The Value of Formative Research & Partnerships in mHealth: The Experience of CycleTel™ in India CORE Group May 1, 2012 Susana Mendoza Birdsong Institute for Reproductive Health, Georgetown University
Q:Can we leverage the growing telecomindustry and ubiquity of mobile phonesto expand access to and addressunmet need for family planning inIndia?
A:Our research in India on CycleTelsuggests “yes.” Let me tell you more.
The Standard Days Method® (SDM):A Direct-to-Consumer Approach to Family Planning SDM IS WELL-POSITIONED FOR DIRECT- TO-CONSUMER APPROACHES Knowledge based Does not require a visit to a provider (for initiation or re-supply) Easy to teach & learn VALUE PROPOSITION As a new FP method, SDM is not yet widely available Direct-to-consumer approaches expand access to SDM thru avenues outside of health services
CycleTel™Family Planning on the Mobile Phone What? A mobile health service that uses text messaging to facilitate use of SDM Unique: Goes beyond unidirectional provision of health information How? Alerts woman of her fertile days via SMS during each menstrual cycle Requires a woman to send in the start date of her period each cycle Where? Tested and built in India
Model: Formative Research to Scale Product Launch Partnership & Scale Development up Business Planning Planned 2012 Planned 2012 Automated Jan-Feb „12 TestingProof-of- Jul „11-Jan „12Concept Sep ‟09 – Jul „11
Structure of CycleTel Proof-of-Concept 3 Phases ObjectivesFocus Group Understand phone use patterns Determine potential interest among targetDiscussions audience54 participants Explore appropriate messaging and preferences for the serviceCognitive Interviews Verify comprehension of messages18 participants Adapt and finalize messages (in English & Hinglish)Manual Testing Enroll women for 2 cycles to assess feasibility,26 women in Lucknow satisfaction and correct method use21-28 years old, housewives Initially used a low-cost open source software to manually send/receive messages (FrontlineSMS)88 women in New Delhi Troubleshoot problems and determine how to24-33 years, working women improve service Determine target audience
Profile of Delhi Phase Participants Age: 24-33 years; mean age 28.4 yrs Education: Bachelors degree and above Employment: 97% employed (either full time or part time) Children: 97% had children, 52% had 1 child, 48% had 2 children Current use of FP: 77% were using condoms inconsistently; others were either not using any method or using traditional methods Mobile phone use: All participants owned a personal mobile phone;15% reported sharing their cell phone with someone regularly
Results: Satisfaction, Ease of Use, Correct Use 100% of users wouldSatisfaction & 92% were very satisfied recommend the service toEase of Use with CycleTel to prevent friends pregnancy Features users liked the most: ease of 98% said it was easy to use, convenience, lack of send/receive SMS side effects 95% participants reported that they received SMS at an appropriate time and that the # of messages sent were the “right amount” 37% of participants 22% reporting havingCorrect Use called the helpline unprotected sex during an during the 1st cycle of unsafe day during the 1st cycle use, 15% called during of use; this decreased to 13% during the 2nd cycle of use the 2nd cycle of use
Results: Male Involvement & Willingness to Pay 23% expressed interested in Male 76% said it was easy to having their husbandInvolvement tell their husband that it receive unsafe day alerts was an unsafe day. too About 70% of women reported showing their husbands messages from CycleTel 83% of users said that they would be willing toWillingness to Pay pay on average Rs. 33 per month for the CycleTel service, ranging from Rs. 15-400 (US $1 = Rs. 45)
Using Research Results to Design the Innovation Confirmed timing and frequency of messages Identified messages that could be improved based on user-feedback Confirmed need for a call center Identified issues with the service‟s functionality (e.g., some women had issues with the screening questions and we are exploring other options to improve the experience) Determined that men do not necessarily want to receive the messages, but some would like to have the option Determined attributes of the service (e.g., ease of use, no side effects, confidential) that could be used in marketing campaigns
Key Takeaways: Value of Formative Research Proof-of-concept results and user-feedback were critical to design and develop a service that met the needs of the target population. There are low-cost open source platforms available (e.g., FrontlineSMS) that can help an organization test a concept. Only with proof-of-concept results did IRH move forward with investing in technology development.
A Note on PartnershipsFORMATIVE RESEARCH Lead org. – IRH Research Agency FrontlineSMS PILOT TESTING Donor - USAID Lead organization – IRH Technology partner – ThoughtWorks SMS Gateway Provider – Unicel Hosting Provider PUBLIC LAUNCH & SUSTAINABILITY Call Center – ISHP Research Agency Lead organization – IRH? Donor - USAID Technology partner Aggregators/Mobile operators SMS Gateway Provider Hosting Provider Call Center Data Management Organization Marketing Agency Regulatory Authorities Donor(s)
CycleTel ™ Family planning via SMSFor more information, contact Meredith Puleio at firstname.lastname@example.org or visit www.irh.org