Impact of Digital Intervention vs WHO Package of Essential Noncommunicable Disease Interventions Approach for Prevention and Control in Resource-Limited Settings: Protocol for a Quasi-Experimental Study.

backgroundNoncommunicable 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 the overall community health. Similarly, the World Health Organization (WHO) Package of Essential NCD (PEN) interventions for primary health care in low-resource settings has demonstrated evidence of improving NCD outcomes. Nevertheless, its effectiveness in the Indian setting has not been explored.

objectiveThis 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 behaviors, risk factor modification, and disease management related to NCD prevention and control in resource-limited settings across 4 Indian sites.

methodsA quasi-experimental, mixed methods study will be conducted across 4 sites in India by using cluster-based allocation. The study will be conducted in 3 phases, where the insights gathered in the first phase will guide the development of a human-centered digital health intervention to help people nudge toward better health-seeking behaviors for common NCDs (diabetes or hypertension/cardiovascular diseases 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 behavior 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.

resultsThe funding for this study was received from the Indian Council of Medical Research in January 2025. In phase 1, across all sites, a total of 80 in-depth interviews (community and community health workers), 320 Knowledge, Attitude, And Practice questionnaires (community), and 32 focus group discussions with 320 individuals (community) were conducted from July 2025 to December 2025. This will be followed by data analysis, and findings will be used to guide the development of the digital intervention. The results of this study are expected to be published in 2028. This study is expected to demonstrate improved health-seeking behavior, self-management practices, and lifestyle modifications 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.

conclusionsThis 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. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/89021.