John D. Piette|Nicolle Marinec|Kathryn M. Janda|Emily Morgan|Karolina Schantz|Amparo Clara Aruquipa Yujra|Bismarck Pinto|José Marecelo Huayta Soto|Mary R. Janevic|James E. Aikens
Structured Caregiver Feedback Enhances Engagement and Impact of Mobile Health Support: A Randomized Trial in a Lower-Middle-Income Country
VA Center for Clinical Management Research|University of Michigan–Ann Arbor|VA Center for Clinical Management Research|University of Michigan–Ann Arbor|University of Michigan–Ann Arbor|University of Michigan–Ann Arbor|University of Michigan–Ann Arbor|Universidad Católica Bolivia San Pablo|Universidad Católica Bolivia San Pablo|Universidad Pública de El Alto|University of Michigan–Ann Arbor|University of Michigan–Ann Arbor
backgroundpatients engagement mobile health mhealth interventions using interactive voice response ivr calls less low middleincome countries lmics industrialized ones conducted study determine whether automated telephone feedback informal caregivers carepartners increased engagement mhealth support among diabetes hypertension patients boliviamaterials methodspatients diabetes andor hypertension identified ambulatory clinics affiliated four hospitals patients enrolled carepartner patients randomized weekly ivr calls including selfmanagement questions selfcare education either alone standard mhealth automated feedback health selfcare needs sent carepartner ivr call mhealthcpresultsthe 72 participants included 39 diabetes 53 hypertension 19 6 years education 1225 patientweeks attempted ivr assessments call completion rate higher among patients randomized mhealthcp compared standard mhealth 620 versus 449 p 0047 carepartner feedback tripled call completion rates among indigenous patients patients low literacy p 0001 mhealthcp patients likely report excellent health via ivr adjusted odds ratio aor 260 95 confidence interval ci 107 632 less likely report days bed due illness aor 042 95 ci 019 091conclusionsin study found caregiver feedback increased engagement mhealth may improve patients health status relative standard approaches mhealthcp represents scalable strategy increasing reach selfmanagement support lmics