2wT for Post-Operative Follow-Up

South Africa

  1. A Randomized Controlled Trial (RCT) determined that 2wT is safe (for adverse event ascertainment) and reduced workload (2wT males attended fewer in-person visits).
  2. Within the RCT, a quantitative usability study revealed that males assigned to 2wT found it to be safe, comfortable and convenient.
  3. Similar to the previous usability study, a qualitative usability study found that health care workers felt confident and satisfied with using 2wT but noted the added burden of responding to messages on the evenings and weekends. They also recommended enhanced post-operative counseling.
  4. A costing study found that 2wT saved $3.56 per client on average.
  5. During a subsequent stepped wedge trial, health workers reported that 2wT reduced in-person visits (preprint) and
  6. WhatsApp was shown to be just as popular and effective as SMS.

Zimbabwe

  1. A Randomized Controlled Trial found that 2wT improved AE ascertainment (but non-inferiority could not be ruled out) and 2wT reduced provider workload.
  2. During the RCT, a mixed methods usability study  showed that males showed 2wT was acceptable and it saved them time and money.
  3. A quantitative study of scale-up after the RCT found that males responded slightly less, though 2wT provided clear efficiency advantages over in-person follow-up. AE rates were the similar among 2wT and standard of care groups.
  4. A costing paper demonstrated that 2wT saved an average of $2.10 per client on average during the RCT.
  5. An exploratory qualitative study of interviews with a diverse set of 2wT stakeholders showed that 2wT was easy to use and saved time and money but infrastructure constraints and duplication of reporting were challenges.

2wT for Antiretroviral Treatment (ART) Retention – Malawi

  1. A human-centered design (HCD) project through initial interviews, a pilot and additional interviews was successful in co-creating an app that met health care workers’ needs and enhance support for 2wT clients.
  2. A quasi-experimental study found that 2wT significantly increased 12-month ART retention. 
  3. In addition, a usability and acceptability study reported that most respondents were satisfied with 2wT and would recommend it to friends, but some were worried about confidentiality. 

Other Related Publications

  1. This qualitative study describes the process of transitioning a project from the University of Washington to the Zimbabwe Technical Assistance, Training and Education Center for Health (Zim-TTECH).
  2. This process evaluation summarizes the first three years of the VMMC project using an integrated approach in Zimbabwe, prior to 2wT.

Recent Conferences

A poster about scaling up 2wT in Zimbabwe and South Africa was presented at the Global Digital Health Forum in November 2024.