User adherence and perceptions of a Volunteer-Led Telemonitoring and Teleorientation Service for COVID-19 community management in Peru: The COVIDA project

Background During the pandemic in Peru, the COVIDA project proposed an innovative way to provide telemonitoring and teleorientation to COVID-19 pandemics led by health student volunteers. However, it has not been described how this interaction is perceived from the user’s perspective. The aim of this study is to describe the adherence and perceptions of users about COVIDA. Methods A mixed-method study was conducted to evaluate the adherence and perceptions of COVIDA users. This telehealth intervention implemented in Peru from August to December 2020 involved daily phone-calls by volunteer students to monitor registered users for 14 days or until a warning sign was identified. The volunteers also provided teleorientation to address the users’ needs and concerns. Quantitative analysis described the characteristics of users and assessed the factors related to adherence to the service. Qualitative analysis trough semi-structured interviews evaluated the user’s perceptions about the service. Results Of the 778 users enrolled in COVIDA, 397 (54.7%) were female and had a mean age of 41 years (SD: 15.3). During the monitoring, 380 users (44.4%) developed symptoms, and 471 (55.5%) showed warning signs for COVID-19. The overall median of adherence was 93% (p25:36%, p75:100%). Among those users who did not develop warning symptoms, a high level of adherence (>66%) was seen predominantly in users that developed symptoms and those with a positive COVID-19 test (p<0.05). Users referred that the information provided by volunteers was clear and valuable and, their accompaniment provided them with emotional support. Communications via phone calls were developed fluently without interruptions. Conclusions COVIDA represented an affordable, well-accepted, and perceived alternative model for telemonitoring, teleorientation and emotional support from student volunteers to users with diseases such as COVID-19 in a context of overwhelmed demand for healthcare services. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The realization of the COVIDA project was founded by the research grant provided National Council of Science, Technology, and Innovation (FONDECYT CONCYTEC) with the Resolution N 037 2020 FONDECYT and the collaborative participation of researchers from of the National University of San Marcos (UNMSM) and the Peruvian National Health Institute (INS). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics committee/IRB for COVID of the Social Security (EsSalud) gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The datasets analyzed during the current study are not publicly available as is being part a confidential information of patients be attended into the COVIDA Project but could be anonymized and shared on reasonable request.