Working to Achieve Behavior Change: The Holy Grail of NCD Prevention

Posted on: October 13th, 2011 by Arogya World

This post was first published on Health Unbound.

At one and a half years old, Arogya World is all grown up.  This September we took one giant step forward in making a meaningful contribution to global health by tackling non-communicable diseases (NCDs) with on-the-ground action.  Brimming with enthusiasm and with the help of like-minded partners, we have embarked on a major new mobile health initiative in India, where the disease burden is very high, to reach one million Indian consumers with text messages to raise awareness about diabetes and its prevention.  We are studying whether text messages are an effective method to achieve behavior change, the holy grail of NCD prevention.  We made this commitment at the 2011 Clinton Global Initiative (CGI) Annual Meeting.…

What sets this effort apart is both its scale and our scientific approach.    We agree with Amanda Glassman and Vicky Hausman notedthat there are far too many pilots in mobile health: “It’s been said,” they write, “there are more pilots in mHealth than there are in the US Air Force”!   We also agree with them and with another recent news article

about the need for measurement and evaluation in mHealth today.

The Right Technology

Our goal was not to introduce another pilot, but to start big and aim high.  We wanted our initiative to be worthy of CGI.  And we wanted to reach consumers all over India – from villagers in Bengal to commuters in Mumbai, from sari weavers in Kanjeevaram to busy moms in Delhi.  Importantly, we wanted to be smart and not re-invent the wheel – we wanted to do this by leveraging the best of what others have to offer. So we went to Nokia, a major mobile phone provider in India. Our initiative leverages Nokia Life Tools, their extraordinary technology platform for creating social change, and their reach in rural and urban India.  Our partnership with Nokia is the backbone of our initiative.

An Emphasis on Science

We wanted our messages to be based on sound science, and to leverage the best practices in behavior change and health promotion.   We partnered with Emory University to develop the messages.  We also set up a Behavior Change Task Force including medical, health promotion, communications and consumer experts from India, the US and the UK to review our messages for technical accuracy and cultural relevancy.   We are also putting together a measurement and evaluation plan to assess the effectiveness of our program. We are eager to figure out whether text messages in their local language about diabetes, its seriousness and complications, and its prevention through increased physical activity and healthy eating could persuade people to make healthy lifestyle choices and take active steps to prevent the disease.

A Consortium of Partners

We knew from the start that we couldn’t do this alone, and have built a consortium of partners and investors to support the initiative financially and by providing the benefit of their expertise.  In addition to Nokia and Emory, we are also working closely with Synovate, a global market research firm, our evaluation partner in India. And Biocon, LifeScan and Aetna have joined us on this journey. We are seeking additional funds to implement the program and carry out the comprehensive evaluation.

We believe we have initiated the largest mobile health diabetes prevention program in a developing country to date, and are sure that the data we generate will be of great interest to the public health world. We couldn’t end this piece without saying how cool we think it is that our initiative was mentioned in a news article commenting on using technology advances in India to help the rural poor.

We like to think we are doing just that.