Digital Health (Jul 2022)

REDCap mobile data collection: Using implementation science to explore the potential and pitfalls of a digital health tool in routine voluntary medical male circumcision outreach settings in Zimbabwe

  • Vi Tran,
  • Farai Gwenzi,
  • Phiona Marongwe,
  • Olbarn Rutsito,
  • Pesanai Chatikobo,
  • Vernon Murenje,
  • Joseph Hove,
  • Tinashe Munyaradzi,
  • Zoe Rogers,
  • Mufuta Tshimanga,
  • Vuyelwa Sidile-Chitimbire,
  • Sinokuthemba Xaba,
  • Gertrude Ncube,
  • Lewis Masimba,
  • Batsirai Makunike-Chikwinya,
  • Marrianne Holec,
  • Scott Barnhart,
  • Bryan Weiner,
  • Caryl Feldacker

DOI
https://doi.org/10.1177/20552076221112163
Journal volume & issue
Vol. 8

Abstract

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Background Digital data collection tools improve data quality but are limited by connectivity. ZAZIC, a Zimbabwean consortium focused on scaling up male circumcision (MC) services, provides MC in outreach settings where both data quality and connectivity is poor. ZAZIC implemented REDCap Mobile app for data collection among roving ZAZIC MC nurses. To inform continued scale-up or discontinuation, this paper details if, how, and for whom REDCap improved data quality using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Methods Data were collected for this retrospective, cross-sectional study for nine months, from July 2019 to March 2020, before COVID-19 paused MC services. Data completeness was compared between paper- and REDCap-based tools and between two ZAZIC partners using two sample, one-tailed t-tests. Results REDCap reached all roving nurses who reported 26,904 MCs from 1773 submissions. REDCap effectiveness, as measured by data completeness, decreased from 89.2% in paper to 76.6% in REDCap app for Partner 1 ( p < 0.001, 95% CI: −0.24, −0.12) but increased modestly from 86.2% to 90.3% in REDCap for Partner 2 ( p = 0.05, 95% CI: -.007, 0.12). Adoption of REDCap was 100%; paper-based reporting concluded in October 2019. Implementation varied by partner and user. Maintenance appeared high. Conclusion Although initial transition from paper to REDCap showed mixed effectiveness, post-hoc analysis from service resumption found increased REDCap data completeness across partners, suggesting locally-led momentum for REDCap-based data collection. Staff training, consistent mentoring, and continued technical support appear critical for continued use of digital health tools for quality data collection in rural Zimbabwe and similar low connectivity settings.