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. 2022 Dec 24;20(1):298. doi: 10.3390/ijerph20010298

  1. Recruit and obtain consent from participants—verbal and written consent. The study is explained to potential participants after a verbal and written consent is provided.

  2. Give time for questions. Voluntarily enrol participants when they have given their informed decisions.

  3. Interview participants at household level. Follow COVID-19 protocols and country-specific guidelines.

  4. Confirm selection criteria. Ask whether the participant has been diagnosed with diabetes or hypertension. If ‘Yes’, the participant will be excluded as it will be assumed that they are already attending a clinic for care.

  5. Take physical measurements:
    1. First, blood pressure (BP) measurements will be taken at three intervals (every 2–3 min) using an electronic BP device (Omron), with the participant made to sit comfortably in an upright position.
    2. Weight, height and waist circumference will also be taken based on the study protocol.
    3. Undertake hand sensitization after the measurement.

  6. Record variables on the mobile app; physical measurements and non-modifiable variables (age, sex, diabetes status) will be recorded on the mobile app. The readings will be double recorded on paper to enable validation and quality control by the study coordinator.

  7. Identify at-risk persons, and make referral; after screening and recording information, each individual risk score will be automatically generated. CHWs will obtain verbal consent from the at-risk persons identified, before referring them to the CHC after counselling. Only when the at-risk person agrees for referral will the referral will be initiated. Referral days will be allocated based on available clinic days (and considering the daily patient workload) at CHCs agreed by designated nurse/manager.

  8. Provide counselling and referral services. All study participants will be provided counselling, and a pamphlet on CVD/NCD (risk) prevention messages will also be provided. The CHW will inform the participants of their possible risk level, and provides counselling, and refer those at high risk (CVD risk score ≥ 20%) to the designated health centre (CHC). Persons whose average systolic blood pressure (SBP) is ≥180 mm Hg, will be referred immediately to the nearest clinic to be assessed by a health professional.

  9. Ask questions necessary on CVD risk screening and health seeking intentions, using the mobile-app questionnaire (See Appendix A.2).