Designing Interventions for the Early Detection of Buruli Ulcer Disease

Buruli ulcer (BU) disease is a disfiguring, stigmatizing mycobacterium ulcereans akin to tuberculosis and leprosy. BU is classified as a Neglected Tropical Disease by the World Health Organization (WHO) yet can be found in more than 30 countries, including our partner countries Cote d' Ivoire and Ghana. BU is treatable, and when detected early disability is 100% preventable. This research supports the development of a mobile, diagnostic device that identifies the key structural characteristics of Buruli lesions. Deployment of software on mobile devices such as hand-held cell phones equipped with a camera to capture an image of the lesion for diagnosis is cost-effective, easy to deploy, easy to use, and available worldwide. This primary objective of this research examines eliminating health disparities for the medically underserved though introducing non-invasive, low-cost, end-user devices for the early detection and management of diseases. Health technologies such as mobile phone based devices have the potential to greatly increase access to care by overcoming geographical and social barriers for the early detection and management of disease. Social network analysis, the health belief model, and diffusion of innovations theory are combined to formulate one cohesive model for developing an intervention for understanding, at the community-level, the acceptance of a diagnostic tool for the early detection of BU. The secondary objectives of this research develop and test 1. a model for a culturally relevant, community-based community assessment in geographically and socially excluded communities; 2. a community-driven theoretical model for technology assessment, adoption, and acceptance; and 3. training and education materials for communication networks and media designed to increase health literacy in medically underserved and endemic communities. This research also investigates other characteristics that might influence acceptance or adoption such as the basis for healthcare decision making, psychosocial influences, the factors that influence access to care, and the barriers to care. Healthcare decision making can be further broken down into decisions to adopt patterns of health behavior, access to medical care, and utilization of prevention services. This research is novel in concept, novel in innovation, and novel in methods. It contributes to our theoretical understanding of eliminating health disparities, increasing access to health and medical care, and is the first-of-its kind to introduce, at the community-level, low-cost, non-invasive, mobile devices for the early detection and management of disease. This theory-driven intervention model is a valid and reliable model for the introduction of future end-user, patient-centered devices.