Diabetes Mellitus is an important health problem in Argentina because of its increasing prevalence and also because it poses a high cardiovascular disease burden. The risk of type 2 diabetes can be significantly reduced through programs oriented to modify lifestyle habits among people with high risk (prediabetes) as the primary risk factor of this chronic condition is obesity. However, there are individual and health system barriers that limits the access of persons with high risk of type 2 diabetes to a confirmatory diagnosis of prediabetes and preventive care. Innovative strategies such as mHealth and social media have improved the access to information and also to care. The purpose of this study is to evaluate if the inclusion of these innovative strategies in a type 2 diabetes primary prevention program in the primary level improves the recruitment and participation of people at high risk, promotes healthy lifestyles and reduce the risk of type 2 diabetes. The study will be conducted in San Rafael, Province of Mendoza. We will first implement a formative research to understand which factors affect the access of persons with high risk of diabetes to preventive interventions.
Then we will conduct a random study meaning that some primary care clinics will receive the intervention and some will be a control. We will include 400 people aged =35 years with high risk of type 2 diabetes, 200 persons in the control and 200 in the intervention group. In the intervention group, community health workers will be trained to use a mobile app to identify persons with high risk integrated to an electronic clinical appointment system so that CHWs can schedule an appointment with the nurse in the clinic for confirmatory diagnosis of prediabetes through a lab test. Participants of this study will also receive SMS as reminders for the appointments and also educational messages to promote healthy lifestyles. People who attend the appointment and are classified as prediabetic will be invited to participate in workshops for lifestyle modification. Information on healthy lifestyle and related activities organized by the clinics will be shared with study participants and healthcare professionals through social media. In the control group, CHWs will identify participants using a paper questionnaire and will verbally refer participants to the clinic for a confirmatory diagnosis. Lifestyle modification workshops will be also organized in control clinics and persons with prediabetes invited to attend them. The main outcome of this study will be the proportion of persons identified with high risk of type 2 diabetes who attended the clinic for a confirmatory diagnosis between the intervention and the control group at 12 months. If proven effective, this initiative could be implemented in the rest of the primary care clinics of Mendoza as part of the Provincial Diabetes Program and could be scaled up to be used in other provinces.
- Andrea Beratarrechea Institute for Clinical Effectiveness and Health Policy (IECS) Argentina
- Oscar Sagás Ministry of Public Health of the Province of Mendoza Argentina
- Vilma Irazola Institute for Clinical Effectiveness and Health Policy (IECS) Argentina
- Laura Gutierrez Institute for Clinical Effectiveness and Health Policy (IECS) Argentina
- Daniela Moyano Institute for Clinical Effectiveness and Health Policy (IECS) Argentina
- Natalia Elorriaga Institute for Clinical Effectiveness and Health Policy (IECS) Argentina
- Argentina Ministry of Health, Argentina