Organization: Indlela@HE2RO
Study objectives: This study conducted by Indlela@HE2RO, builds on a series of exploratory studies that have assessed the usability, acceptability, and appropriateness of AI-powered tools for HIV service delivery in South Africa. While earlier work demonstrated strong interest in AI-driven health tools among both users and providers, it also surfaced real concerns around digital literacy, accessibility, connectivity, and trust. Most existing AI readiness research has focused on high-income countries, leaving the readiness of populations in low- and middle-income countries (LMICs) under explored. This study aims to address that gap.
The specific objectives of the study are:
Primary objective: To assess the digital tech readiness and ability of populations in LMICs to use technology that can inform the design and scaling of AI-enabled health interventions.
Secondary objectives: To explore individual-level factors (e.g., digital literacy, health literacy, trust in technology) that may influence the uptake and use of health-related technologies; and to examine contextual and infrastructural enablers and barriers (e.g., access to internet, smartphone availability, data affordability) that affect technology use for health.
Intervention description: Eligible B-Hub participants will be invited to complete a structured in-person survey adapted for the South African context from the validated Technology Readiness Index (TRI 2.0). The survey will cover demographic and socio-economic information, technology readiness (across four domains: optimism, innovativeness, discomfort, and insecurity), digital ownership and online activity, and AI exposure and understanding.
A randomly selected sub-group of 50 participants will then complete a series of on-site practical digital tasks during the same in-person visit. These tasks will include locating a website using a web browser, initiating a video call, taking and sending a photograph, completing a short information-seeking task via text messaging, and downloading a mobile application from an app store. A further sub-group of 25 smartphone users will be contacted within three months for remote tasks, including completing an online survey via a link, taking and sending a photograph electronically, participating in a WhatsApp audio and video call, testing screen-sharing functionality, and answering questions about access to private space for sensitive health conversations.
Evaluation description: We used an exploratory mixed-methods design, combining quantitative and qualitative approaches to assess the study outcomes.
Study outcomes:
Primary outcome:
- Digital and technology readiness of B-Hub participants in Gauteng Province, measured through the TRI 2.0 and performance on practical digital tasks
Secondary outcomes:
- Individual-level factors influencing the uptake and use of health-related technologies (digital literacy, health literacy, trust in technology)
- Contextual and infrastructural enablers and barriers to technology use for health (internet access, smartphone availability, data affordability, access to private space for health-related calls
Study site: The study will take place in Johannesburg, Gauteng. In-person surveys and practical tasks will be conducted at the HE²RO, offices or at a venue closer to the participant where preferred. Remote tasks will be completed by participants from their own spaces using their cell phones.
Target population:
Inclusion criteria:
- ≥18 years old
- Willing to provide written informed consent for the study, screen and video recordings
- Comfortable consenting and speaking in English
- Willing and able to participate
- Access to a basic phone or smartphone
Exclusion criteria:
- Participants who are not willing or available to take part in this study
Sample size & analysis: We will enrol up to 200 B-Hub participants for the in-person structured survey, with a randomly selected sub-group of 50 participants for the on-site practical tasks and a further 25 smartphone users for the remote tasks. Quantitative data will be analysed descriptively to characterise digital access, technology readiness, and engagement. Associations between demographic and socio-economic characteristics and technology readiness scores will be explored using cross-tabulations and summary statistics. Observational and qualitative feedback collected during task completion will be analysed thematically to identify common barriers, facilitators, and needs that may affect readiness to engage with digital health tools.
Duration: 9 months
