Exploring the feasibility of using mobile phones to improve the management of clients with cervical cancer precursor lesions
Date
2019-01-07
Journal Title
Journal ISSN
Volume Title
Publisher
BMC (part of Springer Nature)
Abstract
Background: Cancer screening programs hold much potential for reducing the cervical cancer disease burden in
developing countries. The aim of this study was to determine the feasibility of mobile health (mHealth) phone
technology to improve management and follow-up of clients with cervical cancer precursor lesions.
Methods: A sequential mixed methods design was employed for this study. Quantitative data was collected using
a cross-sectional survey of 364 women eligible for a Pap smear at public sector health services in Cape Town, South
Africa. Information was collected on socio-demographic status; cell phone ownership and patterns of use; knowledge
of cervical cancer prevention; and interest in Pap smear results and appointment reminders via SMS-text
messages. Descriptive statistics, crude bivariate comparisons and logistic regression models were employed to
analyze survey results. Qualitative data was collected through 10 in-depth interviews with primary health care
providers and managers involved in cervical cancer screening. Four focus group discussions with 27 women
attending a tertiary level colposcopy clinic were also conducted. Themes related to loss of mobile phones,
privacy and confidentiality, interest in receiving SMS-text messages, text language and clinic-based management
of a SMS system are discussed. Thematic analyses of qualitative data complemented quantitative findings.
Results: Phone ownership amongst surveyed women was 98% with phones mostly used for calls and short
message service (SMS) functions. Over half (58%) of women reported loss/theft of mobile phones. Overall,
there was interest in SMS interventions for receiving Pap smear results and appointment reminders. Reasons
for interest, articulated by both providers and clients, included convenience, cost and time-saving benefits
and benefits of not taking time off work. However, concerns were expressed around confidentiality of SMS
messages, loss/theft of mobile phones, receiving negative results via SMS and accessibility/clarity of language
used to convey messages. Responsibility for the management of a clinic-based SMS system was also raised.
Conclusions: Results indicated interest and potential for mHealth interventions in improving follow-up and
management of clients with abnormal Pap smears. Health system and privacy issues will need to be addressed for
mHealth to achieve this potential. Next steps include piloting of specific SMS messages to test feasibility and
acceptability in this setting.
Description
CITATION: Moodley, J., et al. 2019. Exploring the feasibility of using mobile phones to improve the management of clients with cervical cancer precursor lesions. BMC Women's Health, 19:2, doi:10.1186/s12905-018-0702-1.
The original publication is available at https://bmcwomenshealth.biomedcentral.com
The original publication is available at https://bmcwomenshealth.biomedcentral.com
Keywords
Cervical cancer -- Prevention, Cell phones, Medical screening, Pap test, Colposcopy, Wireless communication systems in medical care
Citation
Moodley, J., et al. 2019. Exploring the feasibility of using mobile phones to improve the management of clients with cervical cancer precursor lesions. BMC Women's Health, 19:2, doi:10.1186/s12905-018-0702-1