Adapting and Validating Tools to Assess the Usability and Acceptability of mHealth Tools Among Community Health...

Area of Science:

• Global Health
• Digital Health
• Health Informatics

Background:

• Mobile health (mHealth) apps are crucial for supporting community health workers (CHWs) in low- and middle-income countries.
• Limited usability and acceptability hinder the scaled implementation of mHealth tools for CHWs.
• Systematic evaluation of mHealth tools using context-specific, validated instruments is lacking in sub-Saharan Africa.

Purpose of the Study:

• To adapt and validate existing mHealth usability and acceptability assessment tools for Rwandan CHWs.
• To ensure contextual appropriateness for CHWs involved in postoperative home follow-up for women after cesarean delivery.
• To create a tool for evaluating a novel CHW-led mHealth app in an implementation study.

Main Methods:

• Two established tools were adapted and supplemented with new items reflecting CHW app functions.
• Items were translated into Kinyarwanda and simplified for CHWs' educational levels.
• A three-stage validation process included content validity (experts), face validity (CHWs), and reliability (Cronbach's α).

Main Results:

• The final 22-item tool, the Community Health Worker mHealth Usability and Acceptability Assessment Tool, demonstrated strong validity and reliability.
• Content validity index exceeded 0.78 for 88% of items; face validity index was 0.991.
• High internal consistency was observed with Cronbach's α values of 0.86 (usability), 0.73 (acceptability), and 0.87 (new items).

Conclusions:

• A rigorously adapted and validated tool for assessing mHealth usability and acceptability among Rwandan CHWs has been developed.
• This tool can guide future mHealth intervention evaluations in similar low-resource settings.
• It serves as a model for localizing mHealth assessment tools to ensure effective implementation.