Mobile Phone Technology and Male Circumcision Programs

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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
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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 clients 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

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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

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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 (n600)
  
• Control standard of care (n600)
• 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.

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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

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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.