The largest diabetes prevention mHealth program in the world
Arogya World has completed mDiabetes, a Commitment made at the 2011 Clinton Global Initiative (CGI) Annual Meeting. With this groundbreaking effort, Arogya World reached more than one million people from all over India with text messages in 12 languages about diabetes and its prevention, and has tested the program’s effectiveness in bringing about behavior change known to prevent diabetes.
The Clinton Global Initiative (CGI) convenes leaders to turn ideas into action. CGI Commitments to Action represent bold new ways that CGI members address global challenges—-implemented through new methods of partnership and designed to maximize impact. Commitments can be small or large, global or local. No matter the size or scope, commitments help CGI members translate practical goals into meaningful and measurable results.
mDiabetes was designed and implemented by Arogya World in partnership with Nokia Life. Other partners include Emory University, Johnson & Johnson, Aetna, and Ipsos.
The Scientific Rationale for mDiabetes
Sixty-plus million Indians live with diabetes and one million die from it each year. Indians get the disease an average of 10 years earlier than counterparts in the West, often in their 30s and 40s. If untreated, diabetes can lead to heart disease, blindness, amputations and kidney failure.
And mobile phones are widely used in India, throughout different geographic regions and socio-economic backgrounds. There are said to be about 900 million cell phone subscribers in India.
Importantly, the WHO emphasizes that approximately 80% of heart disease and diabetes, and 40% of cancers can be prevented through healthy lifestyles such as avoiding tobacco use, eating healthy foods and increasing daily physical activity.
mDiabetes was designed as a population-level nationwide public health intervention using mobile technology to establish health behaviors known to prevent diabetes.
The program has been successfully deployed in a large population. In 2012, Nokia Life helped Arogya World recruit 1,052,633 persons who opted-in to receive mDiabetes text messages. Messages were provided free to the consumers twice a week for six months. Participants came from all over India and a variety of socio-economic backgrounds.
Arogya World developed the 56 text messages with Emory University in late 2011, based on science and behavior change theory, and then, with Ipsos, consumer-tested them in simulated conditions as well as in the real world. Arogya World then refined the messages, adapting them culturally for Indian audiences based on consumer feedback and review by its Behavior Change Task Force. Nokia Life provided the translation and transmission infrastructure, and transmitted more than 56 million mDiabetes text messages to the consumers throughout 2012.
Arogya World assessed program effectiveness by comparing responses of 950 consumers, based on telephone interviews, before and after they received the messages, and also by comparing them with the responses of a similar number of consumers who did not receive mDiabetes messages. Detailed analysis of program effectiveness is ongoing.
Consumers’ awareness of diabetes and its complications increased, and promising trends in behavior change were noted: an 11% increase in daily exercise, a 15% increase in the intake of 2-3 servings of fruits a day, and an 8% increase in 2-3 servings of vegetables a day. The self-reported data are statistically significant.
Download our case study: mDiabetes: The Largest Diabetes Prevention mHealth Program in the World
Download our poster from World Diabetes Congress 2013: The Effectiveness of mDiabetes
Manuscript is in preparation, but results show 15% impact. With mDiabetes we believe we have helped 150,000 people lead healthy lives.
mHealth 2.0 + Next Steps
We are currently expanding our mDiabetes program (mHealth 1.0) to mHealth 2.0 with additional content on complications of diabetes including kidney disease, heart disease, and ways to prevent them, including reducing fat, cholesterol, and salt. We are building an NCD prevention mobile “app” to make it more convenient for consumers to increase healthy behaviors and prevent disease. Effectiveness is being tested in a randomized control trial in the workplace setting.
Expansion geographically to other countries, in partnership with global health organizations, governments and private sector partners, is also being explored.
mDiabetes is a core part of the chronic disease prevention model we are building for the developing world.