Process evaluation for the delivery of a water, sanitation and hygiene mobile health program: findings from the randomised controlled trial of the CHoBI7 mobile health program

• Published in: Tropical medicine & international health 2020-08, Vol.25 (8), p.985-995
• Main Authors: Islam Bhuyian, Md. Sazzadul, Saxton, Ronald, Hasan, Khaled, Masud, Jahed, Zohura, Fatema, Monira, Shirajum, Kumar Biswas, Shwapon, Tasdik Hasan, M., Parvin, Tahmina, Minhaj, Ismat, Md. Zillur Rahman, Kazi, Papri, Nowshin, Rashid, Mahamud‐ur, Sharin, Lubaba, Teman, Alana, Thomas, Elizabeth D., Alland, Kelsey, Labrique, Alain, Sack, David A., Perin, Jamie, Alam, Munirul, George, Christine Marie
• Format: Article
• Language: English
• Subjects: Accuracy; Children; Cholera; Diarrhea; diarrhoea; Evaluation; Households; Hygiene; Infections; Messages; mobile health; Patients; randomised controlled trial; Randomization; Sanitation; sanitation and hygiene; Short message service; Text messaging; Vibrio cholerae; Voice; water; Water treatment; Waterborne diseases
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/tmi.13414

Objective The Cholera‐Hospital‐Based Intervention for 7‐days (CHoBI7) mobile health (mHealth) program delivers mobile messages to diarrhoea patient households promoting water treatment and handwashing with soap. The randomised controlled trial (RCT) of the CHoBI7 mHealth program demonstrated this intervention was effective in significantly reducing diarrhoea and stunting amoung young children. The objective of this study was to assess the implementation of the CHoBI7 mHealth program in delivering mHealth messages during this RCT. Methods 517 diarrhoea patient households with 1777 participants received weekly text, voice and interactive voice response (IVR) messages from the CHoBI7 mHealth program over the 12‐month program period. The program process evaluation indicators were the following: the percentage of CHoBI7 mHealth messages received and fully listened to by program households (program fidelity and dose), and household members reporting receiving and sharing an mHealth message from the program in the past two weeks (program reach). Results Ninety two percent of text messages were received by program households. Eighty three percent of voice and 86% of IVR messages sent were fully listened to by at least one household member. Eighty one percent of IVR quiz responses from households were answered correctly. Program households reported receiving a CHoBI7 mHealth message in the past two weeks at 79% of monthly household visits during the 12‐month program. Seventy seven percent of participants reported sharing a program message with a spouse, 55% with a neighbour and 49% with a child during the program period. Conclusion There was high fidelity, dose and reach of mobile messages delivered for the CHoBI7 mHealth program. This study presents an approach for process evaluation that can be implemented to evaluate future mHealth programs. Objectif Le programme CHoBI7 (Cholera‐Hospital‐Based‐Intervention‐for‐7‐days) de santé mobile (mHealth) délivre des messages mobiles aux ménages avec patients atteints de diarrhée pour promouvoir le traitement de l'eau et le lavage des mains au savon. L'essai contrôlé randomisé (ECR) du programme mHealth CHoBI7 a démontré que cette intervention était efficace pour réduire de manière significative la diarrhée et le retard de croissance chez les jeunes enfants. L'objectif de cette étude était d'évaluer la mise en œuvre du programme CHoBI7 mHealth dans la diffusion des messages mHealth au cours de cet ECR. Méthodes 517 ménages