Table 1:
Included studies, by year of publication and author (n=17)
| First Author Citation | Year | Country | Intervention | Technology | Level | Cascade Step | Study Design | Implementation Outcomes |
Key Findings |
|---|---|---|---|---|---|---|---|---|---|
| Bauermeister [23] | 2015 | United States | Get Connected! | Desktop | Pa | 1 | RCT | Ac | High patient acceptability; tailored intervention may be more acceptable than locator-only intervention. |
| Dryden- Peterson [24] | 2015 | Botswana | Tokafatso | SMS | Pr | 2 | RCT; stepped wedge | Ac, C |
SMS platform and provision of airtime appreciated by providers. Cost of $ 1.98 per CD4 result delivered vs. $2.73 with standard delivery methods. |
| Finocchario- Kessler [25] | 2015 | Kenya | HIT System | Deskstop, SMS | Pr, Pa |
1, 2 | Cohort; prospective | Ad, c, Fe, P |
High reach, good effectiveness, adopted by health facilities at different levels, implementation varied depending on health facility, can be maintained by integrating into national EMR system |
| Murray [26] | 2015 | Canada | WelTel | SMS | Pa | 3 | Qualitative; FGDs, interviews | Ac, Ap, Fe |
Providers felt intervention built relationships with patients, streamlined existing mHealth interventions, and dealt with privacy issues. Increase in workload offset by benefits. |
| Georgette [27] | 2016 | South Africa | Not named | SMS | Pa | 3 | Qualitative; interviews | Ac | Patients felt intervention was acceptable and helpful, most would recommend to friends. Two-way communication desired by most. |
| Henwood [28] | 2016 | South Africa | Khaya HIV Positive | Instant message | Pa | 2, 3 |
Qualitative; surveys, FGDs | Ac | Moderate patient acceptability. Cost and need for anonymity were problems. Usage limited by preference for other platforms, logistical obstacles, and loss of interest. |
| Kurth [29] | 2016 | United States | CARE+ Spanish | Tablet | Pa | 3 | RCT; qualitative; interviews; FGDs | Ac, Ap |
High patient acceptability; easy to use, ensured privacy and confidentiality. Providers felt intervention was useful, but could not replace provider-patient relationship. |
| Bardosh [30] | 2017 | Kenya, Canada | WelTel | SMS | Pa | 3 | Qualitative; case study | Ac, Ad, Ap, Fe |
Positive influence on “culture of care” at health facilities. Scale-up viewed as precarious and uncertain process. Challenges: juggling different interests, determining appropriate financing pathways, maintaining network growth, packaging intervention for impact and relevance. |
| Campbell [31] | 2017 | Uganda | Not named | SMS | Pa | 2 | Qualitative; interviews | Ac | SMS language, phone characteristics, and experience with similar technologies contributed to ease of use. Perceived usefulness because system augmented HIV care services and improved access to social support. Importance of confidentiality, disclosure, and stigma. Barriers and facilitators downstream from the intervention impacted target outcome. |
| de Bruin [32] | 2017 | Nether lan ds | AIMS | MEMS caps | Pr, Pa |
3 | RCT; mathematical model | C | Using MEMS caps data to create patient adherence reports was cost-effective. This finding was robust in sensitivity analyses. |
| Hirsch- Moverman [33] | 2017 | Lesotho | START | SMS | Pa | 3 | Qualitative; interviews | Ac | High patient acceptability of intervention and provision of airtime. Some did not perceive SMS usefulness. Providers used phones for text and phone calls. Electricity and technical difficulties were barriers for some. |
| Horvath [34] | 2017 | United States | Get Connected! | Desktop | Pa | 1 | Qualitative; surveys | Ac | Few differences in patient acceptability by intervention type or eHealth literacy, related to information and system quality. |
| Patel [35] | 2017 | Kenya | N/A | SMS | Pa | 3 | Mathematical model | C | SMS adherence interventions cost-effective, especially with retention improvements. ICER sensitive to intervention costs, effectiveness, and cohort CD4 count. |
| Wray [36] | 2017 | United States | eTEST | Smartphone, Bluetooth | Pa | 2 | Qualitative; interviews | Ac, Fe | eTEST system detected HBST use in nearly all cases. Timing, method, and duration of follow-up were appropriate and helpful. |
| Bull [37] | 2018 | T anzania | T-HIT | Tablet | Pr | 1, 2 |
RCT | Ac, Ad, Fe | High acceptability feasibility. Perceived as useful. More antenatal visits during the pilot intervention compared with paper logs. |
| Gbadamosi [38] | 2018 | Nigeria | Vitira Health | Desktop, Smartcard, Smartphone | Pr, Pa |
1 | Qualitative; observation | Fe | Could be used to store encrypted HIV results and display prenatal test results to skilled birth attendants without internet connectivity. |
| Ronen [39] | 2018 | Kenya | Mobile WAChX | SMS | Pa | 3 | Qualitative; FGDs | Ac | Half of participants supported overtly HIV- related terms, wanting detailed educational messages about ART and PMTCT. Concerns about confidentiality. Acceptability of HIV-related content depends on disclosure status and others’ access to phone. |
Abbreviations: SMS = Short message service; Pr = Provider; Pa = Patient; 1 = HIV testing and diagnosis; 2 = Linkage to and retention in care; 3 = Adherence to antiretroviral medication and viral suppression; FGDs = Focus group discussions; RCT = Randomized controlled trial; Ac = Acceptability, Ap = Appropriateness, Ad = Adoption, C = Costs, Fe = Feasibility, Fi = Fidelity, P = Penetration, S = Sustainability