Key result
Mobile app screening by health extension workers successfully identifies ~20% of participants at high CVD risk.
Why the study?
Evidence-based screening strategies for cardiovascular disease prevention are limited in Ethiopia due to manpower shortages and have had limited testing of mobile phone technology by health extension workers.
Does mobile phone-based cardiovascular disease risk screening by Health Extension Workers accurately identify CVD risk in community members compared to nurses?
Cross-Sectional (n=301)
Yes
Does mobile phone-based cardiovascular disease risk screening by Health Extension Workers accurately identify CVD risk in community members compared to nurses?
Mobile phone-based cardiovascular disease risk screening by Health Extension Workers is feasible, acceptable, and as accurate as screening by nurses in Ethiopia.
Supports feasibility of mobile app-based CVD screening by health extension workers in Ethiopia; leaves open questions of accuracy, scalability, and clinical impact.
Introduction: Ethiopia is witnessing an unprecedented rise in cardiovascular disease (CVD) largely due to an epidemiological transition from an agrarian to urban lifestyle coupled with an aging society. Evidence-based screening strategies for CVD prevention are limited due to manpower shortages. Health extension workers (HEWs) in surrounding sub-Saharan countries have successfully screened for CVD risk using mobile phone technology, but this strategy has had limited testing in Ethiopia. The purpose of this study was to determine the feasibility and acceptability of utilizing HEWs to evaluate CVD risk using mobile phone technology in community settings in Ethiopia. Methods: A cross-sectional design was utilized that employed a validated mobile phone application to implement a CVD risk assessment based on the Framingham non-laboratory risk score. We enrolled 10 female HEWs (mean age 28) who received training in CVD risk assessment and blood pressure screening. Each HEW screened 30 community members (N = 300) from 10 different community settings or woredas in Ethiopia under the supervision of nurses. Results: HEWS identified with equal accuracy as master’s prepared nurses those in the community at high, moderate and low CVD risk using the non-laboratory risk score algorithm via a mobile health app. Among all participants, (N = 144, 48.5%) were at low risk, (N = 95, 32%) at moderate and (N = 58, 19.5%) were at high risk for CVD. By gender, men were significantly older, more likely diabetic, current smokers and at almost twice as likely to be at moderate to high risk (70.5%) than women (36.9%). Referrals for CVD risk > 20% occurred in 13% of participants. The HEWs reported easy use and high satisfaction with the mobile phone app. Conclusion: Use of a HEWs and non-laboratory risk score is pragmatic and cost effective and has the potential to significantly improve early detection and management of CVD risk in Ethiopia.
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Beza et al. (2025) conducted a cross-sectional in Cardiovascular Disease Risk (n=301). Mobile phone-based non-laboratory Framingham CVD risk screening by Health Extension Workers was evaluated on Feasibility, acceptability, and identification of 10-year CVD risk categories. Health Extension Workers successfully utilized a mobile phone application to screen community members, identifying 19.5% of participants as being at high 10-year cardiovascular disease risk.
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