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Acceptability and Scalability of an IT-based App for Risk Assessment of Non-Communicable Diseases by Lady Health Workers in Pakistan – Study Protocol for a Mixed Method Pilot Trial

Year: 2025

Type: article

Abstract: The prevalence of non-communicable diseases (NCDs) is rising globally, especially in lower-middle-income countries, underscoring the need for effective public health interventions. There is limited evidence that mobile health interventions can assist in identifying the risk of NCDs in the community. Leveraging existing grassroots infrastructure, such as the Lady Health Worker (LHW) program, presents a promising opportunity to address this challenge. We developed a mHealth application to address this issue. This study protocol describes the design of a pilot study aimed at developing a mHealth application, assessing the feasibility, acceptability (barriers and facilitators), and usability to triage the risk of NCDs and pilot test it in the hands of the LHWs in Pakistan. This study consists of three phases. In phase 1, we develop a comprehensive mHealth application incorporating validated tools for NCD assessment, including the Rose Angina Questionnaire, Questionnaire for Verifying Stroke-free Status, Risk Assessment of Pakistani Individuals for Diabetes, Global Adult Tobacco Survey, International Physical Activity Questionnaire, Refined Food Frequency Questionnaire, and WHO 5 Wellness Index. Phase 2 involves qualitative focus group discussions with LHWs to refine the prototype. Phase 3 entails piloting the application with a sample of 30 LHWs in Karachi and Hyderabad, followed by qualitative exit feedback from LHWs, supervisors, healthcare providers, and community members. The outcomes will be analyzed by means, standard deviation or median with interquartile range for continuous data based on the normality assumption. The frequency with percentages will be registered for the categorical variables to describe the risk identifiers using the NCD tool kit. Internal consistency as validity evidence of the assessment can be determined using Cronbach’s alpha and the content validation index. If deemed feasible or acceptable, our mHealth app will address gaps in the literature and advance NCD research by identifying and improving the quality of life of people in the community in developing countries like Pakistan. The functioning and dissemination of this MHealth application can be an essential step towards highly scalable NCD data collection for a population at high risk for developing NCDs.

Source: F1000Research

DOI: 10.12688/f1000research.163362.1