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Explore the impact of text messaging on post-operative care and adherence in male circumcision programs. Adherence reminders aim to reduce early resumption of sexual activity post-surgery. Study involves SMS intervention compared to standard care.
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Mobile Phone Technology andMale Circumcision Programs Amy Herman-Roloff Research Project Coordinator, UIC/NRHS Scaling-up male circumcision programmes in the Eastern and Southern Africa Region Arusha, Tanzania, 8 –10 June 2010
1. Client Emergency Line • Installed September, 2009 • Receive an average of four calls per week from recently circumcised men (per district) • After phone consultation, a clinical team is dispatched to a client’s residence an average of 2x/month for further evaluation • Since employees receive extra pay for responding in-person to emergency calls outside of normal working hours, it is important to review the records of clients who were visited at home to ensure that a home visit was medically necessary
2. Clinician Support Line • To be launched June, 2010 • Line will be staffed by MC trainers at the UNIM Research and Training Center in Kisumu • Objectives: • To provide MC technical information 24-hours/day to providers • To improve the safety of MC services • To serve as a feedback tool to improve the MC training curriculum • Call information will be recorded on a form and reviewed by the training team every two weeks to ensure consistent, quality information is being disseminated • After six months, a chart review will be conducted to assess the translation of “hotline” support into improved clinical care
3. SMS Study • Title: Text messaging to improve adherence to post-operative clinic appointments and reduce early resumptions of sexual intercourse after adult male circumcision: a randomized controlled trial • Study enrollment July-Sept., 2010 • A randomized controlled trial in which recently circumcised men will be randomized to receive (clinicians are blinded): • Intervention – 16 context-sensitive text messages after MC in English, Kiswahili, or Dholuo (n=600) • Control – standard of care (n=600) • Objectives: • Primary objective 1: To determine the effect of text messages on attendance at the scheduled 7-day post-operative clinic visit • Primary objective 2: To determine the effect of text messages on the resumption of sexual activity before 42 days post-procedure • Secondary objective 1: To identify potential predictors of failure to attend the 7-day visit and the resumption of early sex • SMS text messages will be sent using RapidSMS, an open-source platform created by Dimagi, Inc.
SMS Study Overview • Eligibility: • 18+ years • Circumcised at study facility • Client owns a phone with SMS capability, and has the phone with him (to sign up for SMS service and verify number) • Gives informed consent to participate • Data Collection: • Baseline questionnaire (factors that would promote/inhibit attendance for 7-day follow-up visit) • Chart abstraction – demographic information and 7-day follow-up visit • 42-day questionnaire about AEs and abstinence • A random sample of clients who did not report for their 7-day follow-up visit will be called to ascertain reasons why
SMS Messages A SMS is sent every day for the first week, and then about 1x/week through day 42. Each message costs about $0.15.
