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Feasibility of mobile-based noncommunicable disease risk factor data collection using WhatsApp and interactive voice
Amit Talwar1, Gulam Muhammed Al Kibria2, Carolina Saavedra3
1Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe Street W5501, Baltimore, MD, 21205, USA.
Abstract:
The global increase in mobile phone usage, specifically in low- and middle-income countries (LMICs) provides opportunities for making non-communicable disease (NCD) data collection more efficient and economical. We investigated the feasibility of WhatsApp surveys and compared their population representativeness and NCD risk factor estimates with interactive voice response (IVR) surveys in Colombia. Participants were randomized to receive the NCD survey either via IVR or WhatsApp as the survey mode. Adults aged 18 years and over with a working mobile phone were sampled using random digit dialing (RDD). The survey included questions on demographics, tobacco use, alcohol consumption, and diet, with the primary difference in study arms being that visual examples (e.g., showcards) were used in the WhatsApp survey. We compared the demographic representativeness and NCD indicator estimates of the two surveys using log-binomial regression. The study was conducted between March 8 and March 12, 2023. Approximately 627 completed IVR surveys and 602 completed WhatsApp surveys were analyzed from 127,592 IVR and 2,632 WhatsApp calls (from 245,620 IVR enrollment calls). Overall, the WhatsApp arm had a higher proportion of young (18-44-year-olds: 81.9% vs. 74.2%), high-school educated (90.0% vs. 80.9%), and urban residents (80.4% vs. 73.4%) than IVR respondents. The overall prevalence/mean of most studied indicators was similar. For instance, with an adjusted risk ratio of 1.08 (95% CI: 0.83-1.40), the prevalence of tobacco smoking was 14.4% (95% CI: 11.7-17.3) and 16.4% (95% CI: 13.6-19.7) among IVR (ref.) and WhatsApp arms, respectively. The prevalence/mean differed for only two indicators: "number of vegetable servings consumed per day" and "<5 servings of fruits and/or vegetables consumed per day." Despite the inclusion of images in WhatsApp surveys, only minor differences in NCD indicators were found compared to IVR. Persistent gaps in rural and older populations must be addressed to ensure equitable monitoring in Colombia.
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