03336nas a2200361 4500000000100000008004100001260002300042653002800065653001200093653002800105653003700133100001600170700001200186700002000198700001400218700001500232700001300247700001700260700001500277700001100292700001200303700001400315700001200329700001500341700002600356700001300382245018900395856005300584300000600637490000600643520231100649022001402960 2020 d bF1000 Research Ltd 10 aImplementation barriers 10 aMhealth 10 aimplementation research 10 aLow- and middle-income countries 1 aVan Olmen J 1 aErwin E 1 aGarcía-Ulloa A 1 aMeessen B 1 aMiranda JJ 1 aBobrow K 1 aIwelunmore J 1 aNwaozuru U 1 aUmeh C 1 aSmith C 1 aHarding C 1 aKumar P 1 aGonzales C 1 aHernández-Jiménez S 1 aYeates K 00 aImplementation barriers for mHealth for non-communicable diseases prevention and management in low and middle income countries: a scoping review and field-based views from implementers uhttps://wellcomeopenresearch.org/articles/5-7/v1 a7 0 v5 3 aBackground: Mobile health (mHealth) has been hailed as a potential gamechanger for non-communicable disease (NCD) management, especially in low- and middle-income countries (LMICs). Individual studies illustrate barriers to implementation and scale-up, but an overview of implementation issues for NCD mHealth interventions in LMICs is lacking. This paper explores implementation issues from two perspectives: information in published papers and field-based knowledge by people working in this field. Methods: Through a scoping review publications on mHealth interventions for NCDs in LMICs were identified and assessed with the WHO mHealth Evidence Reporting and Assessment (mERA) tool. A two-stage web-based survey on implementation barriers was performed within a NCD research network and through two online platforms on mHealth targeting researchers and implementors. Results: 18 studies were included in the scoping review. Short Message Service (SMS) messaging was the main implementation tool. Most studies focused on patient-centered outcomes. Most studies do not report on process measures and on contextual conditions influencing implementation decisions. Few publications reported on implementation barriers. The websurvey included twelve projects and the responses revealed additional information, especially on practical barriers related to the patients’ characteristics, low demand, technical requirements, integration with health services and with the wider context. Many interventions used low-cost software and devices with limited capacity that not allowing linkage with routine data or patient records, which incurred fragmented delivery and increased workload. Conclusion: Text messaging is a dominant mHealth tool for patient-directed of quality improvement interventions in LMICs. Publications report little on implementation barriers, while a questionnaire among implementors reveals significant barriers and strategies to address them. This information is relevant for decisions on scale-up of mHealth in the domain of NCD. Further knowledge should be gathered on implementation issues, and the conditions that allow universal coverage. a2398-502X