Acceptability of Mobile Health Interventions to Increase Diabetic Risk Factor Awareness Among the Commuter Population in Johannesburg: Descriptive Cross-Sectional Study

Background Developing countries are experiencing a shift from infectious diseases such as HIV and tuberculosis to noncommunicable diseases (NCDs) such as diabetes. Diabetes accounts for more disability-adjusted life years than any other NCD in South Africa, and research has identified a number of preventable risk factors; however, there is not enough evidence from lower resource settings as to how best to disseminate this information to the population. Today, 90% of the world’s population lives in mobile phone coverage areas, and this provides a unique opportunity to reach large populations with health information. Objective This study aimed to investigate how potential mobile health (mHealth) platforms should be paired with diabetes risk factor education so that at-risk communities are empowered with information to prevent and manage diabetes. Methods A Likert-style survey was distributed to commuters in the City of Johannesburg in July 2018 that explored participants’ background characteristics as well as their knowledge and awareness surrounding diabetic risk factors (such as exercise, smoking, and hypertension) and their comfort level with various information delivery methods (such as WhatsApp, short message service, and email). The grouped variables from diabetic risk factors and information delivery methods were described with mean Likert scores and then investigated for relationships with Spearman Rho correlation coefficients. Results Background characteristics revealed that the self-reported prevalence of diabetes was twice as high in this studied commuter population than the national average. WhatsApp was the most favorable mHealth information delivery method and had a moderate correlation coefficient with diet and nutrition (0.338; P<.001) as well as a weaker correlation with physical activity (0.243; P<.001). Although not as robust as the WhatsApp correlations, each of the other information delivery methods also showed weaker, yet statistically significant, relationships with one or more of the risk factors. Conclusions The elevated self-reported diabetes prevalence reinforces the need for diabetes risk factor education in the studied commuter population of Johannesburg. The most feasible mHealth intervention for diabetic risk factor education should focus on WhatsApp messaging while also offering content across other mHealth and traditional platforms to remove barriers to access and enhance the user experience. The content should emphasize diet and nutrition as well as physical activity while also incorporating information on secondary risk factors.

Acceptability of Mobile Health Interventions to Increase Diabetic Risk Factor Awareness Among the Commuter Population in Johannesburg: Descriptive Cross-Sectional Study (Preprint)

BACKGROUND Developing countries are experiencing a shift from infectious diseases such as HIV and tuberculosis to noncommunicable diseases (NCDs) such as diabetes. Diabetes accounts for more disability-adjusted life years than any other NCD in South Africa, and research has identified a number of preventable risk factors; however, there is not enough evidence from lower resource settings as to how best to disseminate this information to the population. Today, 90% of the world’s population lives in mobile phone coverage areas, and this provides a unique opportunity to reach large populations with health information. OBJECTIVE This study aimed to investigate how potential mobile health (mHealth) platforms should be paired with diabetes risk factor education so that at-risk communities are empowered with information to prevent and manage diabetes. METHODS A Likert-style survey was distributed to commuters in the City of Johannesburg in July 2018 that explored participants’ background characteristics as well as their knowledge and awareness surrounding diabetic risk factors (such as exercise, smoking, and hypertension) and their comfort level with various information delivery methods (such as WhatsApp, short message service, and email). The grouped variables from diabetic risk factors and information delivery methods were described with mean Likert scores and then investigated for relationships with Spearman Rho correlation coefficients. RESULTS Background characteristics revealed that the self-reported prevalence of diabetes was twice as high in this studied commuter population than the national average. WhatsApp was the most favorable mHealth information delivery method and had a moderate correlation coefficient with diet and nutrition (0.338; P<.001) as well as a weaker correlation with physical activity (0.243; P<.001). Although not as robust as the WhatsApp correlations, each of the other information delivery methods also showed weaker, yet statistically significant, relationships with one or more of the risk factors. CONCLUSIONS The elevated self-reported diabetes prevalence reinforces the need for diabetes risk factor education in the studied commuter population of Johannesburg. The most feasible mHealth intervention for diabetic risk factor education should focus on WhatsApp messaging while also offering content across other mHealth and traditional platforms to remove barriers to access and enhance the user experience. The content should emphasize diet and nutrition as well as physical activity while also incorporating information on secondary risk factors.

DIABETES RISK FACTOR SCREENING IN ADULTS USING PERKENI QUESTIONNAIRE AND ORAL GLUCOSE TOLERANCE TEST IN SOCAH COUNTY, BANGKALAN

There are 8.4 million diabetes adult patients in Indonesia and most remained undiagnosed. Screening process for diabetes is very important. PERKENI has recommended the use of questionnaire and Oral Glucose Tolerance Test (OGTT) as risk factor screening tools. This study aimed to find out the use of PERKENI questionnaire and OGTT in adults as diabetes risk factor screening tools. This was a descriptive cross sectional study conducted in 2015 in Socah County Bangkalan. Participants (n=91) were interviewed regarding diabetes risk factor using PERKENI questionnaire. Anthropometric (height, weight, and abdominal circumference) measurements were also taken. The results were categorized into: very low risk, increased risk, moderate risk and high risk. Only those categorized as high risk were asked to take OGTT. Exclusion criteria were participants who had been diagnosed with diabetes by a physician and/or routinely taking anti diabetic medication, consumed drugs during the previous two weeks and does not finish the required procedures. From 91 eligible participants, only 9 (9.89%) were categorized as high risk. The result of OGTT were: 4 were within normal limit, 1 had impaired glucose tolerance (IGT) and 4 were newly diagnosed with diabetes. The use of PERKENI questionnaire and OGTT in high risk adult population as a diabetes risk factor screening tool increased new findings of diabetes cases. Our analysis may support the adoption of diabetes risk factor screening methods through questionnaires and OGTT in high risk adult population, especially in low resource setting.