A mobile health app may improve maternal and child health knowledge and practices among rural women with limited education in Uganda: a pilot randomized controlled trial.

Objective: This article describes the impact of a mobile health app (MatHealth App) on maternal and child health knowledge and practices among women with limited education. Materials and methods: Pregnant women initiating antenatal care (ANC) were randomized (1:1) to the MatHealth App versus routine care. Participants were followed until 6 weeks after delivery. Questionnaires for assessing knowledge and practices were administered to participants from both arms at baseline and endline. Using logistic regression, we estimated the difference in odds of having maternal health knowledge. We reviewed clinic records to capture maternal health practices. Results: Of the 80 enrolled participants, 69 (86%) completed the study with a median follow-up of 6 months. Women in the MatHealth arm had 8.2 (P = .19), 3.6 (P = .14), and 6.4 (P = .25), respectively higher odds of knowing (1) the recommended gestation period for starting ANC, (2) the recommended number of ANC visits, and (3) the timing and frequency of recommended human immunodeficiency virus (HIV) testing, respectively, compared to those in the routine care arm. All women in the MatHealth App arm exclusively breastfed their babies, and brought them at 6 weeks for HIV testing, compared to the routine care arm. Just over half of the women attended at least 4 prenatal visits across the 2 arms. The main reason for noncompliance to ANC appointments was a lack of transport to the clinic. Discussion and conclusion: The app increased knowledge and practices although not reaching statistical significance. Future efforts can focus on addressing social and economic issues and assessing clinical outcomes.

The role of mobile health technologies in promoting COVID-19 prevention: A narrative review of intervention effectiveness and adoption.

Background: Researchers have found innovative ways of using mobile health (mHealth) technologies to prevent the spread of coronavirus disease 2019 (COVID-19). However, fewer studies have been done to determine their adoption and effectiveness. Objective: This review summarises the published evidence on the effect of mHealth technologies on the adoption of COVID-19 preventive measures, prevention knowledge acquisition and risk perception as well as technology adoption features for COVID-19 prevention. Methods: PubMed, IEEE and Google Scholar databases were searched for peer-reviewed literature from 1 January 2020 to 31 March 2022 for studies that evaluated the effect of mHealth technologies on COVID-19 preventive measures adoption, prevention knowledge acquisition and risk perception. Thirteen studies met the inclusion criteria and were included in this review. All the included studies were checked for quality using the mHealth evidence reporting and assessment (mERA) checklist. Results: The review found out that the utilisation of mHealth interventions such as alert text messages, tracing apps and social media platforms was associated with adherence behaviour such as wearing masks, washing hands and using sanitisers, maintaining social distance and avoiding crowded places. The use of contact tracing was linked to low-risk perception as users considered themselves well informed about their status and less likely to pose transmission risks compared to non-users. Privacy and security issues, message personalisation and frequency, technical issues and trust concerns were identified as technology adoption features that influence the use of mHealth technologies for promoting COVID-19 prevention. Conclusion: Utilisation of mHealth may be a feasible and effective way to prevent the spread of COVID-19. However, the small study samples and short study periods prevent generalisation of the findings and calls for larger, longitudinal studies that encompass diverse study settings.

Challenges in accessing maternal and child health services during COVID-19 and the potential role of social networking technologies.

Background: The COVID-19 pandemic causes new challenges to women and their babies who still need to access postnatal care amidst the crisis. The novel application of social network technologies (SNTs) could potentially enhance access to healthcare during this difficult time. Objectives: This study describes the challenges experienced in accessing maternal and child health services by women with limited or no education during this COVID-19 pandemic and discusses the potential of SNTs to support maternal and child health amidst this crisis. Methods: We administered surveys to women who had recently given birth in a rural setting and interviewed a purposively selected subset to ascertain their experiences of accessing maternal and child health services during the COVID-19 pandemic. Our analysis involved descriptive analysis of quantitative data using STATA 13 to describe study participants' characteristics, and content analysis of qualitative data to derive categories describing maternal health challenges. Results: Among 50 women, the median age was 28 years (interquartile range 24-34), 42 (84%) completed upper primary education. Access to the health facility was constrained by transport challenges, fear of contracting COVID-19, and delays at the facility. Due to the COVID-19 crisis, 42 (84%) women missed facility visits, 46 (92%) experienced financial distress, 43 (86%) had food insecurity, and 44 (88%) felt stressed. SNTs can facilitate remote and timely access to health services and information, and enable virtual social connections and support. Conclusion: SNTs have the potential to mitigate the challenges faced in accessing maternal and child health services amidst the ongoing COVID-19 pandemic.

A mobile phone-based multimedia intervention to support maternal health is acceptable and feasible among illiterate pregnant women in Uganda: Qualitative findings from a pilot randomized controlled trial.

BACKGROUND: Uganda's maternal mortality rate remains unacceptably high. Mobile phones can potentially provide affordable means of accessing maternal health services even among the otherwise hard-to-reach populations. Evidence about the acceptability and feasibility of mobile phone-based interventions targeting illiterate women, however, is limited. OBJECTIVE: To assess the acceptability and feasibility of a mobile phone-based multimedia application (MatHealth app) to support maternal health amongst illiterate pregnant women in rural southwestern Uganda. METHODS: 80 pregnant women initiating antenatal care from Mbarara regional referral hospital were enrolled in a pilot randomized controlled trial and followed until six weeks after delivery. The 40 women in the intervention group received a MatHealth app composed of educational videos/audios, clinic appointment reminders, and the calling function. Qualitative interviews on acceptability of this technology were carried out with 30 of the intervention participants. An inductive, content analytic approach was used to analyze qualitative data. Quantitative feasibility data were recorded and summarized descriptively. RESULTS: Participants reported that the intervention is acceptable as it enabled them adopt good maternal health practices, enhanced social support from spouses, provided clinic appointment reminders, and facilitated communication with healthcare providers. Challenges included: phone sharing (74%), accidental deletion of the application 15 (43%), lack of electricity 15 (43%), and inability to set up a reminder function 20 (57%). CONCLUSION: The MatHealth app is an acceptable and feasible intervention among illiterate women, in a resource limited setting. Future efforts should focus on optimized application design, spouse orientation, and incorporating economic support to overcome the challenges we encountered.

A review of technologies for collaborative online information seeking: On the contribution of collaborative argumentation.

In everyday life, people seek, evaluate, and use online sources to underpin opinions and make decisions. While education must promote the skills people need to critically question the sourcing of online information, it is important, more generally, to understand how to successfully promote the acquisition of any skills related to seeking online information. This review outlines technologies that aim to support users when they collaboratively seek online information. Upon integrating psychological-pedagogical approaches on trust in and the sourcing of online information, argumentation, and computer-supported collaborative learning, we reviewed the literature (N = 95 journal articles) on technologies for collaborative online information seeking. The technologies we identified either addressed collaborative online information seeking as an exclusive process for searching for online information or, alternatively, addressed online information seeking within the context of a more complex learning process. Our review was driven by three main research questions: We aimed to understand whether and how the studies considered 1) the role of trust and critical questioning in the sourcing of online information, 2) the learning processes at play when information seekers engage in collaborative argumentation, and 3) what affordances are offered by technologies that support users' collaborative seeking of online information. The reviewed articles that focused exclusively on technologies for seeking online information primarily addressed aspects of cooperation (e.g., task management), whereas articles that focused on technologies for integrating the processes of information seeking into the entire learning processes instead highlighted aspects of collaborative argumentation (e.g., exchange of multiple perspectives and critical questioning in argumentation). Seven of the articles referred to trust as an aspect of seekers' sourcing strategies. We emphasize how researchers', users', and technology developers' consideration of collaborative argumentation could expand the benefits of technological support for seeking online information.

Maternal health-related barriers and the potentials of mobile health technologies: Qualitative findings from a pilot randomized controlled trial in rural Southwestern Uganda.

BACKGROUND: Maternal mortality rate remains unacceptably high in Uganda. In-depth evidence about the barriers to access and utilization of maternal health services specifically among the rural illiterate pregnant women remains lacking. The potentials of mobile health technologies in addressing the maternal health challenges remain unclear. AIM: To explore the maternal health-related barriers among illiterate pregnant women in rural Southwestern Uganda and highlight the potentials of mobile health technologies. MATERIAL AND METHODS: This is a midline qualitative study conducted with the participants of a pilot randomized controlled trial. Between October 2019 and December 2019, we carried out semi-structured interviews with 30 illiterate pregnant mothers. Interviews elicited information on the barriers to access and utilization of maternal health services. An inductive, content analytic approach was used to analyze qualitative data. Quantitative sociodemographic and socioeconomic data were summarized descriptively. RESULTS: Participants reported that lack of money (for transport and medical costs), unfriendly maternal health services, and delays at the maternal health clinic constrain access and utilization of maternal health services. Given their widespread adoption, mobile technologies can potentially address some of these barriers e.g., money for transport or microenterprise start-up can be sent to women through their mobile phones or maternal health-related services (such as health education and consultation) can be provided electronically. CONCLUSION: Future efforts should focus on utilizing mobile health technologies to not only enable women overcome the critical financial challenges but also facilitate remote access and utilization of maternal health services.

Mobile phone-based Multimedia Application Could improve Maternal Health in Rural Southwestern Uganda: Mixed Methods Study.

Background: Reducing maternal and infant mortality rates remains challenging. Illiteracy, lack of reliable information, long distances to health centers continue to limit access to quality maternal healthcare in Uganda. Mobile health technologies could be promising affordable strategies for enhancing access to maternal health services. However, there is lack of studies assessing the experiences of illiterate rural pregnant women regarding these technologies. Objective: To explore how illiterate pregnant women perceive a maternal health mobile application composed of tailored video and audio messages, appointment reminders and calling function. Methods: We purposively sampled illiterate pregnant women initiating antenatal care at Mbarara Regional Referral Hospital. We carried out three focus group discussions with 14 women to elicit information on perceptions of the proposed mobile phone based multimedia application. We used STATA 13 to describe study participants and their preferences. Results: Pregnant women anticipated that intervention would enhance maternal health by reminding them to attend antenatal appointments, enabling transport cost and time saving, providing tailored information that is easy to understand, and recall. However, financial constraints and phone sharing would limit the functionality. Conclusion: Mhealth application may provide acceptable and affordable alternative approaches to providing maternal health services, especially in settings where face-to-face approaches are challenging.

A review of privacy and usability issues in mobile health systems: Role of external factors.

The increased penetration of mobile devices has created opportunities in the health sector and led to emerging of mobile health systems. As much as the mobile health systems have registered tremendous progress, they have been faced with privacy and usability issues. Due to the sensitivity of health information, there is an ethical need to equip mobile health systems with adequate privacy measures. However, these systems should also be useable by the intended users. Even though many researchers are working on solutions, the issues still persist. External factors such as cultural differences have also contributed to the issues, yet they have been under researched. In this article, we conduct a systematic literature review of 22 articles, categorize and present privacy and usability issues and possible solutions. We then discuss the relevance and implications of external factors to the findings on privacy and usability. We end with recommendations to address these external factors.

Inclusive E-Learning - Towards an Integrated System Design.

At first sight there seem to be issues combining technical accessibility guidelines and educational needs when designing inclusive E-Learning. Furthermore Universal Design for Learning seems to contradict individualization. In this paper we address both issues with an inclusive E-Learning design for the LAYA system, which targets disabled and non-disabled learners.

Evaluation of a question generation approach using semantic web for supporting argumentation.

Discourse and argumentation are effective techniques for education not only in social domains but also in science domains. However, it is difficult for some teachers to stimulate an active discussion between students because several students might not be able to develop their arguments. This paper proposes to use WordNet as a semantic source in order to generate questions that are intended to stimulate students' brainstorming and to help them develop arguments in a discussion session. In a study including 141 questions generated by human experts and 44 questions generated by a computer system, the following research questions have been investigated: Are system-generated questions understandable? Are they relevant to given discussion topics? Would they be useful for supporting students in developing new arguments? Are understandable and relevant system-generated questions predicted to be useful for students in order to develop new arguments? The evaluation showed that system-generated questions could not be distinguished from human-generated questions in the context of two discussion topics while the difference between system-generated and human-generated questions was noticed in the context of one discussion topic. In addition, the evaluation study showed that system-generated questions that are relevant to a discussion topic correlate moderately with questions that are predicted as useful for students in developing new arguments in the context of two discussion topics and understandable system-generated questions are rated as useful in the context of one specific discussion topic.