JMIR Publications

ABSTRACT

Background:

Developing countries are experiencing a shift from infectious diseases such as HIV and tuberculosis, to non-communicable diseases (NCDs) such as diabetes. Diabetes accounts for more disability adjusted life years (DALYs) than any other NCD in South Africa, and research has identified a number of preventable risk factors, however there is not enough evidence from developing countries as to how best 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 aims to investigate how potential 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’ demographic characteristics, as well as their knowledge and awareness surrounding diabetic risk factors (such as exercise, smoking, hypertension), and their comfort level with various information delivery methods (such as WhatsApp, SMS, email). The grouped variables from diabetic risk factors and information delivery methods were described with mean Likert scores, then investigated for relationships with Spearman’s Rho correlation coefficients.

Results:

Demographic characteristics revealed that the prevalence of diabetes was twice as high in this commuter population than the national average, and there were also large discrepancies between people’s perceived body weights and body types. WhatsApp was the most favourable mHealth information delivery method, and had a moderate correlation coefficient with diet and nutrition (0.338, p=0.000), as well as a weaker correlation with physical activity (0.243, p=0.000). Although not as robust as the WhatsApp correlations, each of the other information delivery methods also showed weaker, yet still statistically significant, relationships with one or more of the risk factors.

Conclusions:

The elevated diabetes prevalence and misperceptions of body weights and body types reinforces the need for diabetes risk factor education in the 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.