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Effectiveness of a Culturally Responsive mHealth Gaming Application to Improve Diabetes Health Literacy in India: A
Shelby L Garner1, Phil Young, Matthew Fendt
1Author Affiliations: Baylor University, Louise Herrington School of Nursing, Waco, TX (Dr Garner); Baylor University, Hankamer School of Business, Waco, TX (Dr Young); Baylor University, Computer Sciences, Waco, TX (Dr Fendt); Baylor University, Hankamer School of Business Management Information Systems, Waco, TX (Dr Koch); Community Health and Research Department, Bangalore Baptist Hospital, Karnataka, India (Dr George); Department of Art, Department of Medical Humanities, Baylor University, Waco, TX (Ms Hitchcock); Baylor University, Hankamer School of Business, Management Information Systems, Waco, TX (Dr Green); Baylor University, Waco, TX (Dr Kulaba); Emergency Medicine and Critical Care, Bangalore Baptist Hospital, Karnataka, India (Dr Robert G. V.).
Abstract:
The purpose of this study was to determine the effectiveness of a culturally responsive interactive gaming mHealth educational application designed to improve diabetes health literacy among an underserved urban population in India when compared with a traditional approach of verbal education. In addition, relationships between participant sociodemographic variables and participant knowledge were assessed. A randomized controlled trial was conducted using a two-arm parallel, single-blinded intervention and control group design. The parallel groups were the mHealth Education group serving as the intervention group and the Verbal Education group serving as the control group. The mHealth application was as effective in improving diabetes health literacy as verbal education. Results for the difference in posttest and pretest score between the two groups indicated there was no statistically significant difference between groups ( P = .9306). However, there was a significant improvement in the difference in posttest and pretest scores for each group ( P < .0001), indicating that the culturally responsive type 2 diabetes educational content was effective in improving type 2 diabetes health literacy among both groups. This study answers a call by the World Health Organization that advocates for evidence-based mHealth interventions that offer unique opportunities for cost-effective informatics service delivery in low- and middle-income countries.
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