Preliminary effectiveness and feasibility of ASHA-led mobile health intervention for diabetes care in Indian primary health care settings
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Diabetes management in resource-limited settings faces challenges in screening, guideline-based treatment, and healthcare access. The IMPACT Diabetes study evaluated a community-based, technology-enabled task-shifting intervention for diabetes care in India. A cluster randomized controlled trial was conducted in 16 villages/peri-urban areas across 8 primary health centers (PHCs) in two states in India. Accredited Social Health Activists (ASHAs) screened 1,785 community participants, identifying 418 individuals with diabetes. The intervention group received nine months of CDSS-supported care delivered by ASHAs under physician supervision, while the control group received usual care. The primary outcome was the proportion of participants achieving ≥ 0·5% reduction in glycated haemoglobin (HbA1c) from baseline. Secondary outcomes included healthcare utilization and medication adherence. A significantly higher proportion of intervention participants achieved HbA1c reduction ≥ 0·5% compared to the control group (21.8% vs. 10.3%, p < 0.05). Intervention participants had more frequent physician visits (85·0% vs. 29·8%), higher glucose-lowering medication adherence (63·0% vs. 43·1%, p < 0·05), and better engagement with diabetes management practices. Qualitative findings demonstrated that the intervention was acceptable and feasible for patients, ASHAs, and physicians, empowering ASHAs in chronic disease care. This study demonstrates that task-shifting and digital health tools can improve diabetes outcomes in low-resource settings. Future research should explore long-term sustainability and cost-effectiveness.
Date Issued
2025-10-21
Date Acceptance
2025-09-16
Citation
Scientific Reports, 2025, 15
ISSN
2045-2322
Publisher
Nature Portfolio
Journal / Book Title
Scientific Reports
Volume
15
Copyright Statement
© The Author(s) 2025. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Identifier
10.1038/s41598-025-20728-w
Subjects
Diabetes
MHealth
ASHA
Blood glucose
Frontline health workers
Clinical decision support system
Publication Status
Published
Article Number
36712