Table 1.

Suggested ethics consideration in mobile phone survey (MPS) of noncommunicable disease (NCD) risk factors by phase.

Issues		Key considerations or questions	Available options (indicative)
Before data collection
	Defining the activity	Does the activity constitute research, M&E, and/or surveillance?	Nature of activity is defined by independent persons
		Who defines the nature of the activity?	Criteria to distinguish types of MPSb are established and applied
		What ethical requirements follow? IRBa or other review? Disclosures or authorizations? Transformation of data into policy, practice?
	Stakeholder engagement	What are the ethical goals of engagement?	Identify local norms and practices associated with the use of mobile phones
		Who should be engaged?	Determine the social, cultural, legal, and public health significance of the information being collected
		How and when should stakeholders be engaged?	Identify stakeholders, for example, technical experts, community representatives, health system agents, donor agency representatives
	Appropriate design	How should the survey be delivered? What qualities of survey delivery will affect the respondent and data validity? What are the consequences of: IVRc or CATId or SMSe or mixed modality? Will the survey reach minority, disadvantaged, marginalized groups?	Align delivery method with population characteristics, for example, if low literacy, IVR may be preferred
		Does the delivery method influence social desirability bias?	Use all major languages commonly used in other traditional surveys
		Linguistic strategy: how many and which languages ought to be used to administer the survey?
	Anticipating potential harms and benefits	What are the potential burdens or risks of participating in a MPS program (at the individual, community, national levels)? For example, Sensitive information and stigma	User-testing, interviews, and focus groups to identify key sensitive issues and design survey taking these into account
		What are the potential benefits or advantages of participating in a MPS program (at the individual, community, national levels)? For example, More frequent, less costly information, and better NCDf care
		What strategies will minimize harms and maximize benefits?
		How will harms or benefits be balanced for disadvantaged and marginalized groups?
During data collection
	Consent	What information about the MPS should be disclosed to respondents?	Disclose information consistent with basic consent elements
		How should respondents authorize their participation?	Review local practices, population preferences, and legal permissibility of different opt-in or opt-out approaches
		Should types of disclosure and authorization differ based on the MPS delivery method (IVR or CATI or SMS or mixed modality) and population?
	Reaching intended respondents	Which MPS sampling and recruitment methods best reduce unnecessary burdens upon intended and unintended MPS recipients?	Take stock of other existing survey approaches in designing MPS delivery strategies
		What approach to MPS incentive delivery is most appropriate?	Conduct follow up surveys by human caller on limited sample to verify
		Are existing laws likely to make it difficult to reach respondents using MPS?	Consult local regulatory authorities to identify and address potential areas of concern
After data collection
	Data ownership, access and use	To whom do the data belong?	Establish advance agreements to guide terms of data ownership, access, and use
		What data can be shared?	Consider restrictions on data access and use for purposes that do not advance public health
		Who should have access to the data?
		How should the data be shared?
		To what uses can the data be put?
	Ensuring LMICg sustainability	What are different actors’ responsibilities to promote and advance local sustainability?	Agree upon sustainability and capacity development commitments in advance
		Who is responsible for deciding who is allocated which strategies to undertake?	Identify core areas of local need and strength
		Should ongoing MPS efforts be supported only in the original data collection area or more broadly?	Integrate with existing programs and approaches where available

^aIRB: institutional review board.

^bMPS: mobile phone survey.

^cIVR: interactive voice response.

^dCATI: computer-assisted telephone interview.

^eSMS: short message service.

^fNCD: noncommunicable disease.

^gLMIC: low- and middle-income country.