Mobile Digital Technologies Research Articles

Digital dementia in the internet generation: excessive screen time during brain development will increase the risk of Alzheimer's disease and related dementias in adulthood.

Converging evidence from biopsychosocial research in humans and animals demonstrates that chronic sensory stimulation (via excessive screen exposure) affects brain development increasing the risk of cognitive, emotional, and behavioural disorders in adolescents and young adults. Emerging evidence suggests that some of these effects are similar to those seen in adults with symptoms of mild cognitive impairment (MCI) in the early stages of dementia, including impaired concentration, orientation, acquisition of recent memories (anterograde amnesia), recall of past memories (retrograde amnesia), social functioning, and self-care. Excessive screen time is known to alter gray matter and white volumes in the brain, increase the risk of mental disorders, and impair acquisition of memories and learning which are known risk factors for dementia. Chronic sensory overstimulation (i.e., excessive screen time) during brain development increases the risk of accelerated neurodegeneration in adulthood (i.e., amnesia, early onset dementia). This relationship is affected by several mediating/moderating factors (e.g., IQ decline, learning impairments and mental illness). We hypothesize that excessive screen exposure during critical periods of development in Generation Z will lead to mild cognitive impairments in early to middle adulthood resulting in substantially increased rates of early onset dementia in later adulthood. We predict that from 2060 to 2100, the rates of Alzheimer's disease and related dementias (ADRD) will increase significantly, far above the Centres for Disease Control (CDC) projected estimates of a two-fold increase, to upwards of a four-to-six-fold increase. The CDC estimates are based entirely on factors related to the age, sex, race and ethnicity of individuals born before 1950 who did not have access to mobile digital technology during critical periods of brain development. Compared to previous generations, the average 17-19-year-old spends approximately 6 hours a day on mobile digital devices (MDD) (smartphones, tablets, and laptop computers) whereas individuals born before 1950 at the same age spent zero. Our estimates include the documented effects of excessive screen time on individuals born after 1980, Millennials and Generation Z, who will be the majority of individuals ≥65 years old. An estimated 4-to-6-fold increase in rates of ADRD post-2060 will result in widespread societal and economic distress and the complete collapse of already overburdened healthcare systems in developed countries. Preventative measures must be set in place immediately including investments and interventions in public education, social policy, laws, and healthcare.

Copying and Recreation Methods of Painting Works Relying on Mobile Digital Multimedia Big Data Analysis.

In order to improve the effect of copying and recreation of painting works, this paper combines mobile digital multimedia big data technology to improve the image coding algorithm, identify the characteristics of existing works, apply the algorithm to the detailed analysis of painting works, and construct the main functional structure modules of the system. Moreover, this paper combines the existing hardware equipment to construct the painting works' recreation system and obtains the image processing module. After the system is constructed, the effect of copying and recreating painting works is analyzed through the mobile digital multimedia big data analysis technology. Finally, this paper constructs the system of this paper through simulation methods and uses experiments to calculate the feature recognition effect and copy effect of the painting works of the system. Through experimental analysis, it can be known that the copying and recreation system of painting works based on mobile digital multimedia big data analysis proposed in this paper can help painters effectively improve the effect of recreation.

XR Ulysses: addressing the disappointment of cancelled site-specific re-enactments of Joycean literary cultural heritage on Bloomsday

ABSTRACT Site-specific performances are shows created for a specific location and can occur in one or more areas outside the traditional theatre. Social gathering restrictions during the Covid-19 lockdown demanded that these shows be shut down. However, site-specific performances that apply emergent and novel mobile digital technologies have been afforded a compelling voice in showing how performance practitioners and audiences might proceed under the stifling constraints of lockdown and altered live performance paradigms, however they may manifest. Although extended reality (XR) technologies have been in development for a long time, their recent surge in sophistication presents renewed potentialities for site-specific performers to explore ways of bringing the physical world into the digital to recreate real-world places in shared digital spaces. In this research, we explore the potential role of digital XR technologies, such as volumetric video, social virtual reality (VR) and photogrammetry, for simulating site-specific theatre, thereby assessing the potential of these content creation techniques to support future remote performative events. We report specifically on adapting a real-world site-specific performance for VR. This case study approach provides examples and opens dialogues on innovative approaches to site-specific performance in the post-Covid-19 era.

The role of digital mobile technology in elderly health management among health care workers in Indonesia: Analysis of knowledge, attitudes, and practice.

BackgroundTechnology, including information and communication technology (ICT), plays a significant role in the quality of health services. However, its application in elderly health services is still lacking. The aim of this study was to determine the knowledge of, attitudes toward, and practices of cell phone and mobile application use for elderly health care among Indonesian health care workers.MethodsThis was a cross-sectional study conducted with health care workers in Jakarta, Indonesia. The potential subjects were contacted through instant messenger application and/or through conventional short message service or telephone calls from August through November 2020.ResultsThere were 134 subjects. All the subjects had used various health applications to assist with their daily work, including telemedicine (64.2%), guidelines (60.4%), and medical calculators (46.3%). However, 96.3% of the subjects were not aware of the existence of a health application for geriatric assessment. Furthermore, 98.5% of subjects thought that it is important to use ICT to manage geriatric patients, and 94.8% felt that comprehensive geriatric assessment (CGA) in digital form would help them manage geriatric patients better. Nevertheless, 35.10% of subjects had never applied CGA to their geriatric patients.ConclusionsThe current health care system has begun to enter a period of using ICT in performing health services for geriatric patients. Nevertheless, only a few Indonesian health care workers were aware of or were using the geriatric mobile application. It is essential to improve the dissemination of geriatric health care and e-health literacy among them to improve the quality of elderly health care.

High Impact Employee Stress Reduction and Wellness Promotion Delivered via Digital Mobile Technology in the Construction and Aviation Industries

To evaluate the impact of an on demand, digital mobile application deployed via smartphone on subjectively perceived and objectively measured stress levels of employee participants in a mobile digital stress reduction program within two corporate enterprises, as well as on self-reported wellness indicators.

The Hidden Public Health Problem of Inadequate Sleep: Deploying Digital Mobile Technology to Improve Employee Sleep Hygiene in Asia

To evaluate the impact of an on demand, digital mobile application deployed via smartphone on the sleep hygiene and nightly duration of employee program participants within a large multinational banking enterprise.

Venues and methods to improve professional men\u2019s access to HIV self-testing and linkage to HIV prevention or treatment: a qualitative study

BackgroundHIV testing among men in sub-Saharan Africa is sub-optimal. Despite several strategies to improve access to underserved populations, evidence regarding engaging men in professional and formal occupations in HIV testing is limited. This study explored employed professional men’s preferences for uptake of HIV self-testing, and linkage to HIV care, or prevention services.MethodsThis was an explorative-descriptive qualitative study where a sample of 33 men from six Ugandan urban centres. Participants were purposively selected guided by the International Standard Classification of Occupations to participate in in-depth interviews. The data were collected using an interview guide and the sample size was determined by data saturation. Eligibility criteria included fulltime formal employment for over a year at that organization. The data were analyzed manually using thematic content analysis.ResultsThree categories emerged: uptake of HIV self-tests, process of HIV self-testing and linkage to post-test services. The different modes of distribution of HIV self-test kits included secondary distribution, self-tests at typically male dominated spaces, delivery to workplaces and technology-based delivery. The process of HIV self-testing may be optimized by providing collection bins, and mHealth or mobile phone applications. Linkage to further care or prevention services may be enhanced using medical insurance providers, giving incentives and tele counselling.ConclusionWe recommend utilization of several channels for the uptake of HIV self-tests. These include distribution of test kits both to offices and men’s leisure and recreation ‘hot spots’, Additionally, female partners, peers and established men’s group including social media groups can play a role in improving the uptake of HIV self-testing. Mobile phones and digital technology can be applied in innovative ways for the return of test results and to strengthen linkage to care or prevention services. Partnership with medical insurers may be critical in engaging men in professional employment in HIV services.

Enhanced job satisfaction under tighter technological control: The paradoxical outcomes of digitalisation

AbstractVia a multiple case study of work in microfinance institutions in India, this paper reports on the experiences of field officers and branch managers following work digitalisation. It identifies and explains an intriguing post‐digitalisation paradox of reported increased job satisfaction and tighter technological control diminishing branch managers' work‐life balance. The paradox draws attention to the significance of context in workers' experiences of mobile digital technologies (MDTs) and contradicts previous studies on workers' positive experiences of adopting MDTs: the workers in this study did not experience greater autonomy or flexibility but reported enhanced employment security and status. The paper also adds to literature on employment relations following work digitalisation by revealing powerful enforcement of technological control, with ‘WhatsApp’ identified as a key managerial tool used for surveillance and discipline, and worker resistance at the margins.

License Plate Recognition Integrated with Android and Mobile Vision

License plate is an important thing on vehicle. License plate is an identity of vehicle. All of the information about type, year, tax, and owner of vehicle. The development of technology especially in digital image processing and mobile android technology. There are so many android applications that used digital image processing known as optical character recognition. The purpose of this paper is to make an android application that can recognize license plate with mobile vision library. The research method of this paper is waterfall, starts with integrating android with mobile vision library and doing test to find out the accuracy of mobile vision. Designing an application models with flowchart diagram and unified modelling language.

Digital Literacy Skills as Prerequisite for Teaching and Learning in Higher Education Institutions

The advent of digital technologies has brought about new opportunities and challenges to the education system globally. The use of digital technologies by educators in Higher Education Institutions (HEIs) is a portal for innovative teaching and learning. While there is a gradual increase in the use of these innovative technologies by HEIs in South Africa, there is still a long way to transform the educational system fully. Effective use of digital technologies in teaching and learning needs a certain level of digital literacy. Digital literacy enhances teaching and learning by helping educators integrate and use digital technologies, while equipping students with skills to access the internet effectively. The impact of digital technology has beaconed the need of educators to acquire 21st-century skills. Digital literacy skills are critical in realising the potential and benefits of digital technologies. This paper investigates the importance of digital technologies in education and the impact of digital literacy skills on the effective use of these technologies in HEIs in South Africa. Data collection was primarily based on a critical review of literature relating to the application of mobile technologies in HEIs in South Africa. The results revealed various barriers inhibiting educators from adopting mobile technologies in teaching and learning, including lack of digital literacy skills, time constraints, unwillingness to change, lack of educator confidence, poor technological infrastructure, and lack of digital or mobile devices. The study provides recommendations to enable and inspire educators in HEIs to use mobile digital technologies effectively.

Intangible Cultural Heritage High-Definition Digital Mobile Display Technology Based on VR Virtual Visualization

With the continuous improvement of the public’s pursuit of information contact experience, in the era of the development of VR technology, digital mobile display technology has gradually changed the traditional display habits with its unique charm and strong competitive advantage. This article aims to improve the value of art research, meet the needs of the information age, and spread the spirit of intangible cultural heritage by improving the virtual visualization of intangible cultural heritage digital display technology. This article takes Dai ceramics intangible cultural heritage as an example to discuss the modern display technology of the ceramics, using virtual reality technology to enhance the sense of reality and interaction during the exhibition. This article uses visualization technology to digitally and artistically process Dai ceramics to achieve artistic effects while ensuring the authenticity of the ceramics, giving people a different visual experience. The article compares the application of several modern technologies in digital mobile display. Among them, the virtual reality technology has a good application in the system frame structure of the display, which exceeds 25%. In the future, virtual visualization technology will be further popularized and promoted, giving intangible cultural heritage high-definition digital display more opportunities and development space.

CURRICULUM ACTS AND NETWORK EDUCATION IN THE COMMUNITY SERVICE AND STRENGTHENING OF BONDS

The sociocultural scenarios of the interactions of social actors are forged in the acts of curricula amid the experiences and experiences of the subjects causing ruptures that multi-referenize in the midst of pluralities. These performances show learning processes, presuppose transgressions of the elected formative knowledge and go beyond the walls of the school. This paper aims to present glances at the curricular scenes developed from two Social Assistance Reference Centers (CRAS) located in Aracaju-SE that serve children and adolescents from the Coexistence and Strengthening Service of Bonds (SCFV) using educational practices with digital mobile technologies. From a multi-referential perspective, it is perceived that the methodologies used in CRAS break with the logic of formal teaching, thus opening the possibility of charting a new path in the process of elucidating social phenomena in contemporaneity. Acesse o vídeo sobre o artigo, clique aqui!

Adaptation of the World Health Organization Electronic Mental Health Gap Action Programme Intervention Guide App for Mobile Devices in Nepal and Nigeria: Protocol for a Feasibility Cluster Randomized Controlled Trial.

BackgroundThere is a growing global need for scalable approaches to training and supervising primary care workers (PCWs) to deliver mental health services. Over the past decade, the World Health Organization Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) and associated training and implementation guidance have been disseminated to more than 100 countries. On the basis of the opportunities provided by mobile technology, an updated electronic Mental Health Gap Action Programme Intervention Guide (e-mhGAP-IG) is now being developed along with a clinical dashboard and guidance for the use of mobile technology in supervision.ObjectiveThis study aims to assess the feasibility, acceptability, adoption, and other implementation parameters of the e-mhGAP-IG for diagnosis and management of depression in 2 lower-middle-income countries (Nepal and Nigeria) and to conduct a feasibility cluster randomized controlled trial (cRCT) to evaluate trial procedures for a subsequent fully powered trial comparing the clinical effectiveness and cost-effectiveness of the e-mhGAP-IG and remote supervision with standard mhGAP-IG implementation.MethodsA feasibility cRCT will be conducted in Nepal and Nigeria to evaluate the feasibility of the e-mhGAP-IG for use in depression diagnosis and treatment. In each country, an estimated 20 primary health clinics (PHCs) in Nepal and 6 PHCs in Nigeria will be randomized to have their staff trained in e-mhGAP-IG or the paper version of mhGAP-IG v2.0. The PHC will be the unit of clustering. All PCWs within a facility will receive the same training (e-mhGAP-IG vs paper mhGAP-IG). Approximately 2-5 PCWs, depending on staffing, will be recruited per clinic (estimated 20 health workers per arm in Nepal and 15 per arm in Nigeria). The primary outcomes of interest will be the feasibility and acceptability of training, supervision, and care delivery using the e-mhGAP-IG. Secondary implementation outcomes include the adoption of the e-mhGAP-IG and feasibility of trial procedures. The secondary intervention outcome—and the primary outcome for a subsequent fully powered trial—will be the accurate identification of depression by PCWs. Detection rates before and after training will be compared in each arm.ResultsTo date, qualitative formative work has been conducted at both sites to prepare for the pilot feasibility cRCT, and the e-mhGAP-IG and remote supervision guidelines have been developed.ConclusionsThe incorporation of mobile digital technology has the potential to improve the scalability of mental health services in primary care and enhance the quality and accuracy of care.Trial RegistrationClinicalTrials.gov NCT04522453; https://clinicaltrials.gov/ct2/show/NCT04522453.International Registered Report Identifier (IRRID)PRR1-10.2196/24115

PROSPECTS OF THE MOBILE APPLICATIONS USE IN THE PROFESSIONAL TRAINING OF FUTURE TEACHERS OF MATHEMATICS

The relevance of the problem under consideration. The use of modern developments in the field of mobile digital technologies will intensify the process of teaching professional disciplines in the system of pedagogical education of future teachers of mathematics, which encourages the study of the specifics of using mobile applications in the training of future teachers of mathematics. The purpose of the study is to reveal the possibilities of introducing mobile applications in the process of teaching mathematical disciplines to future mathematics teachers. Research methods. Theoretical (analysis, systematization and generalization of pedagogical and psychological research, curricula for future teachers of mathematics) and empirical (pedagogical observation of the educational process, questionnaires) methods. Results of the research. By mobile learning we mean the process of creating a mobile educational environment with the use of mobile technologies for access to educational resources, implemented in face-to-face and distance forms. Active use of mobile educational applications leads to changes in the content of education, learning technology and in the relations between the participants of the educational process, allows to individualize learning, make it more adequate to the abilities of students. According to the survey results, the least attention in the study of mathematical disciplines is paid to applied mobile applications for mathematical calculations, but specialized programs and applications installed on mobile devices make them real assistants to teachers of mathematical disciplines and students of mathematical specialties. Our survey shows that the mobile application PhotoMath is the most popular among students when studying mathematical disciplines. We analyzed the possibilities of using the mobile application PhotoMath in the study of mathematical analysis by students of pedagogical universities.

Nigerian Secondary Students’ Accessibility, Utilization, Competence and Attitude towards the Use of Tablet Pc for Pedagogic Experience

This study was descriptive research of the survey type and the paper examined students’ basic skills, accessibility, utilization, attitudes competence and challenges encountered on the use of digital mobile technologies and the internet for pedagogic experience among the Senior Secondary School 1, 2 and 3 students in Ogbomoso, Oyo State Nigeria. Students from four public secondary schools were purposively sampled for the study based on the access to use Tablet Pc for learning. Researcher-designed questionnaire was employed and contained items on basic skills, accessibility, utilization, attitudes competence and challenges encountered on the use of digital mobile technologies and the internet. Seven hundred and seventy-eight (778) respondents participated in the study and the data collected were analyzed using frequency counts, mean scores and percentages. Findings from this study revealed that considerable number of students have access to Tablet Pc and the internet; possessed skills, frequently accesses and utilizes their tablet Pc for fun, entertainment and non-academic related functions. They also cultivated good deal of interest in accessing social, fun and entertainment functions with their Tablet Pcs. However, students encountered challenges like: slow Internet connection, fragility of the touch screen, short battery life span, irregular electricity supply and uncontrollable challenge on the devices’ charging point. Therefore, seminars, workshops and trainings should be organized for students on competence and skills development that will facilitate maximum utilization of newer mobile devices for academic purposes.

Digital Clinics and Mobile Technology Implementation for Mental Health Care.

Purpose of ReviewInterest in digital mental health, especially smartphone apps, has expanded in light of limited access to mental health services and the need for remote care during COVID-19. Digital clinics, in which apps are blended into routine care, offer a potential solution to common implementation challenges including low user engagement and lack of clinical integration of apps.Recent FindingsWhile the number of mental health apps available in commercial marketplaces continues to rise, there are few examples of successful implementation of these apps into care settings. We review one example of a digital clinic created within an academic medical center and another within the Department of Veterans Affairs. We then discuss how implementation science can inform new efforts to effectively integrate mental health technologies across diverse use cases.SummaryIntegrating mental health apps into care settings is feasible but requires careful attention to multiple domains that will influence implementation success, including characteristics of the innovation (e.g., utility and complexity of the app), the recipients of the technology (e.g., patients and clinicians), and context (e.g., healthcare system buy-in, reimbursement, and regulatory policies). Examples of effective facilitation strategies that can be utilized to improve implementation efforts include co-production of technology involving all end users, specialized trainings for staff and patients, creation of new team members to aid in app usage (e.g., digital navigators), and re-design of clinical workflows.

Mobile-phone-based e-diary derived patient reported outcomes: Association with clinical disease activity, psychological status and quality of life of patients with multiple sclerosis.

BackgroundThe applicability of mobile digital technology to promote clinical care of people with multiple sclerosis (pwMS) is gaining increased interest as part of the implementation of patient-centered approaches. We aimed at assessing adherence to a smartphone-based e-diary, which was designed to collect patient-reported outcomes (PROs). Secondary objectives were to evaluate the construct and predictive validity of e-diary derived PROs and to explore the various factors that were associated with changes in PROs over time.Materials and methodsIn this observational cohort study patients downloaded an MS tailored e-diary into their personal smartphones. Report of PROs was enquired once monthly for a period of one year through a smartphone-based application, using previously validated tools. An e-diary derived bodily function summary score (eBF) was defined as the sum of scores depicting vision, limbs function, pain, bowl/ bladder dysfunction, pseudobulbar affect and spasticity. Multiple linear regression and analysis of covariance were used to determine the association between PROs, clinician-reported outcomes (ClinROs) of disease activity and quality of life (QoL). Regression coefficient analysis was used to compare the slope of change in eBF before and after a relapse.Results97 pwMS downloaded the e-diary [Female: 64 (66%), EDSS 3.4±2.1]. 76 patients (78%) completed the 12-month study period. 53 patients (55%) submitted ≥75% of requested surveys. Anxiety was negatively associated with adherence to periodic PROs assessments by the e-diary. E-diary derived PROs were significantly correlated with corresponding functional system scores (0.38< r <0.8, P<0.001). eBF score significantly predicted QoL (β = -0.36, P = 0.001) while EDSS did not. Change in eBF score over time was independently associated with the occurrence of an MS relapse (F = 4.4, P = 0.04), anxiety (F = 6.4, P = 0.01) and depression (F = 5.1, P = 0.03). Individual regression slopes of eBF scores were significantly higher pre-relapse than post-relapse (3.0±3.3 vs. -0.8±2.0, P = 0.007).ConclusionAdherence of pwMS to recording in an e-diary collecting PROs was high. Changes in e-diary derived PROs over time predict clinical MS relapses on the group level and thus carry the potential of usage in clinical research as well as for improved MS care in real world setting.

Which consumers are more likely to adopt a retirement app and how does it explain mobile technology‐enabled retirement engagement?

AbstractAlthough planning for retirement is fundamental for consumers’ future well‐being, individuals often fail to engage with it. Retirement engagement refers to one's initial interest in and active planning for one's retirement. In this study, we focus on mobile technology‐enabled retirement engagement, operationalized as consumers’ perception of how a retirement app can help them plan for retirement. While rapid advances in digital platforms and mobile technology show promising use to the financial services sector, little is known about the adoption drivers of mobile technology in stimulating retirement engagement as a unique low‐involvement, yet high‐importance context. We address this gap in the existing literature by analyzing survey data from a representative sample of 440 Australian pension fund members. We find that consumers’ financial self‐efficacy, perceived financial security, consideration of future consequences, retirement planning involvement, and perceived usefulness have direct effects on their anticipated engagement with a mobile retirement app as well as indirect effects through their intention to adopt the app (financial self‐efficacy and consideration of future consequences only have direct effects). We also find that mobile computing self‐efficacy, prior finance app use, and perceived ease of use only have indirect effects through consumers’ intention to adopt the app. Notably, the association between adoption intentions and anticipated engagement is stronger for those closer to retirement.

Cerebellar rTMS in PSP: a Double-Blind Sham-Controlled Study Using Mobile Health Technology

There are no effective treatments in progressive supranuclear palsy (PSP). The aim of this study was to test the efficacy of theta burst repetitive transcranial magnetic stimulation (rTMS) on postural instability in PSP. Twenty PSP patients underwent a session of sham or real cerebellar rTMS in a crossover design. Before and after stimulation, static balance was evaluated with instrumented (lower back accelerometer, Rehagait®, Hasomed, Germany) 30-s trials in semitandem and tandem positions. In tandem and semitandem tasks, active stimulation was associated with increase in time without falls (both p=0.04). In the same tasks, device-extracted parameters revealed significant improvement in area (p=0.007), velocity (p=0.005), acceleration and jerkiness of sway (p=0.008) in real versus sham stimulation. Cerebellar rTMS showed a significant effect on stability in PSP patients, when assessed with mobile digital technology, in a double-blind design. These results should motivate larger and longer trials using non-invasive brain stimulation for PSP patients.

Recognition and management of community-acquired acute kidney injury in low-resource settings in the ISN 0by25 trial: A multi-country feasibility study.

BackgroundAcute kidney injury (AKI) is increasingly encountered in community settings and contributes to morbidity, mortality, and increased resource utilization worldwide. In low-resource settings, lack of awareness of and limited access to diagnostic and therapeutic interventions likely influence patient management. We evaluated the feasibility of the use of point-of-care (POC) serum creatinine and urine dipstick testing with an education and training program to optimize the identification and management of AKI in the community in 3 low-resource countries.Methods and findingsPatients presenting to healthcare centers (HCCs) from 1 October 2016 to 29 September 2017 in the cities Cochabamba, Bolivia; Dharan, Nepal; and Blantyre, Malawi, were assessed utilizing a symptom-based risk score to identify patients at moderate to high AKI risk. POC testing for serum creatinine and urine dipstick at enrollment were utilized to classify these patients as having chronic kidney disease (CKD), acute kidney disease (AKD), or no kidney disease (NKD). Patients were followed for a maximum of 6 months with repeat POC testing. AKI development was assessed at 7 days, kidney recovery at 1 month, and progression to CKD and mortality at 3 and 6 months. Following an observation phase to establish baseline data, care providers and physicians in the HCCs were trained with a standardized protocol utilizing POC tests to evaluate and manage patients, guided by physicians in referral hospitals connected via mobile digital technology. We evaluated 3,577 patients, and 2,101 were enrolled: 978 in the observation phase and 1,123 in the intervention phase. Due to the high number of patients attending the centers daily, it was not feasible to screen all patients to assess the actual incidence of AKI. Of enrolled patients, 1,825/2,101 (87%) were adults, 1,117/2,101 (53%) were females, 399/2,101 (19%) were from Bolivia, 813/2,101 (39%) were from Malawi, and 889/2,101 (42%) were from Nepal. The age of enrolled patients ranged from 1 month to 96 years, with a mean of 43 years (SD 21) and a median of 43 years (IQR 27–62). Hypertension was the most common comorbidity (418/2,101; 20%). At enrollment, 197/2,101 (9.4%) had CKD, and 1,199/2,101 (57%) had AKD. AKI developed in 30% within 7 days. By 1 month, 268/978 (27%) patients in the observation phase and 203/1,123 (18%) in the intervention phase were lost to follow-up. In the intervention phase, more patients received fluids (observation 714/978 [73%] versus intervention 874/1,123 [78%]; 95% CI 0.63, 0.94; p = 0.012), hospitalization was reduced (observation 578/978 [59%] versus intervention 548/1,123 [49%]; 95% CI 0.55, 0.79; p < 0.001), and admitted patients with severe AKI did not show a significantly lower mortality during follow-up (observation 27/135 [20%] versus intervention 21/178 [11.8%]; 95% CI 0.98, 3.52; p = 0.057). Of 504 patients with kidney function assessed during the 6-month follow-up, de novo CKD arose in 79/484 (16.3%), with no difference between the observation and intervention phase (95% CI 0.91, 2.47; p = 0.101). Overall mortality was 273/2,101 (13%) and was highest in those who had CKD (24/106; 23%), followed by those with AKD (128/760; 17%), AKI (85/628; 14%), and NKD (36/607; 6%). The main limitation of our study was the inability to determine the actual incidence of kidney dysfunction in the health centers as it was not feasible to screen all the patients due to the high numbers seen daily.ConclusionsThis multicenter, non-randomized feasibility study in low-resource settings demonstrates that it is feasible to implement a comprehensive program utilizing POC testing and protocol-based management to improve the recognition and management of AKI and AKD in high-risk patients in primary care.