mPneumonia, an Innovation for Diagnosing and Treating Childhood Pneumonia in Low-Resource Settings: A Feasibility, Usability and Acceptability Study in Ghana
Identifieur interne : 000108 ( Main/Exploration ); précédent : 000107; suivant : 000109mPneumonia, an Innovation for Diagnosing and Treating Childhood Pneumonia in Low-Resource Settings: A Feasibility, Usability and Acceptability Study in Ghana
Auteurs : Amy Sarah Ginsburg [États-Unis] ; Charlotte Tawiah Agyemang [Ghana] ; Gwen Ambler [États-Unis] ; Jaclyn Delarosa [États-Unis] ; Waylon Brunette [États-Unis] ; Shahar Levari [États-Unis] ; Clarice Larson [États-Unis] ; Mitch Sundt [États-Unis] ; Sam Newton [Ghana] ; Gaetano Borriello [États-Unis] ; Richard Anderson [États-Unis]Source :
- PLoS ONE [ 1932-6203 ] ; 2016.
Abstract
Pneumonia is the leading cause of infectious disease mortality in children. Currently, health care providers (HCPs) are trained to use World Health Organization Integrated Management of Childhood Illness (IMCI) paper-based protocols and manually assess respiratory rate to diagnose pneumonia in low-resource settings (LRS). However, this approach of relying on clinical signs alone has proven problematic. Hypoxemia, a diagnostic indicator of pneumonia severity associated with an increased risk of death, is not assessed because pulse oximetry is often not available in LRS. To improve HCPs’ ability to diagnose, classify, and manage pneumonia and other childhood illnesses, “mPneumonia” was developed. mPneumonia is a mobile health application that integrates a digital version of the IMCI algorithm with a software-based breath counter and a pulse oximeter. A design-stage qualitative pilot study was conducted to assess feasibility, usability, and acceptability of mPneumonia in six health centers and five community-based health planning and services centers in Ghana. Nine health administrators, 30 HCPs, and 30 caregivers were interviewed. Transcribed interview audio recordings were coded and analyzed for common themes. Health administrators reported mPneumonia would be feasible to implement with approval and buy-in from national and regional decision makers. HCPs felt using the mPneumonia application would be feasible to integrate into their work with the potential to improve accurate patient care. They reported it was “easy to use” and provided confidence in diagnosis and treatment recommendations. HCPs and caregivers viewed the pulse oximeter and breath counter favorably. Challenges included electricity requirements for charging and the time needed to complete the application. Some caregivers saw mPneumonia as a sign of modernity, increasing their trust in the care received. Other caregivers were hesitant or confused about the new technology. Overall, this technology was valued by users and is a promising innovation for improving quality of care in frontline health facilities.
Url:
DOI: 10.1371/journal.pone.0165201
PubMed: 27788179
PubMed Central: 5082847
Affiliations:
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Agyemang</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Kintampo Health Research Centre, Kintampo, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kintampo Health Research Centre, Kintampo</wicri:regionArea><wicri:noRegion>Kintampo</wicri:noRegion></affiliation></author><author><name sortKey="Ambler, Gwen" sort="Ambler, Gwen" uniqKey="Ambler G" first="Gwen" last="Ambler">Gwen Ambler</name><affiliation wicri:level="2"><nlm:aff id="aff003"><addr-line>PATH, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>PATH, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region></placeName></affiliation></author><author><name sortKey="Delarosa, Jaclyn" sort="Delarosa, Jaclyn" uniqKey="Delarosa J" first="Jaclyn" last="Delarosa">Jaclyn Delarosa</name><affiliation wicri:level="2"><nlm:aff id="aff003"><addr-line>PATH, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>PATH, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region></placeName></affiliation></author><author><name sortKey="Brunette, Waylon" sort="Brunette, Waylon" uniqKey="Brunette W" first="Waylon" last="Brunette">Waylon Brunette</name><affiliation wicri:level="4"><nlm:aff id="aff004"><addr-line>Department of Computer Science and Engineering, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Computer Science and Engineering, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation></author><author><name sortKey="Levari, Shahar" sort="Levari, Shahar" uniqKey="Levari S" first="Shahar" last="Levari">Shahar Levari</name><affiliation wicri:level="4"><nlm:aff id="aff004"><addr-line>Department of Computer Science and Engineering, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Computer Science and Engineering, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation></author><author><name sortKey="Larson, Clarice" sort="Larson, Clarice" uniqKey="Larson C" first="Clarice" last="Larson">Clarice Larson</name><affiliation wicri:level="4"><nlm:aff id="aff004"><addr-line>Department of Computer Science and Engineering, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Computer Science and Engineering, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation></author><author><name sortKey="Sundt, Mitch" sort="Sundt, Mitch" uniqKey="Sundt M" first="Mitch" last="Sundt">Mitch Sundt</name><affiliation wicri:level="4"><nlm:aff id="aff004"><addr-line>Department of Computer Science and Engineering, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Computer Science and Engineering, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation></author><author><name sortKey="Newton, Sam" sort="Newton, Sam" uniqKey="Newton S" first="Sam" last="Newton">Sam Newton</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Kintampo Health Research Centre, Kintampo, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kintampo Health Research Centre, Kintampo</wicri:regionArea><wicri:noRegion>Kintampo</wicri:noRegion></affiliation></author><author><name sortKey="Borriello, Gaetano" sort="Borriello, Gaetano" uniqKey="Borriello G" first="Gaetano" last="Borriello">Gaetano Borriello</name><affiliation wicri:level="4"><nlm:aff id="aff004"><addr-line>Department of Computer Science and Engineering, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Computer Science and Engineering, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation></author><author><name sortKey="Anderson, Richard" sort="Anderson, Richard" uniqKey="Anderson R" first="Richard" last="Anderson">Richard Anderson</name><affiliation wicri:level="4"><nlm:aff id="aff004"><addr-line>Department of Computer Science and Engineering, University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Computer Science and Engineering, University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Pneumonia is the leading cause of infectious disease mortality in children. Currently, health care providers (HCPs) are trained to use World Health Organization Integrated Management of Childhood Illness (IMCI) paper-based protocols and manually assess respiratory rate to diagnose pneumonia in low-resource settings (LRS). However, this approach of relying on clinical signs alone has proven problematic. Hypoxemia, a diagnostic indicator of pneumonia severity associated with an increased risk of death, is not assessed because pulse oximetry is often not available in LRS. To improve HCPs’ ability to diagnose, classify, and manage pneumonia and other childhood illnesses, “mPneumonia” was developed. mPneumonia is a mobile health application that integrates a digital version of the IMCI algorithm with a software-based breath counter and a pulse oximeter. A design-stage qualitative pilot study was conducted to assess feasibility, usability, and acceptability of mPneumonia in six health centers and five community-based health planning and services centers in Ghana. Nine health administrators, 30 HCPs, and 30 caregivers were interviewed. Transcribed interview audio recordings were coded and analyzed for common themes. Health administrators reported mPneumonia would be feasible to implement with approval and buy-in from national and regional decision makers. HCPs felt using the mPneumonia application would be feasible to integrate into their work with the potential to improve accurate patient care. They reported it was “easy to use” and provided confidence in diagnosis and treatment recommendations. HCPs and caregivers viewed the pulse oximeter and breath counter favorably. Challenges included electricity requirements for charging and the time needed to complete the application. Some caregivers saw mPneumonia as a sign of modernity, increasing their trust in the care received. Other caregivers were hesitant or confused about the new technology. Overall, this technology was valued by users and is a promising innovation for improving quality of care in frontline health facilities.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Liu, L" uniqKey="Liu L">L Liu</name></author><author><name sortKey="Oza, S" uniqKey="Oza S">S Oza</name></author><author><name sortKey="Hogan, D" uniqKey="Hogan D">D Hogan</name></author><author><name sortKey="Perin, J" uniqKey="Perin J">J Perin</name></author><author><name sortKey="Rudan, I" uniqKey="Rudan I">I Rudan</name></author><author><name sortKey="Lawn, Je" uniqKey="Lawn J">JE Lawn</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rambaud Althaus, C" uniqKey="Rambaud Althaus C">C Rambaud-Althaus</name></author><author><name sortKey="Althaus, F" uniqKey="Althaus F">F Althaus</name></author><author><name sortKey="Genton, B" uniqKey="Genton B">B Genton</name></author><author><name sortKey="D Acremont, V" 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John</name></author><author><name sortKey="Menezes, C" uniqKey="Menezes C">C Menezes</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mitchell, M" uniqKey="Mitchell M">M Mitchell</name></author><author><name sortKey="Getchell, M" uniqKey="Getchell M">M Getchell</name></author><author><name sortKey="Nkaka, M" uniqKey="Nkaka M">M Nkaka</name></author><author><name sortKey="Msellemu, D" uniqKey="Msellemu D">D Msellemu</name></author><author><name sortKey="Van Esch, J" uniqKey="Van Esch J">J Van Esch</name></author><author><name sortKey="Hedt Gauthier, B" uniqKey="Hedt Gauthier B">B Hedt-Gauthier</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mitchell, M" uniqKey="Mitchell M">M Mitchell</name></author><author><name sortKey="Hedt Gauthier, Bl" uniqKey="Hedt Gauthier B">BL Hedt-Gauthier</name></author><author><name sortKey="Msellemu, D" uniqKey="Msellemu D">D Msellemu</name></author><author><name sortKey="Nkaka, M" uniqKey="Nkaka M">M Nkaka</name></author><author><name sortKey="Lesh, N" uniqKey="Lesh N">N Lesh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ginsburg, As" uniqKey="Ginsburg A">AS Ginsburg</name></author><author><name sortKey="Delarosa, J" uniqKey="Delarosa J">J Delarosa</name></author><author><name sortKey="Brunette, W" uniqKey="Brunette W">W Brunette</name></author><author><name sortKey="Levari, S" uniqKey="Levari S">S Levari</name></author><author><name sortKey="Sundt, M" uniqKey="Sundt M">M Sundt</name></author><author><name sortKey="Larson, C" uniqKey="Larson C">C Larson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tong, A" uniqKey="Tong A">A Tong</name></author><author><name sortKey="Sainsbury, P" uniqKey="Sainsbury P">P Sainsbury</name></author><author><name sortKey="Craig, J" uniqKey="Craig J">J Craig</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Horwood, C" uniqKey="Horwood C">C Horwood</name></author><author><name sortKey="Voce, A" uniqKey="Voce A">A Voce</name></author><author><name sortKey="Vermaak, K" uniqKey="Vermaak K">K Vermaak</name></author><author><name sortKey="Rollins, N" uniqKey="Rollins N">N Rollins</name></author><author><name sortKey="Qazi, S" uniqKey="Qazi S">S Qazi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Duke, T" uniqKey="Duke T">T Duke</name></author><author><name sortKey="Graham, Sm" uniqKey="Graham S">SM Graham</name></author><author><name sortKey="Cherian, Mn" uniqKey="Cherian M">MN Cherian</name></author><author><name sortKey="Ginsburg, As" uniqKey="Ginsburg A">AS Ginsburg</name></author><author><name sortKey="English, M" uniqKey="English M">M English</name></author><author><name sortKey="Howie, S" uniqKey="Howie S">S Howie</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Duke, T" uniqKey="Duke T">T Duke</name></author><author><name sortKey="Subhi, R" uniqKey="Subhi R">R Subhi</name></author><author><name sortKey="Peel, D" uniqKey="Peel D">D Peel</name></author><author><name sortKey="Frey, B" uniqKey="Frey B">B Frey</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Ghana</li><li>États-Unis</li></country><region><li>Washington (État)</li></region><settlement><li>Seattle</li></settlement><orgName><li>Université de Washington</li></orgName></list><tree><country name="États-Unis"><region name="Washington (État)"><name sortKey="Ginsburg, Amy Sarah" sort="Ginsburg, Amy Sarah" uniqKey="Ginsburg A" first="Amy Sarah" last="Ginsburg">Amy Sarah Ginsburg</name></region><name sortKey="Ambler, Gwen" sort="Ambler, Gwen" uniqKey="Ambler G" first="Gwen" last="Ambler">Gwen Ambler</name><name sortKey="Anderson, Richard" sort="Anderson, Richard" uniqKey="Anderson R" first="Richard" last="Anderson">Richard Anderson</name><name sortKey="Borriello, Gaetano" sort="Borriello, Gaetano" uniqKey="Borriello G" first="Gaetano" last="Borriello">Gaetano Borriello</name><name sortKey="Brunette, Waylon" sort="Brunette, Waylon" uniqKey="Brunette W" first="Waylon" last="Brunette">Waylon Brunette</name><name sortKey="Delarosa, Jaclyn" sort="Delarosa, Jaclyn" uniqKey="Delarosa J" first="Jaclyn" last="Delarosa">Jaclyn Delarosa</name><name sortKey="Larson, Clarice" sort="Larson, Clarice" uniqKey="Larson C" first="Clarice" last="Larson">Clarice Larson</name><name sortKey="Levari, Shahar" sort="Levari, Shahar" uniqKey="Levari S" first="Shahar" last="Levari">Shahar Levari</name><name sortKey="Sundt, Mitch" sort="Sundt, Mitch" uniqKey="Sundt M" first="Mitch" last="Sundt">Mitch Sundt</name></country><country name="Ghana"><noRegion><name sortKey="Tawiah Agyemang, Charlotte" sort="Tawiah Agyemang, Charlotte" uniqKey="Tawiah Agyemang C" first="Charlotte" last="Tawiah Agyemang">Charlotte Tawiah Agyemang</name></noRegion><name sortKey="Newton, Sam" sort="Newton, Sam" uniqKey="Newton S" first="Sam" last="Newton">Sam Newton</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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