NCDs present a significant health challenge globally, particularly in urban slums where various environmental factors contribute to poor health. Existing evidence on digital interventions targeting modifiable risk factors in Indian populations is limited, with few yielding positive outcomes, and insufficient data in urban slum settings. Similarly, the WHO PEN Disease Interventions for Primary Health Care in Low-Resource Settings shows evidence of improving NCD outcomes worldwide. Yet, its effectiveness and adaptability in India remain under-explored. Consequently, there is a notable gap in comparative studies evaluating the impact of digital interventions versus the WHO PEN approach in resource-limited Indian contexts.

We propose a quasi-experimental study aiming to assess the factors influencing digital interventions and the WHO PEN approach in NCD prevention and control. This study will compare the effectiveness of digital interventions against the WHO-PEN approach within resource-limited settings. The study will evaluate the feasibility and impact of both. This research proposal combines comparative analysis, tailored intervention design, and comprehensive methodology, and presents innovative strategies for addressing NCDs in resource- limited urban slums in India. The multi-site, mixed-method quasi-experimental study will collaborate with primary healthcare facilities in resource-limited settings to assess changes in NCD risk factors, treatment adherence, patient satisfaction, and healthcare utilization over one year. The study aims to evaluate the efficacy of digital interventions over WHO-PEN, highlighting their potential to improve healthcare delivery, and patient outcomes, and alleviate NCD burden in resource-constrained environments.

Prevalence of MetS is increasing among the adult population of India. Urban poor adopt an urbanized lifestyle, which places them at a higher risk for obesity, diabetes and hypertension. Along with that, they have poor access to healthcare, high out of pocket expenditure and poor purchasing ability and food availability. In India, there is paucity of data on the interplay of several risky variables in the increased burden of MetS among adults in urban slums settings. There is limited information on multifaceted interventions useful for self-management of cardio-metabolic risk factors leading to MetS. Research Question: What is the feasibility of an interactive, tailored internet and mobile enabled digital health intervention in enhancing self-management of MetS among urban poor populations. To achieve aim one, a mixed method approach including both (qualitative and quantitative) assessments will be used to develop a model that will describe the interplay between the living environment and other cardio-metabolic risk factors such as diet, physical activity, stress and sleep. We will employ focus groups and in-depth interviews among a sample of population enrolled across various urban slum settings of New Delhi. To achieve aim two, we will utilize combined principles of learning, behavioral and humanistic theories with principles of human centered approach to design and develop an interactive, tailored mobile and internet enabled digital health intervention platform aimed to support self-management among individuals living with MetS in urban poor settings. Findings of the objective one will help to inform define the essential elements/modules and features of the proposed digital health intervention. To achieve aim three, pilot test the utility and feasibility of the proposed digital health intervention in an urban poor community settings of New Delhi (areas including North, South, East, West and Central zones of New Delhi) to measure the usage, adherence, satisfaction and acceptance with the proposed digital health intervention platform. The outcome of the study is to develop a model that describes interplay between environmental and cardio metabolic risk factors such as diet, physical activity, stress and sleep to identify barriers and facilitators in enhancing MetS self-management among individuals living in urban poor settings. Identify user needs using human centered approach and findings of objective one to design and develop an interactive, tailored internet and mobile enabled digital health intervention aimed to enhance self-management of MetS among individuals living in urban poor settings. The study will also help identify essential components of the digital health intervention to help individuals self-manage their MetS. Pilot testing of the intervention will help us inform the utility and feasibility of the role of digital health interventions to enhance self-management of MetS especially among high-risk vulnerable and underserved populations. The study will help in developing a model that describes interplay between environmental and cardio metabolic risk factors. Secondly, there is very little information available on successful multi-faceted interventions for enhancing self-management of MetS risk factors among urban poor populations. The proposed digital heath intervention model will utilize principles of human centered approach involving users input all through during the design and development of the intervention to help self-manage MetS among adults living in urban slum settings.

Health professionals especially in low-resource settings often lack the support and tools to follow evidence-based clinical recommendations for diagnosing patients and recommend the accurate diagnostic test to the patients. Diagnostic algorithms, developed by integrating patient health information and other external factors with evidence-based clinical protocols, can help improve the quality of care and the rational use of resources in a cost-effective manner. In regards to that a diagnostic decision support tool was developed to assist patients and at-risk population to make an optimal diagnostic test choice at the right time. The tool act as a value-based care that focuses on improving outcomes, increasing efficiency and reducing costs assisting in early detection, management of COVID-19 in a cost-effective manner. Advanced web-based COVID-19 dashboard assimilate multifaceted indicators for in-depth user analysis. By leveraging strengths across government stakeholders, health systems, data science, and community wisdom into an integrative dashboard, more targeted evidence-based decisions are possible to navigate the volatile pandemic climate. Implementing the continuous collaborative avenues and cyclic improvement philosophy will further bolster its responsiveness to arising needs. Both the depth and scale of data integrated through the dashboard will lead to more informed decision-making by health officials and policymakers. With flexible data visualizations and built-in algorithms, it will enable rapid analysis of the pandemic’s trajectory.
Ultimately the tool will help strengthen outbreak response strategies and resource allocation where they are needed most. While dashboard limitations exist in terms of data validation and quality at such a large scale, the recommendations and precedents within this design plan can serve as the base for the next generation of advanced, patient-centric public health dashboards.

Early childhood caries (ECC) has reached epidemic proportions affecting millions of children worldwide. Its prevention becomes imperative owing to the significant morbidity and financial implications involved with its treatment. The Integrated Child Development Scheme (ICDS), launched in India to provide mid-day meals, pre-school education and primary healthcare to children, can be utilised to counsel and deliver oral health education to mothers. The purpose of the study is to compare the effect of an oral health care package (OHCP) with usual care on the change in dental disease status among 1 to 3-year-old children at Anganwadi centres (AWC) in periurban areas of Chandigarh and rural areas of Cuttack, Orissa over a follow-up period of three years. Two geographically distant ICDS blocks would be selected at each of the two study sites and would be randomly allocated to intervention and control group. Closely located AWCs under each of the selected blocks shall constitute the study setting. OHCP would be delivered to the mothers of the 1–6-year-old children enrolled in the AWCs of the experimental group whereas mothers under control group would receive usual care advice available at the AWCs. ECC prevention had conventionally focused upon testing effectiveness of programs targeting behaviour change among the caregivers and children, but surprisingly minimal efforts have been made to seek translation of these efforts into reduction of ECC at the community level. The present study has two components; testing effect of altering maternal and child behavioral aspects on ECC incidence through cohort follow up of 1–3-year-old children for three consecutive years and cross-sectional follow up of all available 1–6-year old children at the selected AWCs at regular intervals to look for change in prevalence of ECC at community level. In other regions of the world surveys of ECC prevalence before and after the intensive educational programs have shown a significant reduction in ECC prevalence. A similar decline can be anticipated through this program.

Human-centered dietary decision support systems are fundamental to diabetes management, and they address the limitations of existing diet management systems. The objective of the proposed study is to evaluate the use of an interactive, telephone-linked, personalized, human-centered decision support system for facilitating the delivery of personalized nutrition care for patients with diabetes. A quasi-experimental trial was conducted between the period of June and December 2018. Study participants were recruited from Community Health Center, Dharamshala, Kangra (urban population), and Model Rural Health Unit, Haroli Block, Una (rural population). Eligible participants included adults aged ≥30 years with controlled or uncontrolled diabetes, those who agreed to participate in the study, those who were available for follow-up interviews, and those with a telephone or computer at home. Diabetic status was determined via a physician’s diagnosis. Individuals with mental or physical challenges that affected their ability to use an electronic diet record, those who were not available for a telephone follow-up, and those who were involved in other protocols related to dietary assessments were excluded. The study participants were randomized into the following two groups: the intervention group (telephone-linked dietary decision support system) and the control group (paper-based diet record). Study participants in the intervention group recorded their daily dietary intake by using a telephone-linked, personalized, human-centered dietary decision support system and received personalized feedback and diet education via SMS text messaging. Study participants in the control group were provided with only a paper-based diet record for documenting their daily dietary intake. Follow-up visits were conducted at 3 and 6 months from the baseline in both groups. Differences in diabetes knowledge, attitudes, and practices will be measured across groups. The collection of baseline data from 800 study participants in both the intervention (n=400) and control groups (n=400), which were stratified by urban (control group: n=200; intervention group: n=200) and rural settings (control group: n=200; intervention group: n=200), has been completed. Follow-up data collection for months 3 and 6 is ongoing and is expected to be completed by October 2019. We anticipate that the intervention group will show significant changes in nutrition knowledge, attitudes, and practices; satisfaction with care; and overall diabetes management. We also expect to see urban-rural differences across the groups. The uniqueness of our nutrient data capture process is demonstrated by its cultural and contextually relevant features—diet capture in both English and Hindi, diet conversion into caloric components, sustained diet data collection and participant adherence through telephone-linked care, and auto-generated reminders.

Road traffic accidents stand as one of the leading causes of mortality and morbidity across the globe. The reasons for the high burden of road traffic injuries (RTIs) in developing countries are increasing in the number of motor vehicles, poor enforcement of traffic safety regulations, inadequacy of health infrastructure and poor transport facility. However, the systematic collection of road traffic data is not well developed in many developing countries including India and under-reporting of RTIs and deaths are common. Hence, surveillance of RTIs is recommended to assess the burden, to identify high-risk groups, to establish an association with probable risk factors and to plan interventions to control the RTIs. The broad objective of this study is to establish an electronic-based comprehensive and integrated RTI surveillance system, to assess the burden of RTIs, its risk factors and outcomes across rural and urban settings in India. This study with the support of the Indian Council of Medical Research (ICMR) is progressing in three cities (Chennai, Delhi and Jaipur) and two rural areas (Chittoor and Tehri-Garhwal). At each centre, major sources of data can be categorized under two categories including health facilities and community. In urban areas, one trauma centre, one private hospital and a community of 10000-population are included in the study. In rural areas, a district hospital, a private nursing home and two sub-centres areas of different primary health centres at each site are included for the surveillance. Passive surveillance is done at the trauma centres/district hospitals, while active surveillance is done in private hospitals/nursing homes, sub-centres and communities. Before establishing the surveillance system, situational analysis has been undertaken. Surveillance-related software was developed during the preparatory stage. This electronic surveillance platform allowed to gather data electronically across multiple sites. This internet-enabled surveillance platform has several modules to capture and analyse the data. The present study provides a model of surveillance including both passive and active surveillance to cover maximum number of RTIs. This study further provides the first comprehensive epidemiology of RTIs. The results of these studies will contribute to the setting of research and investment priorities to tackle the burden of RTIs.

The lack of surveillance system is a major barrier in prevention and control of rheumatic fever/rheumatic heart disease (RF/RHD). Efficacy of school-based surveillance was evaluated for detection of acute pharyngitis and RF/RHD in Shimla district, HP. The schools in district Shimla were randomly assigned to intervention and controlled arm (442 vs. 441 schools). The trained nodal teachers reported children with symptoms of acute pharyngitis and or RF/RHD in intervention arm and children taken to hospitals by parents for symptoms of acute pharyngitis and or RF/RHD under control arm through mobile phone to coordinating centre. Final outcome for presence of RF/RHD or other heart Diseases was recorded after examination at nearest primary health centers and/or at Indira Gandhi Medical College Hospital, Shimla. Difference in detection rate between intervention arm and control arm was compared using Z test. The number of school children reported from intervention group was significantly higher than in control due to suspected symptoms of acute pharyngitis and or RF/RHD were 65 (2.84/1000) and 15 (0.60/1000), respectively (p < 0.01). Only 4 children in each arm were found to have heart diseases, with prevalence of (0.17/1000 and 0.16/1000), respectively, after clinical and echocardiography evaluation. In intervention arm, one child had RHD while three had congenital heart disease; in control arm, one child had congenital heart disease and three had RHD. School based surveillance had higher rate of suspecting children with acute pharyngitis and or RF/RHD although with low specificity. There is a need of future studies to demonstrate the effectiveness of the proposed intervention in endemic regions of the state.