{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:57:01Z","timestamp":1782842221478,"version":"3.54.5"},"reference-count":53,"publisher":"JMIR Publications Inc.","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Res Protoc"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Traditionally, health promotion and health education have been provided to communities in the global south in the form of leaflets or orally by health care workers. Digital health interventions (DHIs) such as digital health messages accessed by smartphones have the potential to reach more people at a lower cost and to contribute to strengthening of health care systems. The DHI in this study focuses on disseminating digital health education regarding 3 disease complexes of high public health concern: HIV\/AIDS, tuberculosis, and Taenia solium (neuro)cysticercosis or taeniasis, a parasitic zoonotic disease that requires a One Health approach. The DHI presents the participants with animated health videos (animations) and provides access to information spots (InfoSpots) with a free-of-charge digital health platform containing messages about health to rural Tanzanian communities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this study is to measure the effect of the DHI on health knowledge uptake and retention over time in the rural communities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a mixed methods study including a nonrandomized controlled trial and qualitative interviews conducted in rural Tanzania. A health platform containing digital health messages for the communities was developed prior to the study. The health messages consist of text, pictures, quizzes, and animations of everyday stories, aimed at disease prevention and early treatment. The baseline and immediate postintervention assessments were completed in Iringa, Tanzania in May 2019. The participants were interviewed by enumerators and completed questionnaires regarding health knowledge. Participants in the intervention group were exposed to 3 different health animations once on a tablet device. The participants\u2019 health knowledge was assessed again immediately after the exposure. The first follow-up survey was undertaken in August 2019. The InfoSpots with the digital health platform were thereafter launched in the intervention villages in November 2019. Qualitative interviews were undertaken in February 2020. The second follow-up was completed in June 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 600 participants have been enrolled in the trial. We will assess (1) the difference in knowledge scores between baseline and the immediate postintervention assessments in the intervention group and (2) the difference in knowledge scores between the intervention and control groups at baseline, 3 and 6 months post-DHI rollout. Since a randomized design did not prove feasible, potential confounders (eg, age, gender, education, and time of exposure) may be introduced, and results will be adjusted. Data analysis for the 35 qualitative interviews is currently ongoing, and perspectives and experiences related to use and nonuse of the InfoSpots are being explored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The data have been collected, and the analysis is ongoing in this digital health study, aimed at evaluating the effects of a DHI based on relevant health messages. The publications of results can be expected this year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov NCT03808597; https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03808597<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>International Registered Report Identifier (IRRID)<\/jats:title>\n                    <jats:p>RR1-10.2196\/25128<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/25128","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T00:34:12Z","timestamp":1615941252000},"page":"e25128","source":"Crossref","is-referenced-by-count":13,"title":["Digital Health Intervention to Increase Health Knowledge Related to Diseases of High Public Health Concern in Iringa, Tanzania: Protocol for a Mixed Methods Study"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6084-0701","authenticated-orcid":false,"given":"Christine","family":"Holst","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5872-3832","authenticated-orcid":false,"given":"Felix","family":"Sukums","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8738-7903","authenticated-orcid":false,"given":"Bernard","family":"Ngowi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2086-4909","authenticated-orcid":false,"given":"Lien My","family":"Diep","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1522-4296","authenticated-orcid":false,"given":"Tewodros Aragie","family":"Kebede","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8168-5552","authenticated-orcid":false,"given":"Josef","family":"Noll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3131-6983","authenticated-orcid":false,"given":"Andrea Sylvia","family":"Winkler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2021,4,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/15.3.259"},{"key":"ref2","unstructured":"Education for health: a manual on health education in primary health careWorld Health Organization19882021-02-17https:\/\/apps.who.int\/iris\/handle\/10665\/77769"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.4103\/0970-0218.94009"},{"key":"ref4","unstructured":"The 1st International Conference on Health Promotion, Ottawa, 1986World Health Organization19862021-02-17https:\/\/www.who.int\/healthpromotion\/conferences\/previous\/ottawa\/en\/"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/13.4.349"},{"key":"ref6","unstructured":"Health literacy: The solid factsWorld Health Organization20132021-02-17https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/326432\/9789289000154-eng.pdf"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-12-80"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/dax028"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1097\/NCC.0000000000000665"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15458"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.issn.0253-9624.2020.02.008"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3810\/pgm.2009.09.2065"},{"key":"ref13","unstructured":"HIV\/AIDS key factsWorld Health Organization2021-02-17https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hiv-aids"},{"key":"ref14","unstructured":"Global HIV & AIDS statistics \u2014 2020 fact sheet. UNAIDS2021-02-17https:\/\/www.unaids.org\/en\/resources\/fact-sheet"},{"key":"ref15","unstructured":"Global Tuberculosis Report 2019World Health Organization20192021-02-17http:\/\/www.who.int\/tb\/publications\/factsheet_global.pdf?ua=1"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1179\/2047773212Y.0000000047"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0217420"},{"key":"ref18","unstructured":"Sixty-sixth world health assemblyWorld Health Organization20132021-02-17https:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/WHA66-REC1\/A66_REC1-en.pdf"},{"key":"ref19","unstructured":"Tanzania HIV Impact Survey (THIS): a population-based HIV impact assessment 2016-2017Government of Tanzania2019012021-02-17https:\/\/www.nbs.go.tz\/nbs\/takwimu\/this2016-17\/Tanzania_SummarySheet_English.pdf"},{"key":"ref20","unstructured":"TB Prevalence in TanzaniaThe National Tuberculosis and Leprosy Programme (NTLP)2021-02-17https:\/\/ntlp.go.tz\/tuberculosis\/tb-prevalence\/"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.2471\/blt.08.056713"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-14-188"},{"key":"ref23","unstructured":"Classification of digital health interventions v1.0: a shared language to describe the uses of digital technology for healthWorld Health Organization20182021-04-04https:\/\/www.who.int\/reproductivehealth\/publications\/mhealth\/classification-digital-health-interventions\/en\/"},{"key":"ref24","unstructured":"eHealth at WHOWorld Health Organization2021-01-15https:\/\/www.who.int\/ehealth\/about\/en\/"},{"key":"ref25","unstructured":"Fast-forward progress: Leveraging tech to achieve the global goalsInternational Telecommunication Union (ITU)20172021-01-15https:\/\/www.itu.int\/en\/sustainable-world\/Documents\/Fast-forward_progress_report_414709%20FINAL.pdf"},{"key":"ref26","unstructured":"WHO guideline: recommendations on digital interventions for health system strengtheningWorld Health Organization20192021-02-17https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/311941\/9789241550505-eng.pdf?ua=1"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.3402\/gha.v7.25606"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Sustainable Development Goals: Goal 3 Ensure healthy lives and promote well-being for all at all agesUnited Nations2021-01-15https:\/\/www.un.org\/sustainabledevelopment\/health\/","DOI":"10.1201\/9780367814960-3"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1159\/000500247"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.8.2.e9"},{"key":"ref31","unstructured":"The Mobile Economy Sub-Saharan AfricaGSMA20182021-01-15https:\/\/tinyurl.com\/53cyv5wk"},{"key":"ref32","unstructured":"The impact of mobile money interoperability in TanzaniaGSMA20162021-01-15https:\/\/tinyurl.com\/2zzj8cc2"},{"key":"ref33","unstructured":"Triggering mobile internet use in C\u00f4te d\u2019Ivoire and TanzaniaGSMA20182021-01-15https:\/\/tinyurl.com\/59pyz2h8"},{"key":"ref34","unstructured":"Health information dashboardNon-discriminating access for Digital Inclusion (DigI project)2021-01-13https:\/\/migoli.yeboo.com\/health_information_dashboard.php"},{"key":"ref35","unstructured":"About Digital Inclusion (DigI)Basic Internet Foundation2021-01-15https:\/\/its-wiki.no\/wiki\/DigI:About"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.2196\/preprints.25558"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.17645\/si.v8i2.2587"},{"key":"ref38","unstructured":"Rural population (% of total population) - TanzaniaThe World Bank2021-02-17https:\/\/data.worldbank.org\/indicator\/SP.RUR.TOTL.ZS?locations=TZ"},{"key":"ref39","unstructured":"Tanzania: Regions and CitiesCity Population2021-02-17https:\/\/www.citypopulation.de\/en\/tanzania\/cities\/"},{"key":"ref40","unstructured":"Tanzania Country Climate Risk Profile Series: Iringa DistrictInternational Center for Tropical Agriculture (CIAT), CARE Tanzania20192021-02-17https:\/\/tinyurl.com\/d3jjhjvk"},{"key":"ref41","unstructured":"Iringa Regional ReportFinScope Tanzania20172021-02-17https:\/\/www.fsdt.or.tz\/wp-content\/uploads\/2018\/11\/Finscope_Iringa.pdf"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.5027\/jnrd.v6i0.12"},{"key":"ref43","unstructured":"2012 Population and Housing CensusThe United Republic of Tanzania National Bureau of Statistics2021-01-15https:\/\/tinyurl.com\/43vhmms3"},{"key":"ref44","first-page":"1","author":"Lavrakas, PJ","year":"2008","journal-title":"Encyclopedia of Survey Research Methods"},{"key":"ref45","first-page":"1","author":"Lavrakas, PJ","year":"2008","journal-title":"Encyclopedia of Survey Research Methods"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1949.10483314"},{"key":"ref47","unstructured":"Services for sensitive data (TSD)University of Oslo2021-01-15https:\/\/www.uio.no\/english\/services\/it\/research\/sensitive-data\/about\/index.html"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0118541"},{"key":"ref49","unstructured":"KoBoCollectGoogle Play20182021-01-15https:\/\/play.google.com\/store\/apps\/details?id=org.koboc.collect.android&hl"},{"key":"ref50","unstructured":"Data Collection Tools for Challenging EnvironmentsKoBoToolbox20172021-01-15http:\/\/www.kobotoolbox.org\/"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"60","DOI":"10.4135\/9781849208949.n5","author":"Crang, M","year":"2007","journal-title":"Doing Ethnographies"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2003.10.001"},{"key":"ref53","author":"Creswell, JW","year":"2011","journal-title":"Designing and Conducting Mixed Methods Research, 2nd Edition"}],"container-title":["JMIR Research Protocols"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.researchprotocols.org\/2021\/4\/e25128","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:36:46Z","timestamp":1782841006000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.researchprotocols.org\/2021\/4\/e25128"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,22]]},"references-count":53,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.2196\/25128","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.25128","asserted-by":"object"}]},"ISSN":["1929-0748"],"issn-type":[{"value":"1929-0748","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,22]]}}}