Evaluation of Digital Decision-support Tool for Child Nutritional Monitoring: a Protocol for Cluster Randomized Controlled Trial in Urban and Semi-Urban Areas in Indonesia (KSI-RCT)

Center for Indonesia's Strategic Development Initiatives

Status: Active, not recruiting

Conditions: Nutritional Status; Primary Health Care for Children

Treatments: Device: Apps PRIMA Mobile; Device: Web-Based Apps PRIMA; Behavioral: Advance GEDSI Training

Study type: Interventional

Funder types: Other

Identifiers

NCT07027384

koneksiRCT

1447/CRG/2024/46-CISDI (Other Grant/Funding Number)

Details and patient eligibility

About

This research is a collaborative study between Indonesia's Strategic Development Initiatives (CISDI), Knowledge Partnership Platform Australia - Indonesia (KONEKSI), Center on Child Protection and Wellbeing (PUSKAPA), and Center for Development Economics and Sustainability at Monash University. This study is a part of the PN PRIMA research universe, which is a program lead by CISDI with a focus of strengthening the primary healthcare facilities of Indonesia, known as Integrated Health Posts (Posyandu). This project supports the Ministry of Health's (MoH) flagship program: the Integrated Primary Health Care Services (ILP).

This study aims to evaluate the impact of implementing a digital mHealth app, called the PN PRIMA app, in enhancing the work quality of Community Health Workers working in Posyandu, known as Kader. This study specifically improve the PN PRIMA app from a web-based platform to a mobile application. We aim to improve data quality, streamline service delivery workflows, and enhance decision-making support for community health workers. The enhanced version incorporates new features and Gender Equality, Disability, and Social Inclusion (GEDSI) framework to strengthen primary health care delivery.

Impact evaluation of the study will be conducted through a three-arm parallel cluster randomized controlled trial. Posyandu will be the unit in which randomization will occur. The primary outcomes focuses on the improvements of Kader Posyandu performance in delivering follow-up home visits and how the app effectively support Kader in delivering nutrition interventions for children under five years of age.

The study will be conducted in the Puskesmas PN PRIMA catchment area, located in Kabupaten Bekasi and Kota Depok, focusing the intervention at the Posyandu level. In total, 38 Posyandu out of 12 health centers (Puskesmas) across the two areas will be recruited to take part in this study.

Enrollment: 1,030 estimated patients

Sex: All

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Community Health Workers (CHWs) assigned to work in one of the eligible Posyandu PN PRIMA
• Consent to participate in the program and the study

Exclusion criteria

- Community Health Workers working outside of Posyandu PN PRIMA

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

1,030 participants in 3 patient groups

Web-Based App

Active Comparator group

Description:

The first group of Posyandu will use the standard web-based version of the PN PRIMA app in addition to the routine nutritional services. This web-based version is accessible only through browsers and includes the basic functions such as reporting key health indicators and in-app warning alerts. This group will serve as the control group, using the baseline functionality of the app currently available to Kader

Treatment:

Device: Web-Based Apps PRIMA

Mobile-Based App

Experimental group

Description:

This group will receive access to the mobile version of PN PRIMA app. The mobile-based version has additional features unavailable in the web-based version. The mobile-based version has access to the PN PRIMA app using a standalone mobile app. In addition to the standard reporting of patients' key health indicators and in-app warning message alerts which are available in the web-based version, the mobile app includes active notifications for Kader, which serve as reminders to encourage Kader in making on-time assistance for healthcare beneficiaries, especially those considered requiring special attention (kunjungan khusus) and for those facing access barriers who need regular checkups (kunjungan rutin).

Treatment:

Device: Apps PRIMA Mobile

Mobile + GEDSI Training

Experimental group

Description:

In addition to using the new mobile-app as arm 2, this arm will include training module that focuses on identifying and addressing caregiver and community vulnerabilities. This training is designed to strengthen Kader's capacity in recognizing risk factors that may contribute to malnutrition, such as social, economic, and environmental barriers to care. The training emphasizes empathetic and responsive service delivery, equipping Kader not only with technological tools but also with improved understanding and skills for working in complex community settings. This integrated intervention enables the study to assess the combined effect of digital tools and conventional capacity-building efforts on service delivery outcomes.

Treatment:

Behavioral: Advance GEDSI Training

Device: Apps PRIMA Mobile