Feasibility assessment of telehealth-based non-communicable disease screening and monitoring by community health leaders in remote areas: A pilot study in Chiang Mai, Thailand

Limited access to healthcare in remote areas poses a significant challenge for non-communicable disease (NCD) prevention. This study assessed the feasibility and acceptability of HealthD, a telehealth platform enabling Community Health Leaders (CHLs) to screen and monitor NCD risks in rural Thailand. From June to November 2023, a prospective study was conducted in Chiang Mai, Thailand, involving 120 adults (aged 30-70 years) with no prior NCD diagnosis. Trained CHLs performed risk assessments for diabetes mellitus (DM), cardiovascular disease (CVD), and chronic obstructive pulmonary disease (COPD) using the HealthD system. Participants were categorized into four risk levels and received tailored teleconsultations at two- and four-month follow-ups. Satisfaction surveys were conducted among CHLs and participants. At baseline, 73% of participants were at risk for DM (21% high-risk), 3% for CVD, and 10% for COPD. Over follow-up visits, DM risk fluctuated (63% at two months; 76% at four months), while CVD (4% to 6%) and COPD (6% to 8%) risk levels remained relatively stable. CHLs demonstrated significant competency improvement post-training (mean score increase: 8.4 to 9.3, p = 0.010). High satisfaction levels were reported among CHLs (92%) and participants (97%), indicating strong acceptability of the HealthD system. The HealthD telehealth platform is a feasible and well-accepted solution for community-based NCD screening and monitoring. Its integration into Thailands healthcare system could enhance early disease detection and improve health outcomes in remote communities.