Background
During the last two decades, an increasing number of electronic clinical decision support algorithm (eCDSA) implementation programs have been carried out in resource-limited settings to improve the quality of care and support the performance of health care workers (HCWs). While most qualitative studies have evaluated the acceptance of such projects from the clinician standpoint, few studies have explored the acceptance of patients and caretakers managed by these new tools. This study investigates caretaker’s and community’s perceptions regarding the use of a novel eCDSA called Electronic Point of Care Tool Plus (ePOCT+) in the management of sick children in rural und semi-urban primary health care (PHC) facilities in Tanzania.
Methods
This study will be conducted in the framework of the broader DYNAMIC Tanzania study, a large-scale implementation program of a novel eCDSA called ePOCT+.
For the present study, we will employ the mixed methods approach, applying both qualitative and quantitative research methods at patient and community level. We will begin with the quantitative caregivers’ exit-interviews survey in order to be first focus on disentangling the trends we see in the data around app perception, usage, patient experience and other metrics. After the quantitative surveys, we will then focus on the qualitative work to triangulate the findings with in-depth interviews (IDIs) with caretakers of children treated at selected PHC facilities using ePOCT+ and focus group discussions (FGDs) with members of the community living near the selected PHC facilities.
For the elaboration of our data collection tools and for our data analysis, we will use BEAR (BEhavior and Acceptance fRamework), an integrated framework proposed by Camacho et al32 in 2020 that integrates behavioral change and technology acceptance aspects regarding the implementation of clinical decision support systems (CDSSs). It highlights determinants known to be facilitators or barriers to CDSSs uptake. As this study will focus only on determinants at the patients and community level, we will select determinants of interest from the BEAR framework in addition to some determinants found in the literature.
This study will be conducted in the framework of the broader DYNAMIC Tanzania study, a large-scale implementation program of a novel eCDSA called ePOCT+.
Results
We will try to highlight determinants at the patients and community level that could influence, in a positive or negative way, the general uptake and acceptability of ePOCT+ and care seeking behaviors.
Conclusion
Our study will investigate the perception of caregivers and patients regarding the use of eCDSAs. Furthermore, we will try to better understand how those new devices integrate the health system and how they interact with patients and the community.