Acceptability and appropriateness of remote monitoring and self-administered pulse oximetry among COVID-19 patients in Honduras: a mixed-methods study.

AIM: To assess the acceptability and appropriateness of remote patient monitoring and self-administered pulse oximetry among high-risk COVID-19 patients, triage centre staff, and study personnel in Tegucigalpa and Comayagüela, Honduras. INTRODUCTION: During the COVID-19 pandemic, the Honduras Secretariat of Health and partners conducted a randomized trial to assess the impact of remote patient monitoring with versus without self-administered pulse oximetry in high-risk populations in urban Honduras. Acceptability and appropriateness were examined to inform future intervention adaptation. METHODS: This mixed-methods study included trial participants, study and triage centre staff. Data sources include trial data, computer-aided self-interviews, and in-depth interviews. The trial ran from March 2022 to January 2023. FINDINGS: 1767 participants completed a disenrollment questionnaire. Thirty-four providers completed a self-interview, and 16 participated in an in-depth interview. Respondents understood interventions and expressed positive attitudes; SESAL staff attitudes were less positive. 94.9% of participants reported willingness to participate again. Some staff expressed concern over participant comprehension and pulse oximeter self-administration, but participants reported successful use. Providers were confident implementing the intervention, but some questioned its appropriateness given competing priorities. Overall, study participants and healthcare providers believed interventions were an acceptable way to monitor for deterioration during the acute phase of a COVID-19 infection. Findings showed that an intervention can be acceptable, but appropriateness may be less clear-cut due to competing priorities. The approach shows promise for adaptation to other settings experiencing health emergencies where technology penetration is high and healthcare availability does not align with demand; appropriateness considerations should be explored prior to implementation.