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External Validation and Implementation of a Novel Mobile Health Application for Acute Diarrhea Management across the Lifespan

Award Number: R01DK116163
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/01/2018
PERIOD OF PERFORMANCE END DATE: 04/30/2028

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External Validation and Implementation of a Novel Mobile Health Application for Acute Diarrhea Management across the Lifespan - With 6.6 billion episodes and 1.5 million deaths annually, diarrheal diseases remain one of the leading causes of death and disability in both children and adults worldwide. In the United States, diarrheal illness accounts for 1.7 million emergency department visits and 70,000 hospitalizations each year in children alone. While the vast majority of diarrheal episodes follow a relatively benign course, approximately 35% of cases in younger children and 5% of cases in older children and adults lead to moderate or severe disease requiring advanced medical management. Appropriate rehydration with either oral or intravenous fluids remains the most important step for treating acute diarrhea. Accurate assessment of dehydration status has been shown to reduce the morbidity and mortality that results from inappropriate rehydration of patients and can also improve the cost-effectiveness of diarrhea management. Yet no validated tools exist for estimating dehydration severity in patients with acute diarrhea across the lifespan. Using artificial intelligence, our prior research derived and internally validated new clinical diagnostic models for assessing dehydration severity both in children under five years of age (DHAKA models) and patients over five years of age (NIRUDAK models) and demonstrated that they were more accurate and reliable than the current World Health Organization guidelines. We then incorporated our new clinical diagnostic models into a simple mobile health application (mHealth) clinical decision support tool (CDST) that can be used by frontline providers to guide management for patients with acute diarrhea. Building upon the success of our prior work, the proposed R01 renewal award research will evaluate the transportability of our novel clinical diagnostic models to a variety of settings worldwide, including the United States, Africa, and South-East Asia. In addition, we will use an implementation science-based approach to better understand the barriers and facilitators to uptake and usage of the mHealth CDST by a variety of different types of healthcare providers in both Tanzania and the United States. Once validated, our new mHealth CDST has the potential to reduce both the morbidity and mortality that occurs as a result of missed diagnoses of dehydration, as well as the adverse events and inappropriate utilization of limited healthcare resources that can result from inaccurate diagnoses of dehydration. This can potentially improve treatment for the hundreds of millions of patients presenting to healthcare facilities worldwide with acute diarrhea each year, including millions of patients in the United States alone.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $574,980 )
2026	2026	BROWN UNIVERSITY	1 PROSPECT ST	PROVIDENCE	RI	02912	PROVIDENCE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	8	5/18/2026	NON-COMPETING CONTINUATION	$574,980
2026	2025	BROWN UNIVERSITY	1 PROSPECT ST	PROVIDENCE	RI	02912	PROVIDENCE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	7	1/23/2026	NON-COMPETING CONTINUATION	$0
														Subtotal = $574,980

Issue Date FY: 2025 ( Subtotal = $591,642 )
2025	2025	BROWN UNIVERSITY	1 PROSPECT ST	PROVIDENCE	RI	02912	PROVIDENCE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	7	8/28/2025	NON-COMPETING CONTINUATION	$591,642
2025	2022	RHODE ISLAND HOSPITAL	593 EDDY ST	PROVIDENCE	RI	02903	PROVIDENCE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	5	2/12/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $591,642

Issue Date FY: 2024 ( Subtotal = $676,935 )
2024	2024	BROWN UNIVERSITY	1 PROSPECT ST	PROVIDENCE	RI	02912	PROVIDENCE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	6	4/23/2024	COMPETING CONTINUATION	$676,935
2024	2022	RHODE ISLAND HOSPITAL	593 EDDY ST	PROVIDENCE	RI	02903	PROVIDENCE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	5	4/15/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $676,935

Issue Date FY: 2022 ( Subtotal = $543,575 )
2022	2022	RHODE ISLAND HOSPITAL	593 EDDY ST	PROVIDENCE	RI	02903	PROVIDENCE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	5	6/28/2022	NON-COMPETING CONTINUATION	$543,575
														Subtotal = $543,575

Issue Date FY: 2021 ( Subtotal = $546,783 )
2021	2021	RHODE ISLAND HOSPITAL	593 EDDY ST	PROVIDENCE	RI	02903	PROVIDENCE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	4	6/16/2021	NON-COMPETING CONTINUATION	$546,783
														Subtotal = $546,783

Issue Date FY: 2020 ( Subtotal = $618,136 )
2020	2020	RHODE ISLAND HOSPITAL	593 EDDY ST	PROVIDENCE	RI	02903	PROVIDENCE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	3	6/25/2020	NON-COMPETING CONTINUATION	$618,136
														Subtotal = $618,136

Issue Date FY: 2019 ( Subtotal = $556,605 )
2019	2019	RHODE ISLAND HOSPITAL	593 EDDY ST	PROVIDENCE	RI	02903	PROVIDENCE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	2	7/1/2019	NON-COMPETING CONTINUATION	$556,605
2019	2018	RHODE ISLAND HOSPITAL	593 EDDY ST	PROVIDENCE	RI	02903	PROVIDENCE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	11/6/2018	NEW	$0
														Subtotal = $556,605

Issue Date FY: 2018 ( Subtotal = $544,336 )
2018	2018	RHODE ISLAND HOSPITAL	593 EDDY ST	PROVIDENCE	RI	02903	PROVIDENCE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	8/28/2018	NEW	$544,336
2018	2018	RHODE ISLAND HOSPITAL	593 EDDY ST	PROVIDENCE	RI	02903	PROVIDENCE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	1	8/29/2018	NEW	$0
														Subtotal = $544,336

Grand Total All Awards = $4,652,992

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External Validation and Implementation of a Novel Mobile Health Application for Acute Diarrhea Management across the Lifespan

Award Number: R01DK116163

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/01/2018

PERIOD OF PERFORMANCE END DATE: 04/30/2028

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