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Mobile Phone Technology and Male 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 . 1. Client Emergency Line. Installed September, 2009

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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 client’s 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 (n=600)

    • Control – standard of care (n=600)

  • 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.