One of the major health challenges faced in sub-Saharan Africa is having enough blood donors to maintain a sufficient blood supply for transfusions. One of the issues faced in recruiting and retaining blood donors in these countries is the presence of certain social and cultural beliefs, such as the belief that donated blood would be used to perform rituals. Overcoming such beliefs requires communicating with the public in a way that is accurate, understandable and culturally appropriate. This could be accomplished using face-to-face communication, mobile phones and mass media like radio and television.
In a new study, Dr. Bernard Appiah, assistant professor in the environmental and occupational health department at the Texas A&M School of Public Health, along with research colleagues from the United States, Ghana and the United Kingdom, looked at the use of mobile phones to encourage blood donation. Although efforts promoting blood donation using text messaging have proven successful in other parts of the world, few mobile phone users in sub-Saharan Africa use text messaging to receive consumer or health information. Thus, text message-based promotion efforts would miss their intended audience.
To overcome this challenge, Dr. Appiah and colleagues turned their attention to caller tunes, songs and messages that mobile phone users can have play in place of the standard ringing sound when calling another phone. Caller tunes are popular in sub-Saharan Africa, though no research has looked at their use to promote blood donation and no such caller tunes yet exist. The first step in this regard would be to better understand the factors affecting caller tune use, adoption and effectiveness.
In their study, published in the Journal of Medical Internet Research mHealth and uHealth, the research team used the technology acceptance model, a proven method for measuring user acceptance of new technologies, to measure the effects of perceived ease of use, perceived usefulness, attitudes toward caller tunes and cost of downloading mobile phone caller tunes for promoting blood donation among blood donors and non-donors in Accra, Ghana. In this case, perceived ease of use refers to the belief that the technology could be used without effort and perceived usefulness refers to the belief that the technology would help encourage callers to mobile phones to become blood donors. Dr. Appiah and his colleagues used two questionnaires, one for regular blood donors and one for non-donors, covering perceived ease of use, usefulness, attitudes, intention and perception of caller tunes provided without cost. They then divided data from the questionnaires into four groups based on whether participants were blood donors and whether they have used caller tunes before.
Their analysis found relationships between perceived ease of use and usefulness, and attitudes toward intent to use caller tunes that are consistent with other studies showing that these factors can help predict intent to use technology. Dr. Appiah and his colleagues also note that having caller tunes free of cost positively affects attitudes toward caller tunes and intent to use them. This points to the need to have blood donation promoting caller tunes available free of charge for maximum effectiveness.
“We were surprised that making caller tunes free of cost to download was statistically significant among only non-blood donors who do not already use caller tunes,” said Dr. Appiah. “This suggests that blood donors who use or do not use caller tunes may be willing to download caller tunes even at a cost to help others become donors. But for non-blood donors who are already not using caller tunes, the cost of downloading caller tunes, no matter how small it could be, may be a barrier that needs to be addressed.”
This study did not explore the actual use of caller tunes to promote blood donation because such caller tunes have not yet been created. However, the work here is a crucial step in designing this kind of intervention as understanding how perceived usefulness and ease of use, as well as cost, can affect adoption.
According to Dr. Appiah, “This study found that 50.8 percent of mobile phone users found in places where blood donation occurs have caller tunes. This shows the popularity of caller tunes in Ghana. When you call a mobile number in Ghana, don’t be surprised if you hear a song or message instead of the typical ringing sound before the called party answers it. I hope that In the future, mobile phone callers may hear something like, ‘Donate blood to save a life now.’”
Testing of actual products and efforts to promote caller tunes will be needed and future research will also need to explore different types of blood donors, such as regular and paid donors, and to look into additional factors that could also affect attitudes toward caller tunes and intent to use them. However, this study broke new ground on a novel and culturally appropriate communications intervention and serves as an early guidepost for efforts to improve low blood donation rates in sub-Saharan Africa and help overcome this major health challenge.