Objective To estimate the proportion of Chongqing TB patients who have access to mobile phones, to describe the utilization practice of those mobile phones, and to learn the general information of those TB patients, so as to provide feasibility basis for further intervention of SMS reminder systems. Methods The stratified cluster sampling method was used and four TB high-risk districts were selected. Both quantitative and qualitative research methods were used to interview the TB patients and suspects who had come to their local TB dispensaries during the past two months. The quantitative data was double entered using EpiData 3.1. The association of mobile phone utilization parameters with key variables was determined using chi-square test and logistic regression analyses. The qualitative data was managed, coded and retrieved using MAXQDA, and analyzed using thematic framework approach. Results Of the patients interviewed by quantitative research, the mobile phone ownership rate was 91.1%; 914 cases (80.4%) of the respondents were able to receive text messages; and most people (81%) held favorable opinions on SMS reminders. The main factors related to mobile phone ownerships and receiving SMS were age, occupation, education level, and place of residence. The male patients, in the age group of 19-49 years old, with education level of high school or higher were more likely to have access to mobile phones. The results from qualitative interview were similar. Conclusion Considering the high access to mobile phones of patients interviewed and patients’ views on SMS reminders, it is feasible to conduct a pilot intervention using SMS as a strategy to improve adherence to TB treatment in Chongqing.
Objective To describe the range of Public-private partnerships (PPP) in the provision of healthcare services, and how the authors have assessed these partnerships. Methods We searched 19 international electronic databases and 3 grey literature databases up to September 2008. Nine websites of relevant organizations and Google were searched for any missing information. Search terms were determined by both health policy experts and search specialists after repeated discussion and pilot searching. Our inclusion criteria were research papers that reported describing or evaluating any public-private partnerships in provision of healthcare services. Two reviewers independently screened, appraised and extracted the data, and disagreements were resolved by discussion or by consulting a third researcher. The studies that scored A or B in terms of quality assessment were analyzed. Results Of the 38 studies included in the analysis, 22 studies aimed to describe strategies, while 16 ones were to evaluate the effectiveness of strategies. The targeted populations were tuberculosis patients, AIDS patients, psychiatric patients, community residents and children. Six partnership mechanisms were categorized: ① formal/ informal contract; ② working group committee; ③ supervision, training and regulation; ④ support and subsidizing; ⑤ integration of health care organizations; and ⑥ co-location. Most of the studies evaluating effectiveness were observational studies. Only three studies were comparative studies, pre- and post- intervention. The results of the most evaluation studies showed that PPP had positive impact on service provision, while it also had some problems and challenges. Conclusion Current studies show that PPP could improve health service provisions to some extent. There are limitations in the range of health services and the depth of the studies, especially evaluation studies that lack rigorous design. However, people should be cautious when they try to learn from the experience from internationally successful PPPs and consider the Chinese context, as the effect of PPP is closely associated with the relevant implementation context.
Objective To systematic review the international interventions on mental health of involuntary migrants, and evaluate the effects of different interventions. Methods We searched 10 international electronic databases and 3 grey literature databases to November 2008. Websites of relevant organizations and Google were searched for any missing information. Research papers that reported describing or evaluating any interventions on preventing and treating mental health problems of involuntary migrants were included. Two reviewers independently screened, appraised and extracted the data, disagreements were resolved by discussion. Implemented interventions were summarized and analyzed by qualitative synthesis method. As there was heterogeneity in the type of interventions, study design, and outcomes, the study results were not pooled statistically in meta analysis. Results Of the 35 studies included in the analysis, 16 studies aimed to describe intervention strategies, while 19 studies were to evaluate effectiveness of interventions. The targeted population were mainly refugees and asylum seekers caused by the war, violence and other tortures, while only one study targeted at reservoir migrants. All the psychological interventions were divided into prevention intervention and treatment intervention. The main interventions include: integrated psychological intervention, group treatment, cognitive behavior therapy, testimony, narrative exposure therapy, supportive counseling service, family support and therapy, etc. Of which, integrated psychological interventions are the most common intervention. Most of the studies evaluating effectiveness are observational studies, while only six are controlled trials. The results of most evaluation studies show that the implemented psychological interventions have positive impact on mental health of involuntary migrants. Conclusions There are limited intervention studies on mental health of involuntary migrants, and evaluation studies are lack of rigorous design. More research especially preventive intervention study is required. High-quality trials with large sample and rigorous design are needed to evaluate the most effective psycho-interventions for different groups of involuntary migrants.