Mobile Phone Text Messaging Strategies and Perceived Self-Efficacy for Treatment among People Living with HIV/Aids in Homa Bay County, Kenya

Abstract

The field of mobile phone technology has grown widely in Kenya and globally. The increased adoption of mobile technology in Kenya and globally continues to provide opportunities to experience evidence based mobile health benefits through increased access and provision of efficient services that would lead to better health outcomes. Although the field of mHealth is rapidly making significant advances that impact people’s daily lives throughout the world, there is no significant progress in terms of research aimed at evaluating the effect of patient based mHealth solutions. The broad objective of this study was to examine the effect of mobile phone text messaging strategies on perceived self-efficacy for treatment among people living with HIV (PLHIV) in Homa Bay County. Specifically, the study examined 1.) the effect of timing of mobile phone text messaging on perceived self-efficacy for treatment among PLHIV in Homa Bay County; 2.) the effect of frequency of mobile phone text messaging on perceived self-efficacy for treatment among PLHIV in Homa Bay County; 3.) the effect of the type of message on perceived self-efficacy for treatment among PLHIV in Homa Bay County; 4.) the effect of language of choice of mobile phone text messages on perceived self-efficacy for treatment among PLHIV in Homa Bay County; and assessed the moderating effect of demographic characteristics in relation to mobile phone text messaging strategies and perceived self-efficacy for treatment among PLHIV in Homa Bay County. Both theoretical and empirical literature reviewed suggested that there were a myriad factors that influence how mobile health solutions could affect self-efficacy among beneficiaries. This study used a quasi-experimental design. It comprised a sample of 543 (247 test group and 296 control group). The participants were systematically sampled from three facilities in Homa Bay County that were implementing the Text for Adherence (T4A) communication system. Data was analyzed using descriptive and inferential statistics. Qualitative data was analyzed under themes. Inferential statistics using correlations and linear regression models indicate that within the test group, the mobile phone text messaging strategies including language and frequency of messages were not statistically significant determinants of the levels of self-efficacy among participants. Nonetheless, participants who received messages on a monthly basis had demonstrated high levels of self-efficacy. However, timing of the messages and the type of messages had significant effects on the level of self-efficacy. In particular, appointment messages and wellness messages which were directly related to adherence had high levels of self-efficacy compared to those who were receiving general informative messages. All the socio-demographic characteristics studied did not have significant effect on the levels of self-efficacy. In conclusion, comparison of the levels of self-efficacy between participants in the test group and those in the control group revealed significant differences, with participants in the test group exhibiting high levels of self-efficacy. This implies that text messaging as a whole has potential of improving self-efficacy regardless of the strategies employed. This study recommends that 1.) timing 2.) frequency of messages 3.) type of messages and 4.) language, being key communication messaging strategies, should be employed in mobile communication interventions.