Brown S, Krishnan A, Ranjit Y, Marcus R, Altice F. (2019). Assessing mobile health feasibility and acceptability among HIV-infected cocaine users and their healthcare providers: guidance for implementing an intervention. mHealth. 6: 4. doi: 10.21037/mhealth.2019.09.12
Researchers recruited people with HIV (PWH) aged 18 or older who had used cocaine in the past 30 days (n = 20) and their healthcare providers (physicians, healthcare workers, and substance use counselors) (n = 8), through flyers, treatment clinics, a mobile medical unit, support groups, and emails to members of the New England AIDS Education and Training Center, to participate in 5 patient focus groups and 3 provider focus groups between November 2016 and February 2017 to assess the feasibility and acceptability of mobile health (mHealth) in PWH who use cocaine. Patient focus group data revealed 3 main themes: 1) privacy concerns (Internet security, breaches of HIV status on mobile phones), 2) reminder preferences (many preferred text message medication and appointment reminders over phone call reminders, for privacy, accessibility, and affordability), and 3) barriers to use of electronic pillboxes with reminder text messages (difficulties financing phones and sudden housing changes). Provider focus group data revealed 3 key concerns: 1) workplace technology (inadequate), 2) text messaging patients (ease of communication juxtaposed against loss of professional boundaries, encroachment into personal time), and 3) accessibility to patients (physicians favored social distance to prevent miscommunication, missed contact, and potential liability, providers considered case managers and social workers the most appropriate people to text or call patients). Providers preferred more secure, reliable communication with patients through Electronic Medical Record (EMR) portals. Patient and provider responses may offer valuable insight into obstacles and facilitators of mHealth intervention implementation in PWH who use cocaine, a stigmatized, underserved population.