%0 Journal Article %A Malini Pires %A Sanjit Shaha %A Carina King %A Joanna Morrison %A Tasmin Nahar %A Naveed Ahmed %A Hannah Maria Jennings %A Kohenour Akter %A Hassan Haghparast-Bidgoli %A A K Azad Khan %A Anthony Costello %A Abdul Kuddus %A Kishwar Azad %A Edward Fottrell %T Equity impact of participatory learning and action community mobilisation and mHealth interventions to prevent and control type 2 diabetes and intermediate hyperglycaemia in rural Bangladesh: analysis of a cluster randomised controlled trial %D 2022 %R 10.1136/jech-2021-217293 %J Journal of Epidemiology and Community Health %P 586-594 %V 76 %N 6 %X Background A cluster randomised trial of mHealth and participatory learning and action (PLA) community mobilisation interventions showed that PLA significantly reduced the prevalence of intermediate hyperglycaemia and type 2 diabetes mellitus (T2DM) and the incidence of T2DM among adults in rural Bangladesh; mHealth improved knowledge but showed no effect on glycaemic outcomes. We explore the equity of intervention reach and impact.Methods Intervention reach and primary outcomes of intermediate hyperglycaemia and T2DM were assessed through interview surveys and blood fasting glucose and 2-hour oral glucose tolerance tests among population-based samples of adults aged ≥30 years. Age-stratified, gender-stratified and wealth-stratified intervention effects were estimated using random effects logistic regression.Results PLA participants were similar to non-participants, though female participants were younger and more likely to be married than female non-participants. Differences including age, education, wealth and marital status were observed between individuals exposed and those not exposed to the mHealth intervention.PLA reduced the prevalence of T2DM and intermediate hyperglycaemia in all age, gender and wealth strata. Reductions in 2-year incidence of T2DM of at least 51% (0.49, 95% CI 0.26 to 0.92) were observed in all strata except among the oldest and least poor groups. mHealth impact on glycaemic outcomes was observed only among the youngest group, where a 47% reduction in the 2-year incidence of T2DM was observed (0.53, 95% CI 0.28 to 1.00).Conclusion Large impacts of PLA across all strata indicate a highly effective and equitable intervention. mHealth may be more suitable for targeting higher risk, younger populations.Trial registration number ISRCTN41083256.Data are available upon reasonable request. Deidentified data collected for this study and a data dictionary are available from the corresponding author on reasonable request. %U https://jech.bmj.com/content/jech/76/6/586.full.pdf