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Overview on the use of hand-held devices for data collection in Thailand: From science to implementation

Overview on the use of hand-held devices for data collection in Thailand: From science to implementation. Philip Mock and Frits van Griensven Thailand MOPH – US CDC Collaboration. Background.

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Overview on the use of hand-held devices for data collection in Thailand: From science to implementation

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  1. Overview on the use of hand-held devices for data collection in Thailand: From science to implementation Philip Mock and Frits van Griensven Thailand MOPH – US CDC Collaboration

  2. Background • Studies have shown audio-computer assisted self-interviewing to have higher reports of sensitive behaviors than traditional methods • Science 1998; volume 280, p867-73 • Lancet 1999; volume 353, p1657-61 • Control of missing and invalid data • Allows complex skip patterns • Eliminates need for data entry

  3. Audio computer-aided self interviewing (ACASI) • First used in1999 by CDC-Thailand with a behavioral risk survey with commercial college students (15-19 yrs) in Chiang Rai, Northern Thailand • Used PCs that were available at the commercial college computer training rooms • QDS software was used to develop the ACASI tool in Thai language • 300 plus questions including detailed sexual history and use of drugs • 1725 students interviewed

  4. ACASI data collection in 1999, Chiang Rai

  5. Motivation for use of hand-held devices • In 2001 plan to repeat the 1999 behavioral survey among students in Chiang Rai • Use of PCs and/or laptops was cumbersome • Hand-held devices were becoming available in Thailand • Hand-held devices appeared more cost effective and mobile than PCs/laptops • Greater privacy • How to demonstrate the technology was reliable and valid compared to ACASI ?

  6. First Application: Randomized trial comparinghand-held self-interviewing with audio computer assisted self-interviewing (ACASI), and traditional methods (face-to face and self-interview) • Main study aims: • Non-inferiority of hand-held vs ACASI • Superiority of hand-held vs interviews • Study population: Students in Chiang Rai, Northern Thailand in November 2002. • Design: Four-arm randomized trial with ~300 students per arm • Main outcomes: • Sensitive behaviors, eg sex practices, illicit drug use, suicide ideation • Urine testing to validate self-reported drug use Published: Frits van Griensven, Sataphana Naorat, Peter H. Kilmarx et al. Palmtop-assisted self-Interviewing for the collection of sensitive behavioral data: Randomized trial with drug use urine testing. American Journal of Epidemiology (2006); Volume 163, page 271-278.

  7. Main Results - handhelds • Non-inferior to ACASI for sensitive questions, eg self-reports of sexual experience, contraceptive use, buying/selling sex, genital ulcers • Superior to face-to-face interview – higher self-reports on sensitive questions • Agreement between self-reports of tobacco usage and nicotine metabolites in urine were non-inferior to ACASI, and superior to interviews • Same control of skip patterns as ACASI – no missing data or inconsistent responses

  8. Device, tools and challenges • Palm M500 (black and white LCD) • Programming Tool • Satellite Forms (maximum 255 fields) • Does not require programming expertise • Hurdles • Thai language • Language problem solved by hiring Thai OS language support developer as a consultant • Other • Training students to use was not a problem

  9. Subsequent applications • 2003 – Men sex with Men (MSM) HIV prevalence survey in Bangkok conducted at venues where MSM meet, eg bars, saunas, parks • AIDS 2005; volume 19, p521-6 • 2005 – post Tsunami response survey (post-traumatic stress syndrome) in Southern Thailand • JAMA 2006; volume 296, p537-59 • 2005 – MSM/Transgender HIV prevalence survey #2 conducted in Bangkok, Chiang Mai, Phuket and Pattaya • MMWR 2006; volume 55, p844-48

  10. Issues from fieldwork • IT Support for use at remote sites for • Interviewer administration • Self-administration • Use of hand-held devices for interviewing in dark places, eg MSM surveys • Improvised lighting with “penlights” • Participants with poor eyesight • Loss of hand-held devices ? • In 6+ years we have not lost one device

  11. Transfer of technology to MOPH through GAP-Thailand • 2004 – Transfer of technology to MOPH through the support of GAP • Adopted for use with Behavioral Surveillance Survey (BSS) in the Thai youth population • BSS is conducted in 24 of the 76 provinces in Thailand • In the initial 2004 pilot round 13,524 students were successfully interviewed using hand-held devices • In the 2005 round over 60,000 students were interviewed • Now used in 3 rounds of BSS demonstrating successful adoption and sustainability of the technology by the MOPH

  12. Pocket PCs (Windows mobile) • In 2005 we moved to the Windows Pocket PC (PPC) platform • Why ? • Dominance of Microsoft Windows • Better programming tools, eg Visual Studio .NET • Support for greater than 255 questions • Other language support, apart from Thai we have developed applications with questions in Chinese, Japanese and Laotian

  13. Pocket PC (2) • Audio version (Pocket ACASI) • Recent development (2006) has been an audio-version of the Pocket PC hand-held for respondent self-interviewing in populations with limited literacy eg sex-workers from the Hill-tribes of Northern Thailand • Final audio recorded at studio • Visual studio .NET based so same version can be used on PC or hand-held device • More memory required than non-audio version

  14. Applications in 2007-2008 • Successfully used for data collection in a number of different populations, field settings, study designs and sampling methodologies • MSM 2007 HIV prevalence survey • MSM HIV/STI prevalence survey in Laos • Female Sex Workers in Bangkok and Chiang Rai (including audio) • Prisoners in BKK and Phuket jails • Students in College Dormitories in Ubon • Injecting Drug Users project • Karen Refugee Cholera Outbreak investigation in Mae La camp, Tak • Randomized trial on efficacy of behavioral interventions in prevention of influenza • Paper replacement in a routine pneumonia surveillance system

  15. MSM survey in Laos • HIV/STI prevalence survey among MSM in Laos • Adaptation of MSM Thailand surveys in 2003, 2005 and 2007 • Fieldwork in Vientiane August/Sept 2007 • Venue-Date-Time (VDT) sampling (n=545) • PPC application with ~200 questions • Laotian language display (not input)

  16. MSM survey in Laos - training

  17. MSM Laos – night 1

  18. MSM Laos – night 2

  19. MSM Laos – night 3

  20. Female Sex Workers (FSW) survey • HIV prevalence survey (2007) • Respondent-driven sampling (RDS) • non-establishment FSWs • Seeds included • street, internet, coyote dancer • 3 “unsecure” sites in Bangkok and 1 site in Chiang Rai • ~100 questions • Pocket ACASI

  21. Bangkok FSW survey sites – klong lord, traffic circle 22nd July and Siam hotel areas

  22. Pocket ACASI, Chiang Rai 2007

  23. Other applications and changing technologies • PDAs with WiFi can be used as Polling Booth devices • Smart Phones with 3G networks could result in even more timely data collection • New mini-size notebooks mean full ACASI functionality on a device not much bigger or costlier than a PDA

  24. Further Information • PDAs in Thailand • Email: pgm6@th.cdc.gov

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