Grant: Foundation Grant

Evidence to action for Canadian and global mobile health (mHealth) communication to promote patient engagement in care: a rigorous implementation science approach

Adherence; Engagement In Care; Global Health; Healthcare Delivery; Hiv/Aids; Implementation Science; Mobile Health; Retention In Care; Text-Messaging; Tuberculosis

<html> <body> <p>Poor adherence to prescribed therapies is a global problem as it limits their health outcome effectiveness and the efficient use of health resources, costing an estimated $7-9 billion annually in Canada alone. The global pervasiveness of mobile phones has brought about enormous potential to use mobile communications to improve health service delivery (mHealth), including promoting engagement in care for marginalized populations.</p> <p>WelTel Kenya1, a landmark trial led by the Program Leader, demonstrated that interactive text-messaging between health providers and patients taking antiretroviral therapy for HIV significantly improved health outcomes. Since then, the WelTel service and research program has expanded to include support for patients with other infectious and chronic diseases, and has been adapted to Canadian and other global settings. Despite the expanding evidence and adaptive innovation of the WelTel system, there are few mHealth services that have gone from evidence to scale, and a number of critical research questions remain unanswered.</p> <p> <u>The overarching goal of our research program is to develop the evidence required to deliver an effective mHealth service to support patient care at scale in multiple global settings.</u>&nbsp;To meet this goal, we will undertake a comprehensive implementation science evaluation of our WelTel-supported projects in HIV, tuberculosis, and asthma, in both Kenya and Canada. Over the next five years, we will evaluate and scale-up an mHealth service using rigorous scientific methods to evaluate processes and outcomes, based on the Consolidated Framework for Implementation Research (CFIR). In doing so, we will create one of the most comprehensive databases of comparative mHealth outcomes research. Individual, population, health system, and health environment factors associated with the successful uptake, effectiveness, and cost-effectiveness of the service will not only inform implementers, but also other researchers in the fields of implementation science and mHealth. The views of knowledge users will be incorporated into each phase of the program, and we will employ a broad range of integrated knowledge translation strategies to best synthesize and disseminate our findings.</p> <p>Our mentorship program includes capacity building in Canada and Kenya to develop research excellence in mHealth and implementation science. The program is inherently multidisciplinary, with students and later-stage trainees from medicine, health economics, and public health. Our activities include an in-house journal club, weekly one-on-one progress meetings with opportunities to discuss career planning, and the chance to participate in working groups focused on specific areas. Trainees are encouraged to take advantage of the extensive network to which our group belongs, to present at local and international conferences, author publications, and pursue external training opportunities.</p> <p>To ensure that we meet our program&rsquo;s overall goals and that we execute our proposed objectives to the highest standard, we have carefully assembled a committed team of local and international partners, experts and knowledge users. Our program experts include highly competent clinicians, allied health practitioners, scientists, and academic trainees. Knowledge users include government policy makers, clinical program leaders, community leaders and other influential stakeholders specifically chosen to ensure translation of our evidence into policy and action.</p> </body> </html>