“I Hope It Does Not Stop With Me, and That It Continues With Other Patients” – A 360 Degree Qualitative Assessment of mHealth Follow-up in Cameroon

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INTRODUCTION: Despite a high burden of injury, routine follow-up for trauma patients in Cameroon is limited by resource constraints. Previously, we implemented a mobile phone health (mHealth) triage intervention to identify patients who warrant reevaluation. While feasible and acceptable, only 57% of patients were successfully contacted 2 wk postdischarge. To optimize patient participation in this promising, low-cost intervention, we evaluated participant perceptions. METHODS: Research assistants, trauma providers, and trauma patients involved in mHealth follow-up were recruited through purposive random sampling. Semistructured, in-depth interviews were conducted between October 2023 and March 2024. Interviews were performed until thematic saturation was achieved. Qualitative data analysis was completed using grounded theory and the Consolidated Framework for Implementation Research. RESULTS: Thirty interviews were conducted with five research assistants, 10 trauma providers and 15 patients. Three themes emerged that spanned the Consolidated Framework for Implementation Research domains. First, persistent gaps in initial engagement with mHealth stem from the compounding negative effects of poor socioeconomic status and injury. Second, mHealth can improve patient perceptions of their health care experience through the positive emotional and psychological benefits reported from the communication with the research assistants. Third, clear expectations for subsequent communication may mitigate mistrust and improve patient participation. CONCLUSIONS: To optimize mHealth participation we should explore the positive relationships formed between the research assistants and patients during patients' hospital stay and through continued follow-up after discharge. Creative solutions to supplement mHealth follow-up of trauma patients via phone can and should be investigated to reach the individuals most affected by postinjury morbidity and mortality.

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