Currently submitted to: Journal of Medical Internet Research
Date Submitted: Jun 12, 2026
Open Peer Review Period: Jun 14, 2026 - Aug 9, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Development and Efficacy of the "SI-GAP" as A Mobile Health Application for Prediabetes Screening and Early Intervention in Primary Healthcare
ABSTRACT
Background:
The increasing type 2 diabetes mellitus (T2DM) prevalence necessitates scalable prevention strategies. Until now, prediabetes screening and early intervention as a diabetes prevention step in primary healthcare remain suboptimal in terms of effectiveness and feasibility.
Objective:
Therefore, we aimed to develop "SI-GAP," a mobile health application for prediabetes screening and intervention, and evaluate its efficiency in Indonesian primary care.
Methods:
This exploratory sequential mixed-methods study consisted of a qualitative phase to design the app and a quantitative phase comprising a diagnostic test and a Randomized Controlled Trial (RCT). The modified American Diabetes Association risk score integrated into SI-GAP was validated for prediabetes screening. Participants with confirmed prediabetes were then randomly assigned to receive either the SI-GAP app intervention or conventional care for a duration of 12 weeks. Changes in HbA1c and Fasting Blood Glucose (FBG) were the main results.
Results:
The application-based screening instrument showed a sensitivity of 82.42% and a specificity of 31.44%. In the randomized controlled trial, the SI-GAP group demonstrated significant reductions in HbA1c (6.05%-5.50%, P<0.001) and FBG (98.65 mg/dL-94.33 mg/dL, P<0.001) compared with the control group. Analysis using the UTAUT model demonstrated that perceived utility and ease of use substantially influenced user intention.
Conclusions:
The SI-GAP app assists as a valid screening instrument and an effective intervention app to improve glycemic control in primary care settings. It provides a scalable digital solution for diabetes prevention in resource-limited settings. Clinical Trial: NCT04979559
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