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Mobile phones support adherence and retention of indigenous participants in a randomised controlled trial: strategies and lessons learnt

McCallum, Gabrielle B., Versteegh, Lesley A., Morris, Peter S., McKay, Clare C., Jacobsen, Nerida J., White, Andrew V., D'Antoine, Heather and Chang, Anne B. (2014). Mobile phones support adherence and retention of indigenous participants in a randomised controlled trial: strategies and lessons learnt. BMC Public Health,14(Article No. 622).

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IRMA ID 11436xPUB50
NHMRC Grant No. 605809
Title Mobile phones support adherence and retention of indigenous participants in a randomised controlled trial: strategies and lessons learnt
Author McCallum, Gabrielle B.
Versteegh, Lesley A.
Morris, Peter S.
McKay, Clare C.
Jacobsen, Nerida J.
White, Andrew V.
D'Antoine, Heather
Chang, Anne B.
Journal Name BMC Public Health
Publication Date 2014
Volume Number 14
Issue Number Article No. 622
ISSN 1471-2458   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84902300317
Total Pages 7
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
Ensuring adherence to treatment and retention is important in clinical trials, particularly in remote areas and minority groups. We describe a novel approach to improve adherence, retention and clinical review rates of Indigenous children.


This descriptive study was nested within a placebo-controlled, randomised trial (RCT) on weekly azithromycin (or placebo) for 3-weeks. Indigenous children aged ≤24-months hospitalised with acute bronchiolitis were recruited from two tertiary hospitals in northern Australia (Darwin and Townsville). Using mobile phones embedded within a culturally-sensitive approach and framework, we report our strategies used and results obtained. Our main outcome measure was rates of adherence to medications, retention in the RCT and self-presentation (with child) to clinic for a clinical review on day-21.


Of 301 eligible children, 76 (21%) families declined participation and 39 (13%) did not have access to a mobile phone. 186 Indigenous children were randomised and received dose one under supervision in hospital. Subsequently, 182 (99%) children received dose two (day-7), 169 (93%) dose three (day-14) and 180 (97%) attended their clinical review (day-21). A median of 2 calls (IQR 1–3) were needed to verify adherence. Importantly, over 97% of children remained in the RCT until their clinical endpoint at day-21.


In our setting, the use of mobile phones within an Indigenous-appropriate framework has been an effective strategy to support a clinical trial involving Australian Indigenous children in urban and remote Australia. Further research is required to explore other applications of this approach, including the impact on clinical outcomes.
Keywords Mobile phones
Randomised controlled trial
DOI   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License 2.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Description for Link Link to CC Attribution 2.0 License

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