PMID- 32448299 OWN - NLM STAT- MEDLINE DCOM- 20201019 LR - 20201019 IS - 1471-2458 (Electronic) IS - 1471-2458 (Linking) VI - 20 IP - 1 DP - 2020 May 24 TI - Acceptability and feasibility of a behavioral and mobile health intervention (COMBIND) shown to increase uptake of prevention of mother to child transmission (PMTCT) care in India. PG - 752 LID - 10.1186/s12889-020-08706-5 [doi] LID - 752 AB - BACKGROUND: A cluster-randomized trial recently demonstrated that an integrated behavioral and mobile technology intervention improved uptake of key components of a Prevention of Mother to Child Transmission (PMTCT) Option B+ program, among HIV- infected pregnant/breastfeeding women in India. To guide scale-up and optimize programmatic implementation, we conducted a mixed-methods evaluation of the feasibility and acceptability of this intervention. METHODS: The COMmunity Home Based INDia (COMBIND) study, was conducted in four districts of Maharashtra, India and randomized 119 integrated counseling and testing centers (ICTC) and their outreach workers (ORWs) to the COMBIND intervention, an integrated mHealth application that allowed digital data capture, PMTCT educational videos, SMS alerts for missed visits and reminder for visits, combined with personal empowerment and motivational interviewing training for ORWs. This qualitative evaluation was done through 15 in-depth interviews (IDIs) with ORWs and 15 IDIs with HIV-infected pregnant/breastfeeding women from the intervention arm. Utilizing a concurrent nested mixed-method evaluation approach, we assess the feasibility and acceptability of the study intervention. RESULTS: All 30 participants reported that the PMTCT videos were essential in providing easy to understand information on critical aspects of HIV and necessary care related to PMTCT practices. A majority of the ORWs reported that the personal empowerment training with motivational interviewing skills training increased their confidence, motivation and gave them the tools for effectively supporting their clients. The mHealth application improved their working style as it facilitated targeted PMTCT information support, systemized data capture, streamlined their health education delivery practice and provided a sense of work satisfaction. The SMS appointment alerts improved retention in HIV care for mother and baby to the smaller proportion that had access to their phones. Despite reported improvements in knowledge and communication, few ORWs reported that structural challenges such as limited drug stocks, lack of HIV kits or unavailability of trained staff at ICTC, may hamper the uptake of PMTCT services, thus resulting in limited significant impacts of COMBIND on PMTCT outcomes. CONCLUSION: This study found that COMBIND intervention is scalable, feasible, beneficial and very well accepted by ORWs and patients, however structural challenges in goods and services remain. FAU - Suryavanshi, Nishi AU - Suryavanshi N AD - Lakshya Society for Public Health Education and Research, 307, Block II, Llyod Chambers, Mangalwar Peth, Pune, Maharashtra, 411001, India. nishisuryavanshi@hotmail.com. FAU - Kadam, Abhay AU - Kadam A AD - Lakshya Society for Public Health Education and Research, 307, Block II, Llyod Chambers, Mangalwar Peth, Pune, Maharashtra, 411001, India. FAU - Kanade, Savita AU - Kanade S AD - Lakshya Society for Public Health Education and Research, 307, Block II, Llyod Chambers, Mangalwar Peth, Pune, Maharashtra, 411001, India. FAU - Gupte, Nikhil AU - Gupte N AD - Johns Hopkins University, School of Medicine, Baltimore, MD, USA. FAU - Gupta, Amita AU - Gupta A AD - Johns Hopkins University, School of Medicine, Baltimore, MD, USA. FAU - Bollinger, Robert AU - Bollinger R AD - Johns Hopkins University, School of Medicine, Baltimore, MD, USA. FAU - Mave, Vidya AU - Mave V AD - Johns Hopkins University, School of Medicine, Baltimore, MD, USA. FAU - Shankar, Anita AU - Shankar A AD - Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA. LA - eng GR - U01 GH000731-02/TS/ATSDR CDC HHS/United States GR - D43TW009574./TW/FIC NIH HHS/United States PT - Journal Article DEP - 20200524 PL - England TA - BMC Public Health JT - BMC public health JID - 100968562 SB - IM MH - Adult MH - Counseling/*organization & administration MH - Feasibility Studies MH - Female MH - HIV Infections/epidemiology/*prevention & control/transmission MH - Humans MH - India/epidemiology MH - Infectious Disease Transmission, Vertical/*prevention & control MH - Middle Aged MH - Mothers/*psychology MH - Patient Acceptance of Health Care/*psychology MH - Pregnancy MH - Pregnancy Complications, Infectious/prevention & control MH - Pregnant Women/*psychology MH - Telemedicine/*organization & administration PMC - PMC7245843 OTO - NOTNLM OT - HIV OT - Intervention OT - Mhealth OT - Option B + OT - PMTCT COIS- Under a licensing agreement between emocha Mobile Health, Inc. and the Johns Hopkins University, R. Bollinger is entitled to royalties on an invention described in this article. R. Bollinger also is a Board of Directors member of emocha Mobile Health, Inc. This arrangement has been reviewed and approved by the Johns Hopkins University per its conflict of interest policies. EDAT- 2020/05/26 06:00 MHDA- 2020/10/21 06:00 PMCR- 2020/05/24 CRDT- 2020/05/26 06:00 PHST- 2019/07/24 00:00 [received] PHST- 2020/04/15 00:00 [accepted] PHST- 2020/05/26 06:00 [entrez] PHST- 2020/05/26 06:00 [pubmed] PHST- 2020/10/21 06:00 [medline] PHST- 2020/05/24 00:00 [pmc-release] AID - 10.1186/s12889-020-08706-5 [pii] AID - 8706 [pii] AID - 10.1186/s12889-020-08706-5 [doi] PST - epublish SO - BMC Public Health. 2020 May 24;20(1):752. doi: 10.1186/s12889-020-08706-5.