Table 2 The IBM-WASH Framework Applied to the Development of the CHoBI7 Mobile Health Intervention Based on Qualitative Findings

Structural/ Societal

• Existing government mobile health programs send out health-related messages on government health days, these include voice and text mobile messages

• Potential inclusion of CHoBI7 intervention in the National Operational Plan in Bangladesh

• Potential integration of CHoBI7 in existing mobile health programs in Banglades

• Government commitment to mobile health as a method to deliver public health information

• Existing government mobile platform has the potential to be used for CHoBI7 intervention delivery at reduced cost

• Health Education Bureau in the Ministry of Health and Family Welfare currently develops mobile health messages, and can be potentially engaged for CHoBI7 intervention development

Community

• High household mobile phone access and ownership in Bangladesh

• Sharing of mHealth messages with neighbors

• High mobile network coverage in Dhaka, Bangladesh

• Most feature phones available in Bangladesh allow for viewing of Bangla script

Interpersonal

• Females in the households are often the ones responsible for caring for young children

• Male household members may not want female household members to receive text and voice messages from an unknown sender

• Female caregivers requesting access to CHoBI7 mHealth messages to allow them to better care for their children

• Text messages allow for sharing with others at a later time

• Male household members do not always share mobile messages or their mobile phones with other household members

• Timing for mobile message delivery when all household members are present

• Adult male household members typically have primary mobile phone ownership in household

• Lower female access to mobile phones

Individual

• Literacy rate of household members

• Limited mobile message sharing by those working outside of the home

• Self-efficacy to open text messages, and respond to interactive voice response messages

• Concerns about being charged a fee for viewing or listening to mobile messages

Habitual

• Frequency of exposure to mobile messages

• Outcome expectancy that following recommendations contained in mobile messages will reduce disease

• Voice and text messages as reminders to perform the promoted water, sanitation, and hygiene behaviors