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WhatsApp-Based Intervention for Diabetes Prevention and Care in Argentina: Implementation and Process Evaluation
Analia Nejamis1, Laura Gutierrez1, María Victoria López1
1Department of Research in Chronic Diseases, Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina.
JMIR Formative Research
|December 1, 2025
Summary
A WhatsApp-based intervention in Argentina effectively supported diabetes self-care among patients, at-risk individuals, and pregnant women in public health settings. The program demonstrated feasibility and good reception, particularly for those with diabetes.
Area of Science:
- Public Health
- Digital Health
- Health Informatics
Background:
- Diabetes prevalence in Argentina is high (14% in 2024), posing a significant public health challenge.
- A Diabetes Prevention and Care Program utilized a WhatsApp-based intervention in low-income areas across three provinces.
- The intervention targeted individuals with diabetes, those at risk, and pregnant women to promote self-care and healthy behaviors.
Purpose of the Study:
- To describe the implementation and process evaluation of a WhatsApp-based intervention within Argentina's public health system.
- To analyze challenges, strategies, and lessons learned using the Carroll Implementation Fidelity Framework.
- To assess the intervention's effectiveness across three distinct target populations.
Main Methods:
- Implementation across 40 primary care centers in Argentina.
- Inclusion of adults with type 2 diabetes, at-risk individuals (Finnish Diabetes Risk Score), and pregnant women.
- Delivery of 192 tailored educational and reminder messages via WhatsApp Business API, with fidelity assessment.
Main Results:
- High enrollment (11,029 participants), with 90.5% having valid phone numbers.
- Opt-in rates varied: 74.3% for diabetes patients, 62.1% for at-risk individuals, 67.3% overall.
- High message adherence (88.7% received minimum messages) and read rates (82.2%), with a low overall dropout rate (6.1%).
Conclusions:
- The WhatsApp intervention proved feasible and well-received in public primary care, especially by diabetes patients.
- The study highlights WhatsApp's potential to enhance healthcare delivery in low-resource settings.
- Recommendations include improving electronic health record integration, content tailoring, and digital inclusion strategies.
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