Table 3 Diffusion of innovation as applied to community ownership of a text messaging project

Relative advantages to be gained

Improved adherence to medication and appointment, assistance with pharmacy refills, psycho-social support, improved cohesion among PLHIV

Compatibility with existing practices

Weak participation in community activities, text messaging widely used for other purposes

Simplicity of use, trialability and observable results

Non-ubiquitous phone ownership and literacy, high trialability (opting out always possible), results can be appreciated by users

Receiver factors (attitude to change and perceived need)

High acceptability and perceived need

Social system factors (social norms and tolerance for deviancy)

Highly flexible system, positive health worker support