventions developed to encourage self-management and social support and enhance the mental health of people with HIV have been associated with improvement in antiretroviral therapy (ART) adherence and retention in care for at-risk groups [16-25].”
Caldwell, S., Flickinger, T., Hodges, J., Waldman, A. L., Garofalini, C., Cohn, W. F., Dillingham, R., Castel, A. D., & Ingersoll, K. S. (2023) · JMIR Formative Research · doi:10.2196/48739 · Cited by 7 · see citing works
“Several mHealth interventions have been developed to support self-management and provide social and mental health support for people with HIV, and some of these interventions have been associated with improved antiretroviral therapy adherence [14-21].”
Adoption of Mobile Technology by Farmers in Southwest-Nigeria
Okuboyejo, S. R., & Adejo, A. O. (2012) · International Journal of ICT Research and Development in Africa · doi:10.4018/jictrda.2012070103 · Cited by 5 · see citing works
“Mobile technology has been applied in healthcare (Anhoj & Moldrup, 2004; Miskelly, 2005; Kim and Jeong, 2007; Blake, 2008; Iluyemi, 2008, 2009; Lester et al., 2009; Blake, 2009); tourism (Cheverst et al., 2000; Brown & Chalmers, 2003; Fesenmaier et al., 2003; Brown et al., 2003; Schwinger et al.,…”
MethodFuentes, L. W., Johnson, M., & Holtgrave, D. R. (2015) · AIDS Care · doi:10.1080/09540121.2015.1032204 · Cited by 7 · see citing works
Ameli, V., Haberer, J., Sabin, L. L., Meinck, F., Barlow, J., Taj, L., & Mohraz, M. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-042296 · Cited by 5 · see citing works
Prospects of mHealth to Improve the Health of the Disadvantaged Population in Bangladesh
González, A. L. M., Galaviz‐Mosqueda, A., Villarreal‐Reyes, S., Magana-Rodriguez, R., Rivera, R., Casillas, M., & Villasenor, L. (2014) · CRC Press eBooks · doi:10.1201/b17724-27 · Cited by 4 · see citing works
Assessing Mobile Applications Considered Medical Devices
Queirós, A., Silva, A. G., Ferreira, A., Caravau, H., Cerqueira, M., & Rocha, N. P. (2016) · IGI Global eBooks · doi:10.4018/978-1-4666-9978-6.ch010 · Cited by 4 · see citing works
Bundogji, N., Toma, G., & Khan, A. A. (2022) · PEC Innovation · doi:10.1016/j.pecinn.2022.100067 · Cited by 3 · see citing works
“When SMS messages were used as reminders, they were highly effective in increasing adherence to prescriptionmedication [19-22].”
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Pediatric antiretroviral therapy
Cadilla, A., Qureshi, N. K., & Johnson, D. (2010) · Expert Review of Anti-infective Therapy · doi:10.1586/eri.10.127 · Cited by 3 · see citing works
Chirundu, D. (2017) · TEXILA INTERNATIONAL JOURNAL OF CLINICAL RESEARCH · doi:10.21522/tijcr.2014.04.01.art004 · Cited by 2 · see citing works
Potgieter, J.-H. (2014) · University of the Witwatersrand, Johannesburg Institutional Repository on DSpace (University of the Witwatersrand, Johannesburg)
Koedderitzsch, M., Botha, A., Herselman, M. E., & Coleman, A. (2013) · IEEE International Conference on Adaptive Science & Technology · doi:10.1109/icastech.2013.6707500
Tegegne, A. S., Ndlovu, P., & Zewotir, T. Z. (2020) · doi:10.21203/rs.3.rs-17312/v1
Sánchez, A., & de la Serrana, H. L. G. (2018) · doi:10.2196/preprints.11426
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- Authors
- Lester, R. T., Mills, E. J., Kariri, A., Ritvo, P., Chung, M., Jack, W., Habyarimana, J., Karanja, S., Barasa, S., Nguti, R., Estambale, B., Ngugi, E., Ball, T. B., Thabane, L., Kimani, J., Gelmon, L., Ackers, M., & Plummer, F. A.
- Affiliations
- University of Nairobi (KE)
- University of British Columbia (CA)
- York University (CA)
- Georgetown University (US)
- University of Washington (US)
- Health Sciences Centre (CA)
- McMaster University (CA)
- Centers for Disease Control and Prevention (US)
- Public Health Agency of Canada (CA)
- Corresponding author
- Lester, Richard T
- ORCID
- Venue
- Trials
- Published
- 2009-09-22
- Volume
- 10
- Issue
- 1
- Pages
- 87-87
- ISSN
- 1745-6215 (ISSN-L)
- PMC
- PMC2760542
- OpenAlex
- W2166598297
- Cited by
- 91
- References
- 14
- Citations by year
- 2024: 1 · 2023: 1 · 2022: 4 · 2021: 4 · 2020: 5 · 2019: 3 · 2018: 8 · 2017: 6 · 2016: 5 · 2015: 4 · 2014: 16 · 2013: 6 · 2012: 12
- FWCI
- 16.90
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Trials (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- cIRcle (University of British Columbia) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- University of Nairobi Research Archive (University of Nairobi) (submittedVersion)
- Mspace (University of Manitoba) (submittedVersion)
- Funders
- Centers for Disease Control and Prevention
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Keywords
- antiretroviral therapy adherence, text messaging, mobile phone intervention, HIV, patient retention, viral suppression, quality of life, resource-limited settings, highly active antiretroviral therapy, patient-provider communication
- MeSH terms
- Acquired Immunodeficiency Syndrome, Clinical Protocols, Data Collection, Humans, Kenya, Treatment Outcome, Sample Size, Antiretroviral Therapy, Highly Active, Cell Phone, Medication Adherence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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