Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 3, 2023
Date Accepted: Sep 23, 2024
Warning: This is an author submission that is not peer-reviewed or edited.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.
Advantages and challenges for the implementation of a digital non-communicable disease screening application for hypertension and diabetes prevention and management through community-based organizations in Vietnam
ABSTRACT
Background:
The aim of the SUNI-SEA implementation research project (scaling up noncommunicable disease (NCD) interventions in Southeast Asia) was to strengthen the prevention and control of hypertension and diabetes, with a focus on primary health care (PHC) and community level. In Vietnam, volunteers who were members of the Intergenerational Self-help Club (ISHC) implemented community-based NCD screening and health promotion activities in 59 communities across two provinces. The volunteers used a software application based in District Health Information 2 (DHIS2) tracker to record details of participants during screening and other health activities. Data were stored in a national server of the NGO HelpAge International.
Objective:
This study aims to assess the strengths, barriers, and limitations of the NCD screening software application used by the ISHC volunteers, and to provide recommendations for further scaling up.
Methods:
A mixed-method observational study was performed. For the quantitative data analysis, two rounds of screening data collected in 2022 from all 59 ISHCs were analysed. For the qualitative analysis, two rounds of evaluation of the screening application were completed in September 2022 and April 2023. Focus group discussions with health volunteers and club management boards and in-depth interviews with members of the Association of the Elderly and commune health station staff were performed.
Results:
Data completeness of all 3,485 screenings was very high and for anthropomorphic measurements like blood pressure, body weight, and abdominal circumference, less than 1% errors were found. The NCD screening application was appreciated by health volunteers and supervisors, as an easier and more efficient way to report to higher levels, securing data and strengthening relationships with relevant stakeholders. Data were used to analyse the uptake of screening and epidemiological patterns. In addition, some health volunteers used tablets to connect to the internet and online platforms to access information for self-learning and sharing with other club members to promote a healthy lifestyle. The limitations reported by the respondents were: a non-age-friendly application, incomplete translation of parts of the application and some issues with the tablet’s display, lack of sharing of responsibilities among the volunteers, and sub-optimal involvement of the health sector. Volunteers with limited digital literacy faced problems in learning how to use the application.
Conclusions:
The implementation of the NCD screening application by ISHC volunteers can be an effective way to improve community-led NCD screening and increase the uptake of NCD prevention and management services at the PHC level. However, our study has shown that some barriers need to be addressed to maximise the efficient use of the application by ISHC volunteers to record, report and manage the screening data.
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