BACKGROUND
The geographical environments within which individuals conduct their daily activities may influence health behaviors, yet little is known about individual-level geographic mobility and specific, linked behaviors in rural, low-and-middle-income settings.
OBJECTIVE
Nested in a 3-month ecological momentary assessment (EMA) intervention pilot trial in rural Uganda, this study leveraged mHealth app user GPS data to examine activity space through individual spatial mobility and locations of reported health behaviors in relation to their homes.
METHODS
Pilot trial participants used a smartphone that logged their GPS coordinates every 1-2 hours for approximately 90 days. They also reported specific health behaviors (alcohol use, cigarette smoking, and having condomless sex with a non-long-term partner) that were both location- and time-stamped. We characterized participant mobility using multiple measures including individual-level average distance traveled per week, number of unique locations visited, and number of unique locations visited for specific health behaviors. Measures were summarized across the sample using descriptive statistics.
RESULTS
Of the 45 participants with complete GPS data, 24 (53%) were men, 30 (67%) were under age 35, and 32 (71%) were in the top two socioeconomic status quartiles. Participants traveled on median 274 kilometers/week (Interquartile range: 150, 533). Of the participants reporting drinking alcohol, cigarette smoking, and condomless sex, respectively, 19 (83%), 8 (89%), and 12 (86%) reported that behavior at least once outside their 400m home neighborhood and across a median of 3.0 (1.5, 5.5), 3.0 (1.0, 3.0), and 3.5 (1.0, 7.0) unique locations, respectively.
CONCLUSIONS
Among residents in rural Uganda, an EMA app successfully captured high mobility and health-related behaviors in multiple locations. Future mHealth interventions in similar settings could leverage individual-level GPS data to inform place-based strategies for promoting healthy behavior change.