Objectives: To compare the performance of paper-based record-keeping versus an offline digital app when used by vaccination brigades in Indigenous communities in the Peruvian Amazon in 2025, considering four dimensions: operational efficiency, data quality, usability, and acceptance. Secondarily, to identify distinct user profiles.
Methods: Mixed-methods comparative study based on 758 timed records (app = 429; paper = 329) and 30 structured surveys of vaccination brigade staff. Descriptive statistics, bivariate tests, and generalized linear models (GLM, Poisson and Gamma) with 95% CIs were used to measure times. The qualitative component included open-ended testimonials and AI-assisted thematic analysis, organized according to the model proposed by Sittig and Singh. Finally, cluster analysis was conducted to identify user typologies.
Results: The time per record was shorter with the app (3.21 vs. 4.61 min; −30.4%), with a consistent effect across the models (Poisson: 95%CI 0.289–0.435; gamma: 0.234–0.491). The app improved data quality through validation (perceived positively by 100% of users) and demonstrated high usability and acceptance, especially among users more familiar with technology. Cluster analysis identified three user profiles (receptive, hybrid, and cautious), highlighting the influence of technological age, training, and geographic context on app uptake.
Conclusions: Use of the offline app improved operational efficiency, data quality, and acceptance among vaccination brigades. The user adoption profiles identified enable development of tailored strategies and should help strengthen training, optimize technical support, and facilitate the implementation of hybrid systems in low-connectivity settings, with the potential to scale up for nationwide vaccination efforts.