Digital Extension Interactive Voice Response (IVR) mLearning: Lessons Learnt From Uganda Pig Value Chain.
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ABSTRACT:
SUBMITTER: Dione M
PROVIDER: S-EPMC8273433 | biostudies-literature | 2021
REPOSITORIES: biostudies-literature
Publications
Digital Extension Interactive Voice Response (IVR) mLearning: Lessons Learnt From Uganda Pig Value Chain.
Dione Michel M Kangethe Edwin E Poole Elizabeth Jane EJ Ndiwa Nicholas N Ouma Emily E Dror Iddo I
Frontiers in veterinary science 20210628
We assessed the effectiveness of Interactive Voice Response (IVR) technology in delivering biosecurity messages for the control of African swine fever (ASF) in Uganda using a randomized controlled trial (RCT) with 408 smallholder pig farmers. Our results show that IVR technology significantly improved knowledge of farmers who had not been exposed to training on biosecurity. Furthermore, it enhanced knowledge for farmers who had received face-to-face (f2f) training in biosecurity. This group of f ...[more]
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Project description:ObjectiveTo summarise the uses, outcomes and implementation of interactive voice response (IVR) as a tobacco cessation intervention.Data sourcesA systematic review was conducted. Searches were performed on 3 May 2023. The strategies used keywords such as "tobacco cessation", "smoking reduction" and "interactive voice recording". Ovid MEDLINE ALL, Embase, APA PsycINFO, CINAHL, Cochrane Library and Web of Science were searched. Grey literature searches were also conducted.Study selectionTitles and abstracts were assessed by two independent reviewers. Studies were included if IVR was an intervention for tobacco cessation for adults; any outcomes were reported and study design was comparative. Any abstract included by either reviewer proceeded to full-text review. Full texts were reviewed by two independent reviewers.Data extractionData were independently extracted by two reviewers using a standardised form. The Risk of Bias Tool for Randomised Trials and the Risk of Bias in Non-Randomised Studies of Interventions tools were used to assess study quality.Data synthesisOf 308 identified abstracts, 20 moderate-quality to low-quality studies were included. IVR was used standalone or adjunctly as a treatment, follow-up or risk-assessment tool across populations including general smokers, hospitalised patients, quitline users, perinatal women, patients with cancer and veteran smokers. Effective studies found that IVR was delivered more frequently with shorter follow-up times. Significant gaps in the literature include a lack of population diversity, limited implementation settings and delivery schedules, and limited patient and provider perspectives.ConclusionsWhile the evidence is weak, IVR appears to be a promising intervention for tobacco cessation. However, pilot programmes and research addressing literature gaps are necessary.
| S-EPMC11243215 | biostudies-literature
Project description:Few methods estimate the prevalence of child maltreatment in the general population due to concerns about socially desirable responding and mandated reporting laws. Innovative methods, such as interactive voice response (IVR), may obtain better estimates that address these concerns. This study examined the utility of interactive voice response (IVR) for child maltreatment behaviors by assessing differences between respondents who completed and did not complete a survey using IVR technology. A mixed-mode telephone survey was conducted in English and Spanish in 50 cities in California during 2009. Caregivers (n=3,023) self-reported abusive and neglectful parenting behaviors for a focal child under the age of 13 using computer-assisted telephone interviewing and IVR. We used hierarchical generalized linear models to compare survey completion by caregivers nested within cities for the full sample and age-specific ranges. For demographic characteristics, caregivers born in the United States were more likely to complete the survey when controlling for covariates. Parenting stress, provision of physical needs, and provision of supervisory needs were not associated with survey completion in the full multivariate model. For caregivers of children 0-4 years (n=838), those reporting they could often or always hear their child from another room had a higher likelihood of survey completion. The findings suggest IVR could prove to be useful for future surveys that aim to estimate abusive and/or neglectful parenting behaviors given the limited bias observed for demographic characteristics and problematic parenting behaviors. Further research should expand upon its utility to advance estimation rates.
| S-EPMC4225177 | biostudies-literature
Project description:There is a significant resumption of smoking following smoking cessation using varenicline. Both smoking cessation medications and counseling have been shown to increase smoking quit rates at one year. Thus, the combination of varenicline and interactive voice response (IVR) telephony followed by extended IVR may further improve smoking cessation rates at one and two years.101 participants were recruited from the community via newspaper advertisement. They attended a group counseling session and were given smoking information booklets from the Canadian Cancer Society. After 12 weeks of varenicline and 9 IVR calls, all participants who had quit smoking were randomized into 2 groups matched by levels of motivation and addiction as per baseline questionnaire score. The intervention group continued to receive bi-weekly IVR support for weeks 13-52. The control group no longer received IVR. The primary end-point was self-reported abstinence and exhaled carbon monoxide levels of less than 10 ppm for weeks 12, 52 and 2 years. Data were analyzed by Fisher's exact test or Wilcoxon rank-sum test.Of the 101 participants, 44 (43%) had stopped smoking after 12 weeks of varenicline and 9 IVR calls. Of these, 23 (52%) were randomized to receive IVR calls from weeks 13 to 52.At 52 weeks, 26 (59%) participants remained smoke-free. Of the 23 with IVR, 12 (52.2%) stopped smoking compared to 14 of 21 (66.7%) without IVR. At 2 years, 40 of the 44 (90.9%) randomized participants were contacted and 24 of the 44 (54.5%) came in for testing. Fourteen (13% of the original cohort, 30% who were abstinent at 12 weeks and 53% who were abstinent at 52 weeks) remained smoke-free. Five of the 23 (21.7%) randomized to IVR and 9 of the 21 (42.9%) randomized to no IVR remained smoke-free at 2 years.In this pilot study of an apparently healthy population, extended IVR did not affect abstinence rates. There was no relapse prevention benefit in offering 9 months of continued IVR to subjects who had stopped smoking after receiving 3 months of varenicline and IVR treatment.ClinicalTrial.gov: NCT00832806.
| S-EPMC3848019 | biostudies-literature
Project description:This study examined the feasibility of a prize-based contingency-management (CM) approach to encourage interactive voice response (IVR) compliance in a cocaine-treatment study and explored the association between IVR call rate and outcome during a cocaine abstinence-induction trial. Subjects called into the IVR system daily to complete a brief interview assessing cocaine use for the past 24hours. One group earned $1 for each call; the other earned one draw per call from a "prize bowl" with a range of awards. Abstinence was rewarded according to a high-value voucher incentive schedule, which was the same for both groups, and confirmed by thrice-weekly urine testing at clinic visits. Odds of calling were 4.7 times greater (95% CI: 1.23, 17.91) in the prize-CM group than in the fixed dollar CM group. In addition, the percentage of IVR calls was significantly associated with abstinence achievement, ?(2) (1)=5.147, p<.023. The use of prize-based CM to increase the use of IVR is feasible and deserves examination as an innovation for helping participants engage in treatment.
| S-EPMC3818436 | biostudies-literature
Project description:Big Data will be an integral part of the next generation of technological developments-allowing us to gain new insights from the vast quantities of data being produced by modern life. There is significant potential for the application of Big Data to healthcare, but there are still some impediments to overcome, such as fragmentation, high costs, and questions around data ownership. Envisioning a future role for Big Data within the digital healthcare context means balancing the benefits of improving patient outcomes with the potential pitfalls of increasing physician burnout due to poor implementation leading to added complexity. Oncology, the field where Big Data collection and utilization got a heard start with programs like TCGA and the Cancer Moon Shot, provides an instructive example as we see different perspectives provided by the United States (US), the United Kingdom (UK) and other nations in the implementation of Big Data in patient care with regards to their centralization and regulatory approach to data. By drawing upon global approaches, we propose recommendations for guidelines and regulations of data use in healthcare centering on the creation of a unique global patient ID that can integrate data from a variety of healthcare providers. In addition, we expand upon the topic by discussing potential pitfalls to Big Data such as the lack of diversity in Big Data research, and the security and transparency risks posed by machine learning algorithms.
| S-EPMC7080757 | biostudies-literature
Project description:BackgroundTobacco dependence is a chronic, relapsing condition that typically requires multiple quit attempts and extended treatment. When offered the opportunity, relapsed smokers are interested in recycling back into treatment for a new, assisted quit attempt. This manuscript presents the results of a randomized controlled trial testing the efficacy of interactive voice response (IVR) in recycling low income smokers who had previously used quitline (QL) support back to QL support for a new quit attempt.MethodsA sample of 2985 previous QL callers were randomized to either receive IVR screening for current smoking (control group) or IVR screening plus an IVR intervention. The IVR intervention consists of automated questions to identify and address barriers to re-cycling in QL support, followed by an offer to be transferred to the QL and reinitiate treatment. Re-enrollment in QL services for both groups was documented.ResultsThe IVR system successfully reached 715 (23.9%) former QL participants. Of those, 27% (194/715) reported to the IVR system that they had quit smoking and were therefore excluded from the study and analysis. The trial's final sample was composed of 521 current smokers. The re-enrollment rate was 3.3% for the control group and 28.2% for the intervention group (p < .001). Logistic regression results indicated an 11.2 times higher odds for re-enrollment of the intervention group than the control group (p < .001). Results did not vary by gender, race, ethnicity, or level of education, however recycled smokers were older (Mean = 45.2; SD = 11.7) than smokers who declined a new treatment cycle (Mean = 41.8; SD = 13.2); (p = 0.013). The main barriers reported for not engaging in a new treatment cycle were low self-efficacy and lack of interest in quitting. After delivering IVR messages targeting these reported barriers, 32% of the smokers reporting low self-efficacy and 4.8% of those reporting lack of interest in quitting re-engaged in a new QL treatment cycle.ConclusionProactive IVR outreach is a promising tool to engage low income, relapsed smokers back into a new cycle of treatment. Integration of IVR intervention for recycling smokers with previous QL treatment has the potential to decrease tobacco-related disparities.Trial registrationClinicalTrials.gov Identifier: NCT01260597.
| S-EPMC3438078 | biostudies-literature
Project description:The factors associated with digital exclusion in the covid virtual ward population at a North West London teaching hospital were assessed in this study. Patients discharged from the covid virtual ward were contacted to give their feedback on their experience. Questions were tailored to whether or not the patient used the Huma app during their time on the virtual ward and were subsequently divided into 'app user' and 'non-app user' cohorts. The non-app user population accounted for 31.5% of the total patients referred to the virtual ward. Four major themes drove digital exclusion in this group: language barriers, access, inadequate information/training, and poor IT skills. In conclusion, incorporating additional languages and improving hospital-setting demonstration and information provision to patients prior to discharge were highlighted as key factors for reducing digital exclusion in the covid virtual ward patients.
| S-EPMC9931265 | biostudies-literature
Project description:BackgroundCancer awareness is crucial for cancer care and prevention. However, cancer awareness in Uganda is low, and access to cancer information is limited.ObjectiveThis study aims to (1) understand the cancer awareness situation in Uganda (perceptions, beliefs, information needs, and challenges to accessing cancer information) and opinions about interactive voice response (IVR) systems; (2) develop cancer awareness messages and implement them in an IVR system; and (3) evaluate user acceptance and use of the IVR system.MethodsA participatory design approach was adopted. To understand cancer awareness needs and challenges, 3 interviews and 7 focus group discussions (FGDs) were conducted with cancer health care providers, patients with cancer, caregivers and survivors, administrators, and lay citizens (n=73). On the basis of the resulting qualitative data, audio messages addressing cancer information needs were developed and implemented in an IVR system. The system and messages were tested with users (n=12) during 2 co-design workshops before final rollout. Finally, the system was evaluated over 6 months after going live, using call records and user feedback from telephone interviews with callers (n=40).ResultsThe cancer information needs included general topics such as what cancer is, what causes it, cancer screening and diagnosis, cancer treatment, and practical information on what to expect during cancer care. There were also myths and misconceptions that need to be addressed, such as that cancer is due to witchcraft and has no treatment. Information on COVID-19 was also sought after following the outbreak. We developed 20 audio cancer messages (approximately 2 minutes each) in English and Luganda, along with 14 IVR navigation instructions. These were implemented in an IVR system with 24/7 availability from all over Uganda via a toll-free multi-channel telephone number. The total number of calls made to the IVR system 6 months after going live was 3820. Of these, 2437 (63.8%) lasted at least 30 seconds and were made from 1230 unique telephone numbers. There were 191 voice messages and 760 calls to live agents, most of which (681/951, 71.6%) were in Luganda. Call volumes peaked following advertisement of the system and lockdowns due to COVID-19. Participants were generally familiar with IVR technology, and caller feedback was largely positive. Cited benefits included convenience, toll-free access, and detailed information. Recommendations for improvement of the system included adding live agents and marketing of the system to target users.ConclusionsIVR technology provides an acceptable and accessible method for providing cancer information to patients and the general public in Uganda. However, a need remains for health system reforms to provide additional cancer information sources and improve cancer care services in general.
| S-EPMC7872833 | biostudies-literature
Project description:Background:The use of digital health technologies has expanded across low-resource settings, including in programs seeking to improve maternal health care seeking and service usage. However, there has been limited use of these technologies for screening and referral within maternal health, and many interventions have relied on SMS tools, which may have limited impact in settings with low female literacy. Digital health technologies have the potential to increase access to care for chronic maternal morbidities, such as obstetric fistula, and for women facing stigma, geographic isolation, and other sociocultural barriers to care seeking. This study documented the process of developing and implementing an innovative fistula screening and referral hotline using interactive voice response (IVR) technology, and described the service usage results and stakeholder perspectives associated with the hotline. Methods:The IVR hotline was introduced within the context of a broader Fistula Treatment Barriers Reduction Intervention implemented by the USAID-funded Fistula Care Plus project in Ebonyi and Katsina states in Nigeria and Kalungu district in Uganda. The intervention used three communication pathways to disseminate fistula information and conduct fistula screening: trained community agents, trained primary health care providers, and the IVR hotline paired with mass media messaging. All positively-screened women were eligible to receive vouchers for free transportation to an accredited fistula treatment center. Quantitative and qualitative data on intervention implementation and use across all three communication pathways were gathered during intervention implementation, at baseline, midline, and endline; as well as through ongoing program monitoring. This study presents findings specifically on service usage and stakeholder perspectives related to the IVR hotline. Results:Over a period of ten to twelve months of implementation, depending on the intervention area, a total of 566 women completed the IVR hotline screening process. Across the areas, 415 (73%) hotline callers screened positive for fistula symptoms. Hotline users and implementation partners reported positive impressions of the hotline, particularly the ability to preserve anonymity in seeking information and referral for fistula symptoms. Challenges to hotline use included limited mobile phone ownership and poor cellular network connectivity, affecting operability by women and community agents. Conclusions:Implementation of the fistula screening hotline suggests that IVR-based interventions may be useful in expanding access to health services for stigmatized conditions, particularly in settings where literacy is limited. In the current context, such IVR tools require pairing with community and health system partners to complete referral and support clients. Further program experience and evaluation research is required to understand the options for integrating the IVR hotline or other interventions similarly using mobile technologies for screening and referral into broader digital health platforms that are sustained by national health systems or commercial business models.
| S-EPMC7136652 | biostudies-literature
Project description:BackgroundThe use of digital technologies has expanded rapidly in recent years, particularly with the onset of COVID-19. Digital technologies have been implemented in nursing and healthcare to support necessary care.AimsThis research explored how nursing and healthcare researchers engage with digital technologies, including the types of technologies, facilitators, barriers and suggested improvements to enable engagement.MethodsSemi-structured interviews were conducted with 36 nursing and healthcare researchers from an Australian University. Interviews were recorded, transcribed, coded and thematically analysed using the COREQ checklist.ResultsFour major types of digital technologies were engaged by nursing and healthcare researchers. These included monitoring, intervention, communication and data collection and analysis technologies. The research setting provided the overarching systems and policies that could delay actions or provide necessary supports. Access to experts, good communication, sharing digital technology information, and time and funding were identified as important.ConclusionThis research highlights that nursing and healthcare researchers are engaging with digital technologies but there are areas for improvement that are underpinned by the research setting and need to be considered to ensure effective use of digital technologies in nursing and healthcare research.
| S-EPMC9669936 | biostudies-literature