Approaches that will yield greater success when implementing self-administered electronic data capture ICT systems in the developing world with an illiterate or semi-literate population

The Information Technology (IT) Group at the Population Council responded to a need for a technology solution that would help researchers obtain more accurate responses to survey questions that concerned subject matter of a sensitive nature. The IT Group had three goals: (1) to enhance research by obtaining the best data possible, (2) to operate successfully in the local environment and be welcomed by the local populations, and (3) to increase the efficiency and cost-effectiveness of the survey process. This paper outlines approaches to consider when designing and implementing self-administered information and communications technology (ICT) questionnaires in developing countries, and reviews the problems and issues we encountered and how we overcame them. Many of the approaches outlined may also be used in general for ICT-related projects in the developing world. To meet future challenges, we have begun an effort to build a prototype system that would operate on a variety of devices—when connected to the internet or not (securely storing the data when the system is offline)—and provide an administrative application to step through simple screens to build a self-administered questionnaire with the most frequently used functions

Assessing the reporting of adherence and sexual activity in a simulated microbicide trial in South Africa: An interview mode experiment using a placebo gel

Misreporting of adherence undermines detection of an association between product use and HIV infection in microbicide trials. This study investigates whether, in a placebo trial, audio computer-assisted self-interviewing (ACASI) produces more accurate reporting of adherence and sexual behavior than a face-to-face interview (FTFI). At three South African clinics, 849 women were enrolled and instructed to use applicators filled with placebo gel; participants were randomly assigned to FTFI or ACASI. Behavioral reports were validated through two biomarkers that detect product usage and unprotected sex. For most behaviors, ACASI generated significantly higher reporting, although differences by interview mode appeared to diminish over time. ACASI participants were more likely to report having had sex without gel, but reported and tested applicators did not indicate greater honesty about gel insertion with ACASI. While comparisons of reported unprotected sex with the validated biomarker revealed more agreement with ACASI than with FTFI, differences were small

Effect of computer-assisted interviewing on self-reported sexual behavior data in a microbicide clinical trial

In a microbicide safety and effectiveness trial (HPTN 035) in Malawi, 585 women completed the same questionnaire through a face-to-face interview (FTFI) and an audio computer-assisted self-interview (ACASI). Concordance between FTFI and ACASI responses ranged from 72.0% for frequency of sex in the past week to 95.2% for anal intercourse (AI) in the past 3 months. Reported gel and condom use at last sex act were marginally lower with ACASI than FTFI (73.5% vs. 77.2%, p = 0.11 and 60.9% vs. 65.5%, p = 0.05, respectively). More women reported AI with ACASI than FTFI (5.0% vs. 0.2%, p \u3c 0.001). Analyses of consistency of responses within ACASI revealed that 15.0% of participants in the condom-only arm and 28.7% in the gel arm provided at least one discrepant answer regarding total sex acts and sex acts where condom and gel were used (19.2% reported one inconsistent answer, 8.1% reported two inconsistent answers, and 1.4% reported three inconsistent answers). While ACASI may provide more accurate assessments of sensitive behaviors in HIV prevention trials, it also results in a high level of internally inconsistent responses