A brief description of the framework used in data analysis
| Thematic framework components and quotes | Codes | Summary | Categories | Subthemes | Theme* |
|---|---|---|---|---|---|
| Helpfulness of IVR | Forgetfulness due to work—reminders help | Phone calls minimised forgetfulness and enabled development of a medication routine, improving adherence. Concern from healthcare provider perceived | Improves adherence | Different perceptions regarding the helpfulness as a reminder | 1 |
| We will be busy with our work, when we get busy, I feel that the reminder is very important for me take the tablets | |||||
| When I get a call at 8:00, I feel happy that a call has come from hospital. I feel people from hospital have called | Perceived concern of the healthcare provider along with. Feels happy with the calls | Healthcare providers concern | Different perceptions regarding the helpfulness as a reminder | 1 | |
| Helpfulness of SMS | SMS not liked, the inconspicuous alert tone makes the patient miss the SMS | A general dislike for SMS. The SMS is missed on arrival because of its inconspicuous ring tone. Unintended disclosure of HIV status perceived | SMS disliked | Different perceptions regarding the helpfulness as a reminder | 1 |
| I never liked SMS, I didn't like it at all. I would be busy during the day. I would never hear its sound at all…I never get to know when SMS comes… | |||||
| I delete it on the spot but by chance if someone sees it, “LM arogyam”†, they will question me | Perceive the disclosure of HIV status with the SMS | Fear of disclosure of HIV status | Preventing unintended disclosure of HIV status | 3 | |
| Perception of importance of the intervention | Intervention does not matter, patient adherent | The necessity of calls is not seen as patients claim to be adherent without the calls. External cues to support adherence used | Perception of being adherent | Different perceptions regarding the helpfulness as a reminder | 1 |
| Whether I get a phone call or SMS, it doesn't matter, I have taken tablets regularly. That is more important right? | |||||
| By 9.00 sharp, after having my breakfast and while taking the cash for my expenses…I will also take the medicines | Patient takes medicines daily after breakfast | External cues for adherence used | Different perceptions regarding the helpfulness as a reminder | 1 | |
| Preference between IVR and SMS | Fear of disclosure of HIV status from the phone call | A preference for phone calls in comparison to SMSs. Phone calls thought to have the potential for disclosure of HIV status | Fear of disclosure of HIV status | Preventing unintended disclosure of HIV status | 3 |
| Yes, she has read the message and asked who is the ‘arogyam’, no one knows, but if you are calling, whoever is attending the call will come to know about the problem | |||||
| The call is sufficient, SMS is not necessary…in the phone call they speak, at least to respect (them) we take the call…If we take the call we have to respond…We do not have to respond to the SMS… | Calls are considered sufficient as they are interactive, SMS considered passive | Interaction in the call preferred to passivity of the SMS | Engagement: IVR vs SMS | 2 |
*Themes: 1. Perceptions of varying usefulness of the intervention, 2. preference for calls over messages and 3. perceived risk of unintentional disclosure of HIV status.
†The name under which the SMS is delivered, ‘arogyam’ means health.
IVR, interactive voice response; SMS, short messaging service; LM, prefix to the alpha numeric sender identifier ‘arogyam’ L- code for the service provider, M- code for the service area. This prefix follows the regulations for SMS sender identification issued by the Telecom Regulatory Authority of India on 10th December 2008, http://www.trai.gov.in/WriteReadData/Direction/Document/direction10dec08.pdf.