Yin-leng Theng*, Nanyang Technological University, Singapore, Singapore Lynette Ying Qin Goh, Nanyang Technological University, Singapore, Singapore Shalini Chandra, Nanyang Technological University, Singapore, Singapore Schubert Foo, NanyangTechnological University, Singapore, Singapore May O. Lwin, NanyangTechnological University, Singapore, Singapore Ravi Poovaiah, Indian Institute of Technology (Bombay), Mumbai, India Ajanta Sen, Indian Institute of Technology (Bombay), Mumbai, India Track: Practice Presentation Topic: Public (e-)health, population health technologies, surveillance Presentation Type: Poster presentation Submission Type: Single Presentation Last modified: 2012-09-12

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Background: Tuberculosis (TB) is an airborne disease that accounts for nearly 15% of 2010 deaths in Mumbai and has killed 1.7 million people in 2009 worldwide. Left untreated, the person with active TB infects 10-15 people a year. The recent 2012 TB outbreak in India and particularly in Mumbai has highlighted three salient problems: (i) TB patients are not completing the TB treatment regime and developing resistance to current TB vaccines; (ii) health authorities are not taking active steps/interventions to curb the spread of TB to caregivers (families, friends, neighbours, etc.); and (iii) there are minimal campaigns and outreach, mainly in traditional mass media (TV/radio) to educate the general public on TB civic literacy and responsibility.

Objectives: To address this urgent need for TB control in treatment monitoring and infection control, we are proposing the design and development of a Socially-Mediated Mobile System for Tuberculosis Public Health Alert, Care and Education (MobiTB-ACE). As mobile phone ownership among the “middle-of-the-pyramid” (MOP) segment in India is among the highest in the world, this Singapore-funded project is a tripartite collaboration between Nanyang Technological University, National University of Singapore and Indian Institute of Technology (Bombay) to exploit social media in mobile applications in the fight against TB for public health alert, care and education. In MobiTB-ACE, we aim to address the problems associated with TB in three significant ways, and investigate interventions in:
 monitoring TB patients for the completion of their drug treatment regime through alerts, reminders and testimonials to TB patients;
 supporting active assessment and monitoring of possible exposure of TB caregivers (families, friends, neighbours, community); and
 disseminating timely information about TB-prone areas and outbreaks to the general public, TB hospitals and relevant health authorities for further action.

Design Rationale and Concrete Design: Social media provide opportunities for large-scale information gathering from people in the MOP (e.g., about diseases or illnesses). Using Scenario-Based Design and Claims Analysis, the design team brainstormed on the conceptual design of MobiTB-ACE underpinned in the design rationale of three sets of activities: (i) information gathering developing front-end applications to gather reliable information (e.g., diseases, illnesses, location, time, climate, and geography); (ii) sense-making developing back-end applications to make sense out of information gathered through intelligent computation and algorithms; and (iii) information dissemination developing front-end applications to disseminate reliable information (e.g., forecasts of diseases or illnesses, location, and time) to people in the TOP. The conceptual design of MobiTB-ACE can be found at http://cosmic.ntu.edu.sg/Resources/mobitbace/Architecture%20Diagram%20of%20MobiTB-ACE.pdf.

Method: The components of MobiTB-ACE on public health alert, care and education system will be based on findings from formative research that elicits systemic and user needs from patients, caregivers, health workers and medical doctors. Quantitative and qualitative assessments will be conducted to evaluate the system’s usability, reliability, functionality and appeal. Findings from surveys, key informant interviews and literature reviews will inform the design and development of this mobile-based system. MobiTB-ACE will be pilot-tested among patients and caregivers to get feedback on usability, reliability and overall appeal of the system’s components. The feedback will be used to modify the system and the final MobiTB-ACE system is expected to be rolled out in a staggered manner across the targeted population, first in Mumbai and then other TB-endemic states in India.

Conclusions: This is preliminary work in the conceptualization of MobiTB-ACE. We are currently building the MobiTB-ACE prototype. Future plans include usability evaluations patients and caregivers as well as health and medical professionals from King Edward Memorial (KEM), Hinduja Hospital (TB hospital, Mumbai) and the National Tuberculosis Institute (Bangalore, India) for further refinement.