Currently accepted at: JMIR Research Protocols
Date Submitted: Dec 8, 2025
Date Accepted: Jan 9, 2026
This paper has been accepted and is currently in production.
It will appear shortly on 10.2196/89021
The final accepted version (not copyedited yet) is in this tab.
Evaluating the Impact of Digital Intervention versus WHO PEN Approach in Non-Communicable Disease Prevention and Control in Resource-Limited Settings: Protocol for a Quasi-Experimental Study
ABSTRACT
Background:
Non-communicable diseases (NCDs) are increasingly becoming a public health challenge, particularly in resource-limited settings, due to limited access to preventive care, early detection, and health literacy. Nevertheless, there is immense potential for digital technologies to enhance overall community health. Similarly, the WHO PEN Disease Interventions for Primary Healthcare in Low-Resource Settings has demonstrated evidence of improving NCD outcomes. Nevertheless, its effectiveness in the Indian setting has not been explored.
Objective:
This study aims to evaluate the effectiveness of a mobile- and web-based digital intervention, compared with the WHO PEN approach and a no-intervention control group, in improving health-seeking behaviours, risk factor modification, and disease management related to NCD prevention and control in resource-limited settings across four Indian sites.
Methods:
A quasi-experimental, mixed-methods study will be conducted across four sites in India. The study will be conducted in three phases, where the insights gathered in the first phase will guide the development of a human-centered digital health intervention to help people nudge towards better health-seeking behaviours towards common NCDs (Diabetes or Hypertension/CVDs, or both). The effectiveness of the digital intervention will be compared against the WHO PEN intervention and a control group that will receive no intervention. Standard validation tools will be used to assess behaviour and changes related to modifiable risk factors. Data will be analyzed using descriptive and inferential statistics, with pre-post comparisons and between-group analyses. Qualitative data will be thematically analyzed to complement quantitative findings.
Results:
The study is expected to demonstrate improved health-seeking behaviour, self-management practices, and lifestyle modification among participants exposed to the digital intervention compared with the WHO PEN and control groups. Findings will illuminate the feasibility and scalability of integrating digital health solutions within community-based NCD prevention frameworks in India. Data collection is anticipated to be completed within 12 months of study initiation.
Conclusions:
This protocol outlines a community-based, multi-site comparative study to evaluate the role of digital health interventions vis-à-vis WHO PEN in addressing NCD prevention and management. The results will contribute to evidence-based recommendations for strengthening digital health integration in resource-limited primary care settings. Clinical Trial: Not Applicable
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.