Accepted for/Published in: JMIR Nursing
Date Submitted: Feb 6, 2025
Open Peer Review Period: Feb 6, 2025 - Apr 3, 2025
Date Accepted: Apr 15, 2025
(closed for review but you can still tweet)
Effect of Digital Tools on Frontier Health Workers' Knowledge and Performance Regarding Diabetes Control in Myanmar: A Cost-Effective Analysis and Quasi Experimental Study
ABSTRACT
Background:
Diabetes has become a significant global health issue, particularly imposing a deep economic burden on developing countries. Innovative and integrated digital solutions can reduce the impact of diabetes and enhance the quality of care. However, digital solutions have not been utilized before in Myanmar.
Objective:
This study aims to demonstrate the novel integrated effect of diabetes knowledge and registry tools on the performance of front-line health workers in primary healthcare settings.
Methods:
A quasi-experimental study with an intervention and control group was conducted in two townships from October 2022 to April 2023. For the first time, researchers trained the intervention group to use digital tools for diabetes control and monthly follow-up. The study employed multiple linear regression models to explore the novel impact of digital tools on knowledge and performance scores, their correlations, and their association with covariates. Additionally, it assessed the cost-effectiveness of the intervention by using self-administered questionnaires as measurement tools formulated based on the National Diabetes Guidelines.
Results:
96 participants were enrolled in the study, divided evenly into two groups. The intervention group exhibited a significant increase in mean knowledge scores from 85.81 to 99.25 (P < .001) and performance scores from 71.22 to 107.16 (P < .001). The intervention accounted for 43.2% of the variance in knowledge scores and 62.5% in performance scores (P < .001). A positive correlation was found between knowledge and performance scores (r = .45, P < .001). The intervention was also cost-effective, with a cost-effectiveness analysis value of 0.711 and an incremental cost-effectiveness ratio of 10127.04 Kyats.
Conclusions:
Since the new integrated intervention yields significant economic gains and positive effects, researchers suggest policymakers replicate this intervention as a nationwide program and recommend scaling up the utilization of digital tools to improve knowledge and performance for diabetes control in frontier health workers.
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