Abstract
BackgroundDeveloping 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.ObjectiveThis 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.MethodsA 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.ResultsBackground 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.ConclusionsThe 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.
Highlights
BackgroundIn developing countries, advances in maternal health and infectious disease treatments are causing a shift in the burden of disease from communicable diseases to noncommunicable diseases (NCDs)
The elevated self-reported diabetes prevalence reinforces the need for diabetes risk factor education in the studied commuter population of Johannesburg
The most feasible mobile health (mHealth) intervention for diabetic risk factor education should focus on WhatsApp messaging while offering content across other mHealth and traditional platforms to remove barriers to access and enhance the user experience
Summary
BackgroundIn developing countries, advances in maternal health and infectious disease treatments are causing a shift in the burden of disease from communicable diseases to noncommunicable diseases (NCDs). The prevalence of diabetes in low-income communities is estimated to be 7.1%, as these communities are more susceptible to diabetes because of specific risk factors [3] These risk factors include unbalanced diets because of food insecurity, cultural influence on food and body-image perceptions, lack of physical activity, as well as a general lack of knowledge surrounding diabetes [4,5]. In South Africa mobile penetration has reached 68%, and up to 90% of smartphone users regularly use at least one app-based messaging service, such as WhatsApp or Facebook Messenger [7] This provides a unique opportunity to distribute health information to large populations, and in 2015, the South African National Department of Health introduced the South African mHealth Strategy 2015-2019. 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
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