A unified Indigenous Knowledge System (IKS)-integrated biosocial and digital health model to reduce cancer disparity in rural India

Background: Through a three decades of community based participatory action research (CBPAR) (Ref.1), we are studying cancer disparity. Since 2010, the "KaviKrishna Satra" program has developed a long-term cancer disparity research platform through an Indigenous Knowledge System (IKS)-based social-network framework (Ref.2) and using ethnography + phenomenology (Ref. 3), plus pancha-padika education (1-2). We are developing a digital IKS-based intervention (KaviKrishna HealArt App + Nigudah Yoga + nutrition + Focussed group discussions/FGDs) and a biosocial resilience scale (Sahasa-Ojash) rooted in Vedic Jiva Upakara Cikitsha Tantra, an Avatar-Kosha-based biosocial healing system (Ref. 1 & 4). We hypothesize that cancer disparity in rural India is a biosocial phenomenon that can be reduced by combining IKS-based communication systems, digital health connectivity, and psychosocial care. Methods: We mapped the social-support networks of 200 rural cancer patients through home visits, interviews, FGDs, and clinician-interaction analysis to detect the emergence of an IKS-based communication system through CBPAR. We measured Sahasa-Ojash in the first 35 patients, and will longitudinally measure all 200 patients through the Heal-Art app for continuous biosocial analytics. We also evaluated the continuity of care (adherence to scheduled follow-ups, completion of treatment, and persistence in telemedicine contact over 12 months). Results: The integrated digital-IKS intervention produced measurable biosocial and clinical impact: 1) Sahasa-Ojash increased 2-3-fold after the intervention (mean increase, p = 0.065; trend toward significance due to sample size). 2) Fatigue and insomnia reduced by 35-45% (p = 0.046), whereas appetite increased by 50-60% (p = 0.032) . 3 ) Treatment adherence and follow-up continuity increased 3-fold through the KaviKrishna HealArt App. 4) Preliminary IKS-network analysis showed reactivation of indigenous social-communication pathways resembling historical IKIN structures, improving patient navigation and trust. 5) Patients reported greater psychological resilience, enhanced self-care, and improved communication with oncologists. 6) Clinical co-morbidities decreased (anemia, hypertension fluctuations, and GI disturbances). These biosocial gains correlated with a 3-fold improvement in continuity of care, greater chemotherapy completion, and markedly reduced treatment dropout. Conclusion: We have developed a unified, scalable, and cost-effective IKS-integrated cancer disparity model that Maps biosocial determinants using ethnography and phenomenology. (1). https://doi.org/10.1158/1538-7445.AM2024-1005 (2). https://doi.org/10.1158/1538-7445.AM2019-3342 (3). https://doi.org/10.1158/1538-7445.AM2024-807 (4). https://zenodo.org/records/8062404