mHealth-supported tuberculosis contact investigation by community health workers in high-burden countries: a scoping review.
Community health workers found mHealth interventions for tuberculosis contact investigations to be acceptable and feasible, but specific effectiveness metrics were not detailed.
Where it sits
this study against the rest of the eloralintide corpusSummary and findings
This scoping review examined mHealth implementation strategies for tuberculosis (TB) contact investigations conducted by community health workers (CHWs) in high-burden countries. Nine studies were included, focusing on barriers, facilitators, acceptability, and feasibility of these interventions. Overall, CHWs found mHealth interventions to be acceptable and feasible.
Abstract
Mobile health (mHealth) implementation strategies in tuberculosis (TB) contact investigations are intended to increase community health workers' (CHWs) engagement in TB contact investigations and case detection. This scoping review aimed to map and synthesize existing evidence on the design and development of acceptable and feasible mHealth implementation strategies for CHW-led TB contact investigations. We conducted a scoping review following the Arksey and O'Malley framework and PRISMA-ScR guidelines. We searched PubMed, Scopus, Cochrane Library, Web of Science, and Google Scholar for English-language studies published through October 2024 on mHealth interventions for TB contact investigation by CHWs. Eligible studies included empirical studies conducted in high-burden countries (HBCs) for TB, HIV-associated TB, and MDR/RR-TB. Studies were screened, and data were extracted using Rayyan AI-assisted software. We mapped implementation strategies, barriers, facilitators, acceptability, and feasibility of mHealth interventions. Quantitative findings were described, and qualitative data were synthesized thematically. Nine studies were included. Most interventions used hybrid mHealth technologies for communication, case registration, health records, and decision support. Implementation strategies specified actors, actions, targets, temporality, dose, and justifications. Barriers were related to CHWs, digital systems, service implementation, and TB-affected persons. Facilitators included stakeholder support, CHW training, mHealth design, community engagement, and patient-centered approaches. Overall, CHWs perceived mHealth interventions as acceptable and feasible. Successful implementation in HBCs requires strengthened CHW capacity, reliable technology, optimizing interaction between CHWs and digital tools, and continuous monitoring and evaluation throughout implementation.
Background
This paper addresses the role of mobile health (mHealth) strategies in enhancing tuberculosis (TB) contact investigations, particularly by community health workers (CHWs) in high-burden countries. Prior research has indicated that mHealth can potentially improve engagement and case detection, but systematic evidence on its implementation and effectiveness was lacking. This scoping review aims to synthesize existing evidence to inform future mHealth strategies in TB management.
Methods
The study employed a scoping review methodology, guided by the Arksey and O'Malley framework and PRISMA-ScR guidelines. It included empirical studies published through October 2024 that focused on mHealth interventions for TB contact investigation in high-burden countries. The review utilized Rayyan AI-assisted software for screening and data extraction.
Results
The review included nine studies that mapped various implementation strategies, barriers, and facilitators related to mHealth interventions. Specific numeric findings regarding the effectiveness of these strategies were not reported in the abstract. However, it was noted that CHWs perceived these interventions as acceptable and feasible.
Interpretation
While the review provides a comprehensive overview of the barriers and facilitators associated with mHealth interventions, it lacks detailed quantitative findings that would allow for a robust comparison to prior literature. The absence of specific metrics limits the ability to assess the clinical significance of the findings. Additionally, the reliance on qualitative data may not fully capture the effectiveness of these interventions in practice.
Key findings
- Nine studies included in the review.
- Most interventions utilized hybrid mHealth technologies for communication, case registration, health records, and decision support.
- Barriers identified included issues related to CHWs, digital systems, service implementation, and TB-affected persons.
- Facilitators included stakeholder support, CHW training, mHealth design, community engagement, and patient-centered approaches.
Limitations
- Not reported in abstract.
- Lacks specific quantitative outcomes or metrics.
- Relies on qualitative data without robust quantitative support.
- Limited to nine studies, which may not represent broader trends.