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Vives N, Travier N, Farre A, Binefa G, Vidal C, Pérez Lacasta MJ, Ibáñez-Sanz G, Niño de Guzmán EP, Panera JA, Garcia M. Effectiveness and Acceptability of Targeted Text Message Reminders in Colorectal Cancer Screening: Randomized Controlled Trial (M-TICS Study). JMIR Public Health Surveill 2024; 10:e57959. [PMID: 39083331 PMCID: PMC11325104 DOI: 10.2196/57959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/30/2024] [Accepted: 06/08/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Mobile phone-based SMS text message reminders have the potential to improve colorectal cancer screening participation rates. OBJECTIVE This study assessed the effectiveness and acceptability of adding targeted SMS text message reminders to the standard procedure for those who picked up but did not return their screening kit at the pharmacy within 14 days in a colorectal cancer screening program in Catalonia, Spain. METHODS We performed a randomized control trial among individuals who picked up a fecal immunochemical test (FIT) kit for colorectal cancer screening at the pharmacy but did not return it within 14 days. The intervention group (n=4563) received an SMS text message reminder on the 14th day of kit pick up and the control group (n=4806) received no reminder. A 30-day reminder letter was sent to both groups if necessary. The main primary outcome was the FIT completion rate within 30, 60, and 126 days from FIT kit pick up (intention-to-treat analysis). A telephone survey assessed the acceptability and appropriateness of the intervention. The cost-effectiveness of adding an SMS text message reminder to FIT completion was also performed. RESULTS The intervention group had higher FIT completion rates than the control group at 30 (64.2% vs 53.7%; P<.001), 60 (78.6% vs 72.0%; P<.001), and 126 (82.6% vs 77.7%; P<.001) days. Participation rates were higher in the intervention arm independent of sex, age, socioeconomic level, and previous screening behavior. A total of 339 (89.2%) interviewees considered it important and useful to receive SMS text message reminders for FIT completion and 355 (93.4%) preferred SMS text messages to postal letters. We observed a reduction of US $2.4 per participant gained in the intervention arm for invitation costs compared to the control arm. CONCLUSIONS Adding an SMS text message reminder to the standard procedure significantly increased FIT kit return rates and was a cost-effective strategy. SMS text messages also proved to be an acceptable and appropriate communication channel for cancer screening programs. TRIAL REGISTRATION ClinicalTrials.gov NCT04343950; https://www.clinicaltrials.gov/study/NCT04343950. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1371/journal.pone.0245806.
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Affiliation(s)
- Nuria Vives
- Cancer Screening Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Early Detection of Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
| | - Noemie Travier
- Cancer Screening Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Early Detection of Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
| | - Albert Farre
- School of Health Sciences, University of Dundee, Dundee, United Kingdom
| | - Gemma Binefa
- Cancer Screening Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Early Detection of Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
- Ciber Salud Pública (CIBERESP), Instituto Salud Carlos III, Madrid, Spain
| | - Carmen Vidal
- Cancer Screening Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Early Detection of Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
- Ciber Salud Pública (CIBERESP), Instituto Salud Carlos III, Madrid, Spain
| | - Maria Jose Pérez Lacasta
- Department of Economics, University Rovira i Virgili, Reus, Spain
- Research Group Economic Challenges for the Next Generation (ECO-NEXT), Reus, Spain
- Research Center on Economics and Sustainability (ECO-SOS), Reus, Spain
| | - Gemma Ibáñez-Sanz
- Gastroenterology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- Colorectal Cancer Group, ONCOBELL Program, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Spain
| | - Ena Pery Niño de Guzmán
- Cancer Screening Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Vall d' Hebron University Hospital, Barcelona, Spain
| | - Jon Aritz Panera
- Cancer Screening Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Early Detection of Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
| | - Montse Garcia
- Cancer Screening Unit, Institut Català d'Oncologia (ICO), L'Hospitalet de Llobregat, Spain
- Early Detection of Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
- Ciber Salud Pública (CIBERESP), Instituto Salud Carlos III, Madrid, Spain
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Chanakira EZ, Thomas CV, Balen J, Mandrik O. A systematic review of public health interventions to address breast cancer inequalities in low- and middle-income countries. Syst Rev 2024; 13:195. [PMID: 39054497 PMCID: PMC11271015 DOI: 10.1186/s13643-024-02620-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 07/18/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Breast cancer is the most diagnosed cancer in the world, with a worse prognosis documented in low- and middle-income countries. Inequalities pertaining to breast cancer outcomes are observed at within-country level, with demographics and socioeconomic status as major drivers. AIM This review aims to aggregate all available evidence from low- and middle-income countries on public health interventions that can be utilized to reduce breast cancer inequalities within the breast cancer continuum. METHODS The study was a systematic review and narrative synthesis of available literature, with the literature search conducted between September and October 2021. The search was re-run in September 2022 to update the review. PubMed, Scopus, Embase, African Index Medicus and LILACS were searched, based on predetermined criteria. Randomized controlled trials, cohort studies and quasi-experimental studies were included for review, while studies without an intervention and comparator group were excluded. The Joanna Briggs Institute family of checklists was used for quality assessment of the included studies. Data pertaining to study design, quality control and intervention effectiveness was extracted. RESULTS A total of 915 studies were identified for screening and 21 studies met the selection criteria. Only one study specifically evaluated the impact of an intervention on breast cancer inequalities. Diverse, multi-level interventions that can be utilized to address breast cancer inequalities through targeted application to disadvantaged subpopulations were identified. Educational interventions were found to be effective in improving screening rates, downstaging through early presentation as well as improving time to diagnosis. Interventions aimed at subsidizing or eliminating screening payments resulted in improved screening rates. Patient navigation was highlighted to be effective in improving outcomes throughout the breast cancer continuum. CONCLUSION Findings from the systematic review underline the importance of early detection in breast cancer management for low- and middle-income countries. This can be achieved through a variety of interventions, including population education, and addressing access barriers to public health services such as screening, particularly among under-served populations. This study provides a comprehensive database of public health interventions relevant to low- and middle-income countries that can be utilized for planning and decision-making purposes. Findings from the review highlight an important research gap in primary studies on interventions aimed at reducing breast cancer inequalities in low- and middle-income countries. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number: CRD42021289643.
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Affiliation(s)
- Esther Z Chanakira
- School of Health and Related Research, University of Sheffield, 30 Regent St, Sheffield, S1 4DA, UK.
| | - Chloe V Thomas
- School of Health and Related Research, University of Sheffield, 30 Regent St, Sheffield, S1 4DA, UK
| | - Julie Balen
- School of Health and Related Research, University of Sheffield, 30 Regent St, Sheffield, S1 4DA, UK
- School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, UK
- Medical Research Council Unit The Gambia at the London, School of Hygiene and Tropical Medicine, Fajara, The Gambia
- Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
| | - Olena Mandrik
- School of Health and Related Research, University of Sheffield, 30 Regent St, Sheffield, S1 4DA, UK
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Ye J, Xiong S, Wang T, Li J, Cheng N, Tian M, Yang Y. The Roles of Electronic Health Records for Clinical Trials in Low- and Middle-Income Countries: Scoping Review. JMIR Med Inform 2023; 11:e47052. [PMID: 37991820 PMCID: PMC10701650 DOI: 10.2196/47052] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 09/10/2023] [Accepted: 09/22/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Clinical trials are a crucial element in advancing medical knowledge and developing new treatments by establishing the evidence base for safety and therapeutic efficacy. However, the success of these trials depends on various factors, including trial design, project planning, research staff training, and adequate sample size. It is also crucial to recruit participants efficiently and retain them throughout the trial to ensure timely completion. OBJECTIVE There is an increasing interest in using electronic health records (EHRs)-a widely adopted tool in clinical practice-for clinical trials. This scoping review aims to understand the use of EHR in supporting the conduct of clinical trials in low- and middle-income countries (LMICs) and to identify its strengths and limitations. METHODS A comprehensive search was performed using 5 databases: MEDLINE, Embase, Scopus, Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature. We followed the latest version of the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guideline to conduct this review. We included clinical trials that used EHR at any step, conducted a narrative synthesis of the included studies, and mapped the roles of EHRs into the life cycle of a clinical trial. RESULTS A total of 30 studies met the inclusion criteria: 13 were randomized controlled trials, 3 were cluster randomized controlled trials, 12 were quasi-experimental studies, and 2 were feasibility pilot studies. Most of the studies addressed infectious diseases (15/30, 50%), with 80% (12/15) of them about HIV or AIDS and another 40% (12/30) focused on noncommunicable diseases. Our synthesis divided the roles of EHRs into 7 major categories: participant identification and recruitment (12/30, 40%), baseline information collection (6/30, 20%), intervention (8/30, 27%), fidelity assessment (2/30, 7%), primary outcome assessment (24/30, 80%), nonprimary outcome assessment (13/30, 43%), and extended follow-up (2/30, 7%). None of the studies used EHR for participant consent and randomization. CONCLUSIONS Despite the enormous potential of EHRs to increase the effectiveness and efficiency of conducting clinical trials in LMICs, challenges remain. Continued exploration of the appropriate uses of EHRs by navigating their strengths and limitations to ensure fitness for use is necessary to better understand the most optimal uses of EHRs for conducting clinical trials in LMICs.
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Affiliation(s)
- Jiancheng Ye
- Weill Cornell Medicine, New York, NY, United States
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Shangzhi Xiong
- The George Institute for Global Health, Faulty of Medicine and Health, University of New South Wales, Sydney, Australia
- Global Health Research Centre, Duke Kunshan University, Kunshan, China
| | - Tengyi Wang
- School of Public Health, Harbin Medical University, Harbin, China
| | - Jingyi Li
- School of Basic Medicine, Harbin Medical University, Harbin, China
| | - Nan Cheng
- The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Maoyi Tian
- The George Institute for Global Health, Faulty of Medicine and Health, University of New South Wales, Sydney, Australia
- School of Public Health, Harbin Medical University, Harbin, China
| | - Yang Yang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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El-Jardali F, Bou-Karroum L, Jabbour M, Bou-Karroum K, Aoun A, Salameh S, Mecheal P, Sinha C. Digital health in fragile states in the Middle East and North Africa (MENA) region: A scoping review of the literature. PLoS One 2023; 18:e0285226. [PMID: 37115778 PMCID: PMC10146476 DOI: 10.1371/journal.pone.0285226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
INTRODUCTION Conflict, fragility and political violence, that are taking place in many countries in the Middle East and North Africa (MENA) region have devastating effects on health. Digital health technologies can contribute to enhancing the quality, accessibility and availability of health care services in fragile and conflict-affected states of the MENA region. To inform future research, investments and policy processes, this scoping review aims to map out the evidence on digital health in fragile states in the MENA region. METHOD We conducted a scoping review following the Joanna Briggs Institute (JBI) guidelines. We conducted descriptive analysis of the general characteristics of the included papers and thematic analysis of the key findings of included studies categorized by targeted primary users of different digital health intervention. RESULTS Out of the 10,724 articles identified, we included 93 studies. The included studies mainly focused on digital health interventions targeting healthcare providers, clients and data services, while few studies focused on health systems or organizations managers. Most of the included studies were observational studies (49%). We identified no systematic reviews. Most of the studies were conducted in Lebanon (32%) followed by Afghanistan (13%) and Palestine (12%). The first authors were mainly affiliated with institutions from countries outside the MENA region (57%), mainly United Kingdom and United States. Digital health interventions provided a platform for training, supervision, and consultation for health care providers, continuing education for medical students, and disease self-management. The review also highlighted some implementation considerations for the adoption of digital health such as computer literacy, weak technological infrastructure, and privacy concerns. CONCLUSION This review showed that digital health technologies can provide promising solutions in addressing health needs in fragile and conflict-affected states. However, rigorous evaluation of digital technologies in fragile settings and humanitarian crises are needed to inform their design and deployment.
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Affiliation(s)
- Fadi El-Jardali
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Knowledge to Policy Center, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Lama Bou-Karroum
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Knowledge to Policy Center, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Mathilda Jabbour
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Knowledge to Policy Center, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Karen Bou-Karroum
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Andrew Aoun
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Sabine Salameh
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | | | - Chaitali Sinha
- International Development Research Centre, Ottawa, Ontario, Canada
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Nduka IJ, Ejie IL, Okafor CE, Eleje GU, Ekwunife OI. Interventions to increase mammography screening uptake among women living in low-income and middle-income countries: a systematic review. BMJ Open 2023; 13:e066928. [PMID: 36750281 PMCID: PMC9906257 DOI: 10.1136/bmjopen-2022-066928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
OBJECTIVE To systematically identify interventions that increase the use of mammography screening in women living in low-income and middle-income countries (LMICs). DESIGN Systematic review. DATA SOURCES MEDLINE, Embase, Global Health, CINAHL, PsycINFO, Web of Science, Cochrane Central Register of Controlled Trials, Google Scholar and African regional databases. ELIGIBILITY CRITERIA Studies conducted in LMICs, published between 1 January 1990 and 30 June 2021, in the English language. Studies whose population included asymptomatic women eligible for mammography screening. Studies with a reported outcome of using mammography by either self-report or medical records. No restrictions were set on the study design. DATA EXTRACTION AND SYNTHESIS Screening, data extraction and risk-of-bias assessment were conducted by two independent reviewers. A narrative synthesis of the included studies was conducted. RESULTS Five studies met the inclusion criteria consisting of two randomised controlled trials, one quasi-experiment and two cross-sectional studies. All included studies employed client-oriented intervention strategies including one-on-one education, group education, mass and small media, reducing client out-of-pocket costs, reducing structural barriers, client reminders and engagement of community health workers (CHWs). Most studies used multicomponent interventions, resulting in increases in the rate of use of mammography than those that employed a single strategy. CONCLUSION Mass and small media, group education, reduction of economic and structural barriers, client reminders and engagement of CHWs can increase use of mammography among women in LMICs. Promoting the adoption of these interventions should be considered, especially the multicomponent interventions, which were significantly effective relative to a single strategy in increasing use of mammography. PROSPERO REGISTRATION NUMBER CRD42021269556.
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Affiliation(s)
- Ifeoma Jovita Nduka
- Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Nigeria
| | - Izuchukwu Loveth Ejie
- Department of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Nigeria
| | - Charles Ebuka Okafor
- Centre for Applied Health Economics, School of Medicine and Dentistry, Griffith University, Nathan, Queensland, Australia
- Menzies Health Institute, Southport, Queensland, Australia
| | - George Uchenna Eleje
- Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
- Effective Care Research Unit, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Obinna Ikechukwu Ekwunife
- Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Nigeria
- Takemi Program in International Health, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
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Schliemann D, Tan MM, Hoe WMK, Mohan D, Taib NA, Donnelly M, Su TT. mHealth Interventions to Improve Cancer Screening and Early Detection: Scoping Review of Reviews. J Med Internet Res 2022; 24:e36316. [PMID: 35969450 PMCID: PMC9425170 DOI: 10.2196/36316] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cancer screening provision in resource-constrained settings tends to be opportunistic, and uptake tends to be low, leading to delayed presentation and treatment and poor survival. OBJECTIVE The aim of this study was to identify, review, map, and summarize findings from different types of literature reviews on the use of mobile health (mHealth) technologies to improve the uptake of cancer screening. METHODS The review methodology was guided by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Ovid MEDLINE, PyscINFO, and Embase were searched from inception to May 2021. The eligible criteria included reviews that focused on studies of interventions that used mobile phone devices to promote and deliver cancer screening and described the effectiveness or implementation of mHealth intervention outcomes. Key data fields such as study aims, types of cancer, mHealth formats, and outcomes were extracted, and the data were analyzed to address the objective of the review. RESULTS Our initial search identified 1981 titles, of which 12 (0.61%) reviews met the inclusion criteria (systematic reviews: n=6, 50%; scoping reviews: n=4, 33%; rapid reviews: n=1, 8%; narrative reviews: n=1, 8%). Most (57/67, 85%) of the interventions targeted breast and cervical cancer awareness and screening uptake. The most commonly used mHealth technologies for increasing cancer screening uptake were SMS text messages and telephone calls. Overall, mHealth interventions increased knowledge about screening and had high acceptance among participants. The likelihood of achieving improved uptake-related outcomes increased when interventions used >1 mode of communication (telephone reminders, physical invitation letters, and educational pamphlets) together with mHealth. CONCLUSIONS mHealth interventions increase cancer screening uptake, although multiple modes used in combination seem to be more effective.
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Affiliation(s)
- Désirée Schliemann
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Min Min Tan
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Subang Jaya, Malaysia
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Wilfred Mok Kok Hoe
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Subang Jaya, Malaysia
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Nur Aishah Taib
- Department of Surgery, Faculty of Medicine, University Malaya Cancer Research Institute, University of Malaya, Kuala Lumpur, Malaysia
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Tin Tin Su
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
- South East Asia Community Observatory (SEACO), Monash University Malaysia, Subang Jaya, Malaysia
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
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Ntiri SO, Swanson M, Klyushnenkova EN. Text Messaging as a Communication Modality to Promote Screening Mammography in Low-income African American Women. J Med Syst 2022; 46:28. [PMID: 35416511 PMCID: PMC9005912 DOI: 10.1007/s10916-022-01814-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/27/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Though text messages are increasingly used in health promotion, the current understanding of text message-based interventions to increase screening mammography in low-income African American women is limited. This study aimed to assess the feasibility and acceptability of a text message-based intervention to increase screening mammography in low-income African American women. MATERIALS AND METHODS A 15-item, self-administered, paper-based survey on cell phone ownership, text messaging practices and preferences for future breast health information was administered to 120 female patients at an urban family medicine office. Descriptive analyses and demographic correlates of text messaging practices and preferences were examined. RESULTS AND DISCUSSION The majority of respondents (95%) were cell phone owners of whom 81% reported texting. Prior receipt of a text message from a doctor's office was reported by 51% of cell phone owners. Mammography appointment reminders were the most desired content for future breast health text messages. Age (≥ 70 years old) was found to have a significant negative relationship with text messaging practices and perceptions. IMPLICATIONS The use of text messages to promote mammography was found to be acceptable in this patient population. In addition to age, variables such as the frequency, timing and subject content of text messages also influence their acceptability.
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Affiliation(s)
- Shana O Ntiri
- Department of Family & Community Medicine, University of Maryland School of Medicine, 29 S. Paca Street, Baltimore, MD, 21201, United States.
| | - Malia Swanson
- University of Maryland School of Medicine, 29 S. Paca Street, Baltimore, MD, 21201, United States
| | - Elena N Klyushnenkova
- Department of Family & Community Medicine, University of Maryland School of Medicine, 29 S. Paca Street, Baltimore, MD, 21201, United States
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Stewart de Ramirez S, McGarvey J, Lotz A, McGee M, Oderwald T, Floess K, Foulger R, Cooling M, Handler JA. Closing the Gap: A Comparison of Engagement Interventions to Achieve Equitable Breast Cancer Screening in Rural Illinois. Popul Health Manag 2022; 25:244-253. [PMID: 35442784 PMCID: PMC9058878 DOI: 10.1089/pop.2021.0382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Mammography screening rates are typically lower in those with less economic advantage (EA). This study, conducted at an integrated health care system covering a mixed rurality population, assessed the ability of interventions (text messages linking to a Web microsite, digital health care workers, and a community health fair) to affect mammography screening rates and disparity in those rates among different EA populations. Payor type served as a proxy for greater (commercially insured) versus lower (Medicaid insured) EA. 4,342 subjects were included across the preintervention ("Pre") and postintervention ("Post") periods. Interventions were prospectively applied to all Medicaid subjects and randomly selected commercial subjects. Applying interventions only to lower EA subjects reversed the screening rate disparity (2.6% Pre vs. -3.7% Post, odds ratio [OR] 2.4 P < 0.01). When intervention arms ("Least," "More," "Most") were equally applied, screening rates in both EA groups significantly increased in the More arm (Medicaid OR = 2.04 P = 0.04, Commercial OR = 3.08 P < 0.01) and Most arm (Medicaid OR 2.57 P < 0.01, Commercial OR 2.33 P < 0.01), but not in the Least (text-only) arm (Medicaid OR 1.83 P = 0.11, Commercial OR 1.72 P = 0.09), although this text-only arm was inadequately powered to detect a difference. In summary, targeting interventions to those with lower EA reversed screening rate disparities, text messaging combined with other interventions improved screening rates in both groups, and future research is needed to determine whether interventions can simultaneously improve screening rates for all without worsening the disparity.
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Affiliation(s)
- Sarah Stewart de Ramirez
- OSF HealthCare System, Population Health Services, Peoria, Illinois, USA
- University of Illinois College of Medicine at Peoria, Department of Emergency Medicine, Peoria, Illinois, USA
| | - Jeremy McGarvey
- OSF HealthCare System, Department of Health Care Analytics, Peoria, Illinois, USA
| | - Abby Lotz
- Beartooth Billings Clinic, Red Lodge, Montana, USA
- OSF HealthCare System, OSF OnCall, Peoria, Illinois, USA
| | - Mackenzie McGee
- OSF Saint Francis Medical Center, Department of Radiation Oncology, Peoria, Illinois, USA
| | - Tenille Oderwald
- OSF Saint Francis Medical Center, Division of Cancer Support Services, Peoria, Illinois, USA
| | - Katherine Floess
- University of Illinois College of Medicine at Peoria, Department of Emergency Medicine, Peoria, Illinois, USA
| | - Roopa Foulger
- OSF HealthCare System, Department of Health Care Analytics, Peoria, Illinois, USA
- OSF HealthCare System, OSF OnCall, Peoria, Illinois, USA
| | | | - Jonathan A. Handler
- OSF HealthCare System, OSF Innovation, Peoria, Illinois, USA
- Northwestern University Feinberg School of Medicine, Department of Emergency Medicine, Chicago, Illinois, USA
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Acharya A, Sounderajah V, Ashrafian H, Darzi A, Judah G. A systematic review of interventions to improve breast cancer screening health behaviours. Prev Med 2021; 153:106828. [PMID: 34624390 DOI: 10.1016/j.ypmed.2021.106828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 09/27/2021] [Accepted: 10/03/2021] [Indexed: 12/17/2022]
Abstract
Whilst breast cancer screening has been implemented in many countries, uptake is often suboptimal. Consequently, several interventions targeting non-attendance behaviour have been developed. This systematic review aims to appraise the successes of interventions, identifying and comparing the specific techniques they use to modify health behaviours. A literature search (PROSPERO CRD42020212090) between January 2005 and December 2020 using PubMed, Medline, PsycInfo, EMBASE and Google Scholar was conducted. Studies which investigated patient-facing interventions to increase attendance at breast cancer screening appointments were included. Details regarding the intervention delivery, theoretical background, and contents were extracted, as was quantitative data on the impact on attendance rates, compared to control measures. Interventions were also coded using the Behavioural Change Techniques (BCT) Taxonomy. In total fifty-four studies, detailing eighty interventions, met the inclusion criteria. Only 50% of interventions reported a significant impact on screening attendance. Thirty-two different BCTs were used, with 'prompts/cues' the most commonly incorporated (77.5%), however techniques from the group 'covert learning' had the greatest pooled effect size 0.12 (95% CI 0.05-0.19, P < 0·01, I2 = 91.5%). 'Problem solving' was used in the highest proportion of interventions that significantly increased screening attendance (69.0%). 70% of the interventions were developed using behavioural theories. These results show interventions aimed at increasing screening uptake are often unsuccessful. Commonly used approaches which focus upon explaining the consequences of not attending mammograms were often ineffective. Problem solving, however, has shown promise. These techniques should be investigated further, as should emerging technologies which can enable interventions to be feasibly translated at a population-level.
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Affiliation(s)
- Amish Acharya
- Institute of Global Health Innovation, Imperial College London, London W2 1NY, United Kingdom; Imperial Patient Safety and Translational Research Centre, Imperial College London, W2 1NY, United Kingdom
| | - Viknesh Sounderajah
- Institute of Global Health Innovation, Imperial College London, London W2 1NY, United Kingdom
| | - Hutan Ashrafian
- Institute of Global Health Innovation, Imperial College London, London W2 1NY, United Kingdom.
| | - Ara Darzi
- Institute of Global Health Innovation, Imperial College London, London W2 1NY, United Kingdom; Imperial Patient Safety and Translational Research Centre, Imperial College London, W2 1NY, United Kingdom
| | - Gaby Judah
- Imperial Patient Safety and Translational Research Centre, Imperial College London, W2 1NY, United Kingdom
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Kazi AM, Ahsan N, Jamal S, Khan A, Mughis W, Allana R, Kazi AN, Kalimuddin H, Ali SA, McKellin W, Collet JP. Characteristics of mobile phone access and usage among caregivers in Pakistan - A mHealth survey of urban and rural population. Int J Med Inform 2021; 156:104600. [PMID: 34638012 DOI: 10.1016/j.ijmedinf.2021.104600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 09/02/2021] [Accepted: 09/25/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Globally mobile ownership and access is becoming very common, and breakthroughs in mobile technology have shaped digital communication, with 7 billion mobile phone users globally. Developing countries account for 80% of newly purchased mobile phone devices with majority of such countries having low Routine Immunization coverage and a high risk of vaccine preventable diseases. The use of mobile phones provides a tremendous potential for public health involvement. OBJECTIVE The aim of this study is to assess the acceptability and usability of mobile phones among infant caregivers in a LMIC setup and to explore the role of mHealth to improve immunization uptake and coverage. METHODS This is a cross-sectional survey exploring the regional differences in mobile phone ownership, usability and preferences, along with level of trust with others while sharing a mobile phone. The study was conducted with caregivers of infants in an urban and rural sites of Pakistan. RESULTS A total of 4472 households were approached, of which 3337 participants were eligible for the study (74.61 %). The reasons for not participating in the study (n = 1135) included (i) household locked or refusal to participate for 594 families (52%), (ii) child older than 14 days of life in 409 cases (36%), (iii) 80 (7%) families did not have access to a functional mobile phone, (iv) 36 (3%)families did not provide a mobile phone number, and (v) 14 (1%) could not stay within the HDSS for 6 months. Access to mobile phone with SMS features was considerably high at both sites: 99.1% in Matiari (rural site) and 96.7% in Karachi (urban). In Matiari 96.6% of the respondents reported having daily access to the phone, contrasting with only 51.4% in Karachi. In Karachi, the predominant spoken language was Urdu, whereas majority of the respondents in Matiari spoke Sindhi (34.6% vs. 70.9%). CONCLUSION Our study indicates high access to mobile phone in both urban and rural setup, However access to smart phone is still limited, urban and rural setup. Further, the acceptance of overall health- and barrier-based child immunization messages through mobile phone were quite high in both settings. Lastly automated calls were preferred over SMS due to literacy and local settings. This bears important implications for improving child immunization uptake through mobile phones in developing regions such as Pakistan.
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Affiliation(s)
- Abdul Momin Kazi
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan; Department of Experimental Medicine, University of British Columbia, Graduate and Postdoctoral Studies 170-6371 Crescent Road Vancouver, BC, V6T 1Z2, Canada.
| | - Nazia Ahsan
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
| | - Saima Jamal
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
| | - Ayub Khan
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
| | - Waliyah Mughis
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
| | - Raheel Allana
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
| | - Abdul Nafey Kazi
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
| | - Hussain Kalimuddin
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
| | - Syed Asad Ali
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
| | - William McKellin
- Department of Anthropology, University of British Columbia, Vancouver, BC, Canada.
| | - Jean-Paul Collet
- Department of Pediatrics, University of British Columbia and BC Children's Hospital Research Institute, Vancouver, BC, Canada; BC Children's Hospital Research Institute, Vancouver, BC, Canada.
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Ruco A, Dossa F, Tinmouth J, Llovet D, Jacobson J, Kishibe T, Baxter N. Social Media and mHealth Technology for Cancer Screening: Systematic Review and Meta-analysis. J Med Internet Res 2021; 23:e26759. [PMID: 34328423 PMCID: PMC8367160 DOI: 10.2196/26759] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/15/2021] [Accepted: 06/21/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Cancer is a leading cause of death, and although screening can reduce cancer morbidity and mortality, participation in screening remains suboptimal. OBJECTIVE This systematic review and meta-analysis aims to evaluate the effectiveness of social media and mobile health (mHealth) interventions for cancer screening. METHODS We searched for randomized controlled trials and quasi-experimental studies of social media and mHealth interventions promoting cancer screening (breast, cervical, colorectal, lung, and prostate cancers) in adults in MEDLINE, Embase, PsycINFO, Scopus, CINAHL, Cochrane Central Register of Controlled Trials, and Communication & Mass Media Complete from January 1, 2000, to July 17, 2020. Two independent reviewers screened the titles, abstracts, and full-text articles and completed the risk of bias assessments. We pooled odds ratios for screening participation using the Mantel-Haenszel method in a random-effects model. RESULTS We screened 18,008 records identifying 39 studies (35 mHealth and 4 social media). The types of interventions included peer support (n=1), education or awareness (n=6), reminders (n=13), or mixed (n=19). The overall pooled odds ratio was 1.49 (95% CI 1.31-1.70), with similar effect sizes across cancer types. CONCLUSIONS Screening programs should consider mHealth interventions because of their promising role in promoting cancer screening participation. Given the limited number of studies identified, further research is needed for social media interventions. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42019139615; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=139615. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2019-035411.
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Affiliation(s)
- Arlinda Ruco
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Fahima Dossa
- Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Jill Tinmouth
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Prevention & Cancer Control, Ontario Health (Cancer Care Ontario), Toronto, ON, Canada
- Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Diego Llovet
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Prevention & Cancer Control, Ontario Health (Cancer Care Ontario), Toronto, ON, Canada
| | - Jenna Jacobson
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Ted Rogers School of Management, Ryerson University, Toronto, ON, Canada
| | - Teruko Kishibe
- Library Services, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Nancy Baxter
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Lakkis NA, El-Kibbi O, Osman MH. Colorectal Cancer in Lebanon: Incidence, Temporal Trends, and Comparison to Regional and Western Countries. Cancer Control 2021; 28:1073274821996869. [PMID: 33618551 PMCID: PMC8482742 DOI: 10.1177/1073274821996869] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/02/2020] [Accepted: 01/28/2021] [Indexed: 01/02/2023] Open
Abstract
Global trends in the incidence and mortality rates of colorectal cancer show a steady increase with significant predilection to western developed countries, possibly linking it to westernized lifestyles among other risk factors. This study aims to investigate the incidence and trends of colorectal cancer in Lebanon, a country in the Middle East and North Africa region, and to compare these rates to those in regional and western countries. Colorectal cancer incidence data were extracted from the Lebanese National Cancer Registry for the currently available years 2005 to 2016. The calculated age-standardized incidence rates and age-specific rates were expressed as per 100,000 population. The age-standardized incidence rates of colorectal cancer in Lebanon increased from 16.3 and 13.0 per 100,000 in 2005 to 23.2 and 20.2 per 100,000 in 2016, among males and females, respectively. The incidences were higher for males, and they increased with age. The annual percent change was +4.36% and +4.45%, in males and females respectively (p-value < 0.05). There was a non-statistically significant trend of decrease in recent years (since 2012 in males and since 2011 in females). The age-standardized incidence rates in Lebanon were higher than those in the majority of the regional countries, but lower than the rates in developed western countries. There were high age-specific incidence rates at age groups 40-44 and 45-49 years in Lebanon in both males and females (with significant rising temporal trend) compared to other countries, including the ones reported to have the highest colorectal cancer age-standardized incidence rate worldwide. Therefore, the burden of colorectal cancer is significant in Lebanon. This raises the necessity to develop national strategies tailored to reduce colorectal cancer incidence through promoting healthy lifestyles, raising awareness, and early detection as of 40 years of age.
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Affiliation(s)
- Najla A. Lakkis
- Department of Family Medicine, American University of Beirut Medical Center (AUBMC) Beirut, Lebanon
| | - Ola El-Kibbi
- Faculty of Medicine, American University of Beirut Medical Center (AUBMC) Beirut, Lebanon
| | - Mona H. Osman
- Department of Family Medicine, American University of Beirut Medical Center (AUBMC) Beirut, Lebanon
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Schliemann D, Su TT, Paramasivam D, Treanor C, Dahlui M, Loh SY, Donnelly M. Effectiveness of Mass and Small Media Campaigns to Improve Cancer Awareness and Screening Rates in Asia: A Systematic Review. J Glob Oncol 2020; 5:1-20. [PMID: 30969807 PMCID: PMC6528732 DOI: 10.1200/jgo.19.00011] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
PURPOSE The main objective of this systematic review was to identify whether mass and small media interventions improve knowledge and attitudes about cancer, cancer screening rates, and early detection of cancer in Asia. METHODS The review was conducted according to a predefined protocol. Medline, EMBASE, CINAHL, Web of Science, Cochrane Library, and Google Scholar were searched in September 2017, and data extraction and rating of methodologic study quality (according to Joanna Briggs Institute rating procedures) were performed independently by reviewers. RESULTS Twenty-two studies (reported across 24 papers) met the inclusion criteria. Most studies (n = 21) were conducted in high or upper-middle income countries; targeted breast (n = 11), cervical (n = 7), colorectal (n = 3), or oral (n = 2) cancer; and used small media either alone (n = 15) or in combination with mass media and other components (n = 5). Studies regarding cancer screening uptake were of medium to high quality and mainly reported positive outcomes for cervical cancer and mixed results for breast and colorectal cancer. The methodologic strength of research that investigated change in cancer-related knowledge and the cost effectiveness of interventions, respectively, were weak and inconclusive. CONCLUSION Evidence indicated that small media campaigns seemed to be effective in terms of increasing screening uptake in Asia, in particular cervical cancer screening. Because of the limited number of studies in Asia, it was not possible to be certain about the effectiveness of mass media in improving screening uptake and the effectiveness of campaigns in improving cancer-related knowledge.
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Affiliation(s)
| | - Tin Tin Su
- Monash University Malaysia, Bandar Sunway, Malaysia.,University of Malaya, Kuala Lumpur, Malaysia
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Khani Jeihooni A, Darvishi N, Harsini PA. The Effect of Educational Intervention Based on the Theory of Planned Behavior on Mammography Screening in Iranian Women. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:264-273. [PMID: 30604386 DOI: 10.1007/s13187-018-1460-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Mammography is the most special screening method for early diagnosis of breast cancer. The purpose of present research is investigating the effect of educational intervention based on theory of planned behavior on mammography screening of women in Fasa city, Fars province, Iran. In this quasi-experimental study, 400 subjects (200 subjects for experimental group and 200 subjects for control group) were selected in 2017-2018. Educational intervention for the experimental group included 8 educational sessions. A questionnaire used for evaluating demographic information and constructs of theory of planned behavior (knowledge, perceived behavioral control, subjective norms, and attitude) investigated mammography performance of women before and 6 months after intervention. Data were analyzed by using SPSS 22 through chi-square test, McNemar's test, and Wilcoxon-Mann-Whitney test at significance level of P < 0.05. The average age of subjects was 45.52 ± 6.76 years in the experimental group and 45.12 ± 6.64 years in the control group. Six months after intervention, the experimental group showed significant increase in knowledge, perceived behavioral control, subjective norms, and attitude compared to the control group and 174 people (78%) of the experimental group had intention for doing mammography and 148 people (74%) of the experimental group performed mammography. Also, 6 months after educational intervention, 38 people (19%) of the control group had intention for performing mammography and 14 people (7%) of the control group performed mammography.
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Affiliation(s)
- Ali Khani Jeihooni
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa, Iran.
- Fasa Ibn Sina square, Fasa University of Medical Sciences, Fasa, P.Code:7461686688, Iran.
| | - Niloofar Darvishi
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa, Iran
| | - Pooyan Afzali Harsini
- Department of Public Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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15
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Gibson DG, Tamrat T, Mehl G. The State of Digital Interventions for Demand Generation in Low- and Middle-Income Countries: Considerations, Emerging Approaches, and Research Gaps. GLOBAL HEALTH, SCIENCE AND PRACTICE 2018; 6:S49-S60. [PMID: 30305339 PMCID: PMC6203418 DOI: 10.9745/ghsp-d-18-00165] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 09/08/2018] [Indexed: 01/08/2023]
Abstract
The recent introduction of digital health into generating demand for health commodities and services has provided practitioners with an expanded universe of potential tools to strengthen demand and ensure service delivery receipt. However, considerable gaps remain in our understanding of which interventions are effective, which characteristics mediate their benefit for different target populations and health domains, and what is necessary to ensure effective deployment. This paper first provides an overview of the types of digital health interventions for demand generation, including untargeted client communication, client-to-client communication, on-demand information services, personal health tracking, client financial transactions, and targeted client communication. It then provides a general overview of 118 studies published between January 1, 2010, and October 3, 2017, that used digital interventions to generate demand for health interventions. The majority (61%) of these studies used targeted client communication to provide health education or reminders to improve treatment adherence, and the most frequently (27%) studied health condition was HIV/AIDS. Intervention characteristics that have been found to have some effect on gains in demand generation include modality, directionality, tailoring, phrasing, and schedule. The paper also explores new emergent digital approaches that expand the potential effect of traditional demand generation in terms of personalization of content and services, continuity of care, and accountability tracking. Applying existing frameworks for monitoring and evaluation and reporting, research on emerging approaches will need to consider not only their feasibility but also their effectiveness in achieving demand generation outcomes. We propose a research agenda to help guide the field of digital demand generation studies and programs within a broader health systems strengthening agenda, including establishing and documenting the influence of intervention characteristics within different populations and health domains and examining the long-term effects and cost-effectiveness of digital demand generation interventions, as well as equity in access to such interventions.
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Affiliation(s)
- Dustin G Gibson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Tigest Tamrat
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Garrett Mehl
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Le D, Aldoory L, Garza MA, Fryer CS, Sawyer R, Holt CL. A Spiritually-Based Text Messaging Program to Increase Cervical Cancer Awareness Among African American Women: Design and Development of the CervixCheck Pilot Study. JMIR Form Res 2018; 2:e5. [PMID: 30684433 PMCID: PMC6334685 DOI: 10.2196/formative.8112] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 12/29/2017] [Accepted: 01/28/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although Hispanic women have the highest cervical cancer incidence rate, African American women account for a disproportionate burden of cervical cancer incidence and mortality when compared with non-Hispanic white women. Given that religion occupies an essential place in African American lives, delivering health messages through a popular communication delivery channel and framing them with important spiritual themes may allow for a more accessible and culturally appropriate approach to promoting cervical cancer educational content to African American women. OBJECTIVE The aim of this paper was to describe the design and development of the CervixCheck project, a spiritually based short message service (SMS) text messaging pilot intervention to increase cervical cancer awareness and Papanicolaou test screening intention among church-attending African American women aged 21 to 65 years. METHODS Through focus group interviews (n=15), formative research was conducted to explore facilitators, motivators, and barriers to cervical cancer screening. The interviews were also used to identify logistical factors that should be considered when developing the CervixCheck intervention. Culturally appropriate and spiritually grounded SMS text messages were developed based on the analysis of focus group data and the review of previous studies that incorporated technology into health behavior change interventions. After the CervixCheck intervention was developed, cognitive response interviews (n=8) were used to review the content of the SMS text messaging library, to ensure that the content was acceptable and understandable, particularly for church-attending African American women aged 21 to 65 years. RESULTS Design and development of the SMS text messages involved consideration of the content of the messages and technological specifications. Focus group participants overwhelmingly reported cell phone use and an interest in receiving spiritually based SMS text messages on cervical cancer prevention and early detection. Findings from the cognitive response interviews revealed that the content of the SMS text messaging library was acceptable and understandable with the target population. The revised SMS text messaging library currently includes 22 messages for delivery over 16 days, averaging 11 texts per week, with no more than two messages delivered per day. Initial usability testing also showed early feasibility. CONCLUSIONS The design and development of the CervixCheck intervention provides important insight into what may be considered an overlooked minority population and missed opportunity in health information technology research. With increased internet penetration through the use of mobile phones, it is appropriate to investigate the viability of technology as a means to reach minority communities and to reduce health disparities.
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Affiliation(s)
- Daisy Le
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, United States
| | - Linda Aldoory
- Department of Communication, University of Maryland, College Park, MD, United States
| | - Mary A Garza
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, United States
| | - Craig S Fryer
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, United States
| | - Robin Sawyer
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, United States
| | - Cheryl L Holt
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, United States
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Abstract
OBJECTIVE To review the history, current status, and future trends related to breast cancer screening. DATA SOURCES Peer-reviewed articles, web sites, and textbooks. CONCLUSION Breast cancer remains a complex, heterogeneous disease. Serial screening with mammography is the most effective method to detect early stage disease and decrease mortality. Although politics and economics may inhibit organized mammography screening programs in many countries, the judicious use of proficient clinical and self-breast examination can also identify small tumors leading to reduced morbidity. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses have exciting opportunities to lead, facilitate, and advocate for delivery of high-quality screening services targeting individuals and communities. A practical approach is needed to translate the complexities and controversies surrounding breast cancer screening into improved care outcomes.
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Dehdari T, Dehdari L, Jazayeri S. Diet-Related Stomach Cancer Behavior Among Iranian College Students: A Text Messaging Intervention. Asian Pac J Cancer Prev 2016; 17:5165-5172. [PMID: 28124882 PMCID: PMC5454653 DOI: 10.22034/apjcp.2016.17.12.5165] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Stomach cancer is one of the five most common cancers in Iran. This study examined the effectiveness
of a mobile telephone short-message service (SMS) based-education intervention using Health Belief Model (HBM)
variables in improving dietary behavior in terms of stomach cancer prevention among a sample of Iranian female college
students. Materials and Methods: In this quasi-experimental study, 124 female college students in the dormitories
of Yazd University, Yazd, Iran were randomly selected and assigned to either the intervention (n=62) or the control
group (n=62). Information (data) regarding HBM variables and dietary behavior related to stomach cancer prevention
was collected by a self-administrated questionnaire. Forty eight messages were designed and sent to the participants’
phones in the intervention group during the 48-day intervention period. Two groups were followed-up one month
after the intervention delivered via SMS. Results: There were significant differences in HBM variables (except for
the perceived severity) and the preventive dietary behaviors for stomach cancer in the intervention group compared to
the comparison group following the education intervention delivered via SMS. Conclusions: SMS-delivered nutrition
education intervention can be a practical strategy to improve dietary behavior related to stomach cancer prevention.
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Bashshur RL, Krupinski EA, Thrall JH, Bashshur N. The Empirical Foundations of Teleradiology and Related Applications: A Review of the Evidence. Telemed J E Health 2016; 22:868-898. [PMID: 27585301 PMCID: PMC5107673 DOI: 10.1089/tmj.2016.0149] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 07/10/2016] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Radiology was founded on a technological discovery by Wilhelm Roentgen in 1895. Teleradiology also had its roots in technology dating back to 1947 with the successful transmission of radiographic images through telephone lines. Diagnostic radiology has become the eye of medicine in terms of diagnosing and treating injury and disease. This article documents the empirical foundations of teleradiology. METHODS A selective review of the credible literature during the past decade (2005-2015) was conducted, using robust research design and adequate sample size as criteria for inclusion. FINDINGS The evidence regarding feasibility of teleradiology and related information technology applications has been well documented for several decades. The majority of studies focused on intermediate outcomes, as indicated by comparability between teleradiology and conventional radiology. A consistent trend of concordance between the two modalities was observed in terms of diagnostic accuracy and reliability. Additional benefits include reductions in patient transfer, rehospitalization, and length of stay.
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Affiliation(s)
| | | | - James H. Thrall
- Department of Radiology, Massachusetts General Hospital, Harvard, Boston, Massachusetts
| | - Noura Bashshur
- University of Michigan Health System, Ann Arbor, Michigan
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Haji A, Lowther S, Ngan'ga Z, Gura Z, Tabu C, Sandhu H, Arvelo W. Reducing routine vaccination dropout rates: evaluating two interventions in three Kenyan districts, 2014. BMC Public Health 2016; 16:152. [PMID: 26880141 PMCID: PMC4754928 DOI: 10.1186/s12889-016-2823-5] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 02/03/2016] [Indexed: 11/17/2022] Open
Abstract
Background Globally, vaccine preventable diseases are responsible for nearly 20 % of deaths annually among children <5 years old. Worldwide, many children dropout from the vaccination program, are vaccinated late, or incompletely vaccinated. We evaluated the impact of text messaging and sticker reminders to reduce dropouts from the vaccination program. Methods The evaluation was conducted in three selected districts in Kenya: Machakos, Langata and Njoro. Three health facilities were selected in each district, and randomly allocated to send text messages or provide stickers reminding parents to bring their children for second and third dose of pentavalent vaccine, or to the control group (routine reminder) with next appointment date indicated on the well-child booklet. Children aged <12 months presenting for their first dose of pentavalent vaccine were enrolled. A dropout was defined as not returning for vaccination ≥2 weeks after scheduled date for third dose of pentavalent vaccine. We calculated dropout rate as a percentage of the difference between first and third pentavalent dose. Results We enrolled 1,116 children; 372 in each intervention and 372 controls between February and October 2014. Median age was 45 days old (range: 31–99 days), and 574 (51 %) were male. There were 136 (12 %) dropouts. Thirteen (4 %) children dropped out among those who received text messages, 60 (16 %) among who received sticker reminders, and 63 (17 %) among the controls. Having a caregiver with below secondary education [Odds Ratio (OR) 1.8, 95 % Confidence Interval (CI) 1.1–3.2], and residing >5 km from health facility (OR 1.6, CI 1.0–2.7) were associated with higher odds of dropping out. Those who received text messages were less likely to drop out compared to controls (OR 0.2, CI 0.04–0.8). There was no statistical difference between those who received stickers and controls (OR 0.9, CI 0.5–1.6). Conclusion Text message reminders can reduce vaccination dropout rates in Kenya. We recommend the extended implementation of text message reminders in routine vaccination services.
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Affiliation(s)
- Adam Haji
- College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya. .,Field Epidemiology and Laboratory Training Program, Kenya Ministry of Health, Nairobi, Kenya. .,Division of Vaccines and Immunization, Kenya Ministry of Health, Nairobi, Kenya.
| | - S Lowther
- Global Immunization Division, US Centers of Disease Control, and Prevention, Nairobi, Kenya
| | - Z Ngan'ga
- College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Z Gura
- Field Epidemiology and Laboratory Training Program, Kenya Ministry of Health, Nairobi, Kenya
| | - C Tabu
- Division of Vaccines and Immunization, Kenya Ministry of Health, Nairobi, Kenya
| | - H Sandhu
- Division for Global Health Protection, US Centers of Disease Control and Prevention, Nairobi, Kenya
| | - Wences Arvelo
- Field Epidemiology and Laboratory Training Program, Kenya Ministry of Health, Nairobi, Kenya.,Division for Global Health Protection, US Centers of Disease Control and Prevention, Nairobi, Kenya
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Zallman L, Bearse A, West C, Bor D, McCormick D. Patient preferences and access to text messaging for health care reminders in a safety-net setting. Inform Health Soc Care 2016; 42:32-42. [PMID: 26864932 DOI: 10.3109/17538157.2015.1113177] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Text messaging may be an effective method for providing health care reminders to patients. We aimed to understand patient access to and preferences for receiving health-related reminders via text message among patients receiving care in safety-net hospitals. MATERIALS AND METHODS We conducted face-to-face surveys with 793 patients seeking care in three hospital emergency departments at a large safety-net institution and determined clinical and demographic predictors of preferences for text messaging for health care reminders. RESULTS 95% of respondents reported having daily access to text messaging. Text messaging was preferred over e-mail, phone, and letters for communication. 78% of respondents wanted to receive appointment reminders, 56% wanted expiring insurance reminders, and 36% wanted reminders to take their medications. We found no clinical predictors but did find some demographic predictors-including age, ethnicity, insurance status, and income-of wanting text message reminders. DISCUSSION In our convenience sample of safety-net patients, text messaging is an accessible, acceptable, and patient-preferred modality for receiving health care reminders. Text messaging may be a promising patient-centered approach for providing health care and insurance reminders to patients seeking care at safety-net institutions.
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Affiliation(s)
- Leah Zallman
- a Department of Medicine , Cambridge Health Alliance , Cambridge , MA , USA.,b Institute for Community Health , Malden , MA , USA.,c Kraft Center for Community Health , Boston , MA , USA.,d Department of Medicine , Harvard Medical School , Boston , MA , USA
| | | | - Catherine West
- e Center for Health and Information Analysis, Commonwealth of Massachusetts , Boston , MA , USA
| | - David Bor
- a Department of Medicine , Cambridge Health Alliance , Cambridge , MA , USA.,d Department of Medicine , Harvard Medical School , Boston , MA , USA
| | - Danny McCormick
- a Department of Medicine , Cambridge Health Alliance , Cambridge , MA , USA.,d Department of Medicine , Harvard Medical School , Boston , MA , USA
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DeKoekkoek T, Given B, Given CW, Ridenour K, Schueller M, Spoelstra SL. mHealth SMS text messaging interventions and to promote medication adherence: an integrative review. J Clin Nurs 2015. [DOI: 10.1111/jocn.12918] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Tracy DeKoekkoek
- College of Nursing; Michigan State University; East Lansing MI USA
| | - Barbara Given
- College of Nursing; Michigan State University; East Lansing MI USA
| | - Charles W Given
- Department of Family Medicine; Michigan State University; East Lansing MI USA
| | | | - Monica Schueller
- College of Nursing; Michigan State University; East Lansing MI USA
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Spoelstra SL, Given CW, Sikorskii A, Coursaris CK, Majumder A, DeKoekkoek T, Schueller M, Given BA. A randomized controlled trial of the feasibility and preliminary efficacy of a texting intervention on medication adherence in adults prescribed oral anti-cancer agents: study protocol. J Adv Nurs 2015; 71:2965-76. [PMID: 26100719 DOI: 10.1111/jan.12714] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2015] [Indexed: 11/27/2022]
Abstract
AIM The aim of this study was to report a study protocol that examines feasibility, preliminary efficacy and satisfaction of a text message intervention on the outcome of medication adherence in adult patients prescribed oral anti-cancer agents. BACKGROUND Administration of oral anti-cancer agents occurs in the home setting, requiring patients to self-manage the regimen as prescribed. However, many barriers to medication adherence exist: regimens are often complex, with cycling of two or more medications; side effects of treatment; most cancer patients are older with comorbid conditions and competing demands; and cognitive decline and forgetfulness may occur. Research indicates patients miss nearly one-third of the prescribed oral anti-cancer agent dosages. Text message interventions have been shown to improve medication adherence in chronic conditions other than cancer. However, a majority of those patients were less than 50 years of age and most cancer patients are diagnosed later in life. DESIGN A two-group randomized controlled trial with repeated measures. METHODS Seventy-five adult patients newly prescribed an oral anti-cancer agent will be recruited (project funded in April 2013) from community cancer centres and a specialty pharmacy. Participants will be randomized to either a control group (n = 25; usual care) or an intervention group (n = 50; usual care plus text messages timed to medication regimen). Outcome measures include: medication adherence, feasibility and satisfaction with the intervention. Data will be collected over 8 weeks: baseline, weekly and exit. DISCUSSION Standardized text message intervention protocol and detailed study procedures have been developed in this study to improve medication adherence.
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Affiliation(s)
- Sandra L Spoelstra
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Charles W Given
- Institute for Health Care Studies, Michigan State University, East Lansing, Michigan, USA
| | - Alla Sikorskii
- Department of Statistics and Probability, Michigan State University, East Lansing, Michigan, USA
| | - Constantinos K Coursaris
- Department of Telecommunication, Information Studies (Dr. Coursaris), Michigan State University, East Lansing, Michigan, USA
| | - Atreyee Majumder
- Department of Statistics and Probability, Michigan State University, East Lansing, Michigan, USA
| | - Tracy DeKoekkoek
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Monica Schueller
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Barbara A Given
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
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Davis SW, Oakley-Girvan I. mHealth Education Applications Along the Cancer Continuum. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:388-394. [PMID: 25482319 DOI: 10.1007/s13187-014-0761-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The majority of adults worldwide own a mobile phone, including those in under-resourced communities. Mobile health (mhealth) education technologies present a promising mechanism for improving cancer prevention, treatment, and follow-up. The purpose of this study was to summarize the literature related to mobile phone (mhealth) applications for patient education specific to cancer and identify current recommendations from randomized studies. In particular, we were interested in identifying mobile phone applications along the cancer continuum, from cancer prevention to survivorship. The authors identified 28 articles reporting on mobile applications for patients related to cancer. Articles were identified in all categories along the cancer continuum, including health professional involvement in application development. Of these, six involved direct patient education, and eight focused on improving patient/professional communication and patient self-management. However, only six of the studies were randomized interventions. The potential for mobile applications to help overcome the "health care gap" has not yet been realized in the studies from the USA that were reviewed for this paper. However, early recommendations are emerging that support the use of mHealth communications to change behaviors for cancer prevention, early detection, and symptom management and improved patient-provider communication. Recommendations include short messages, use of multiple modalities as patient characteristics dictate comfort with mHealth communication, and the inclusion of patients and health professionals to develop and test applications. Tailoring mHealth to particular cultures, languages, and ethnic groups may also represent a unique possibility to provide accessible information and education at minimal cost for under-resourced communities and individuals.
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Affiliation(s)
- Sharon Watkins Davis
- Cancer Prevention Institute of California, 2201 Walnut Ave., Suite 300, Fremont, CA, 94538, USA,
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Kerrison RS, Shukla H, Cunningham D, Oyebode O, Friedman E. Text-message reminders increase uptake of routine breast screening appointments: a randomised controlled trial in a hard-to-reach population. Br J Cancer 2015; 112:1005-10. [PMID: 25668008 PMCID: PMC4366892 DOI: 10.1038/bjc.2015.36] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 01/06/2015] [Accepted: 01/12/2015] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND There is a need for interventions to promote uptake of breast screening throughout Europe. METHODS We performed a single-blind randomised controlled trial to test whether text-message reminders were effective. Two thousand two hundred and forty women receiving their first breast screening invitation were included in the study and randomly assigned in a 1 : 1 ratio to receive either a normal invitation only (n=1118) or a normal invitation plus a text-message reminder 48 h before their appointment (n=1122). FINDINGS In the intention-to-treat analysis, uptake of breast screening was 59.1% among women in the normal invitation group and 64.4% in the text-message reminder group (χ(2)=6.47, odds ratio (OR): 1.26, 95% confidence intervals (CI): 1.05-1.48, P=0.01). Of the 1122 women assigned to the text-message reminder group, only 456 (41%) had a mobile number recorded by their GP and were thereby sent a text. In the per-protocol analysis, uptake by those in the control group who had a mobile number recorded on the GP system was 59.77% and by those in the intervention group who were sent a reminder 71.7% (χ(2)=14.12, OR=1.71, 95% CI=1.29-2.26, P<0.01). INTERPRETATION Sending women a text-message reminder before their first routine breast screening appointment significantly increased attendance. This information can be used to allocate resources efficiently to improve uptake without exacerbating social inequalities.
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Affiliation(s)
- R S Kerrison
- Health Behaviour Research Centre, Research Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, UK
| | - H Shukla
- Public Health England, Wellington House, 133–155 Waterloo Road, London SE1 8UG, UK
| | - D Cunningham
- West of London Breast Screening Service, Imperial College Healthcare NHS Trust, First Floor, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK
| | - O Oyebode
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - E Friedman
- London Borough of Sutton, Civic Offices, St Nicholas Way, Sutton SM1 1EA, UK
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Rempel GR, Ballantyne RT, Magill-Evans J, Nicholas DB, Mackie AS. Texting teens in transition: the use of text messages in clinical intervention research. JMIR Mhealth Uhealth 2014; 2:e45. [PMID: 25379624 PMCID: PMC4260009 DOI: 10.2196/mhealth.3232] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 04/24/2014] [Accepted: 09/13/2014] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The rapidly growing population of young adults living with congenital heart disease (CHD), currently challenging ill-prepared cardiac care systems, presents a novel population in which to consider the use of mHealth. This methodological study was part of a larger study that tested the effectiveness of a clinic-based nursing intervention to prepare teens for transfer from pediatric to adult cardiology care. The intervention included creation of a MyHealth Passport and subsequently SMS (short message service) text messages between the intervention nurse and study participant. OBJECTIVE Our aim was to determine (1) the preference of teens with CHD to be contacted via text message following the nursing intervention, (2) the effectiveness of texting to collect data regarding the use of MyHealth Passport after participation in the intervention, (3) the nature of the texting interaction, and (4) the risks and benefits of texting. METHODS Participants were recruited through the intervention study (n=24) by either choosing to receive information from the study coordinator through text message, or texting a question to the study nurses. Inclusion criteria were age 15-17 years, diagnosed with moderate or complex heart disease, and currently being followed by the Division of Cardiology at Stollery Children's Hospital. Exclusion criteria were heart transplantation and/or less than a 6th grade reading and comprehension ability. Text message transcripts were analyzed by qualitative inductive content analysis. RESULTS Two-thirds of teens (16/24, 67%) chose text messaging as their preferred contact, making them eligible for the study. Texting was effective in collecting information regarding the MyHealth Passport; all but one teen had their MyHealth Passport on them, and many reported carrying it with them wherever they went. All teens reported showing their MyHealth Passport to at least one person. Seven themes were identified in the texting transcripts: mixing formal and informal language, the passive teen, interaction with health care providers, texting teens in transition, texting as a mechanism to initiate other forms of communication, affirmation, and the nurse as an educator. Benefits of texting were identified as flexibility, ability to respond over time, information presented in byte-sized amounts, and information directly related to patient questions. Risks of texting were identified as the possibility that interactions may not be in-depth, distraction of teen and researcher, and invasiveness. CONCLUSIONS Text messaging was useful in collecting data regarding the use of the MyHealth Passport. Text messaging resulted in conversations with the teens that were sometimes in-depth and meaningful, especially when combined with other communication modalities. Using text messaging in a manner resulting in full conversations with the patients requires more study and may benefit from protocols and the use of solid theoretical foundations that would standardize the interaction so that more conclusions could be drawn.
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Affiliation(s)
- Gwen R Rempel
- Athabasca University, Faculty of Health Disciplines, Athabasca, AB, Canada.
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Arcas MM, Buron A, Ramis O, Esturi M, Hernández C, Macià F. [Can a mobile phone short message increase participation in breast cancer screening programmes?]. ACTA ACUST UNITED AC 2014; 29:188-96. [PMID: 25002239 DOI: 10.1016/j.cali.2014.02.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 01/27/2014] [Accepted: 02/07/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the impact of a mobile phone short message on women's uptake in a breast cancer screening programme. METHODS A total of 703 women from a Basic Health Area of Barcelona, and with a mobile phone number registered, were invited to participate in a breast cancer screening programme between 25 January 2011 and 22 March 2011. The control group (n=470) followed the usual appointment track, and the intervention group (n=233) received, after the first letter of invitation, a mobile phone short message reminder. The differences between the two groups were analysed, comparing the uptake rates according to age, educational level, and participation in previous round, as well as the number of re-invitation calls to non-attenders according to uptake, age and level of education;and the percentages of exclusions of both groups. RESULTS The intervention group had a greater uptake than the control group (78.1% vs. 72.3%), with a significant trend observed in the 55-59 years age group (P=.036) and the low secondary educational level (P=.014).The intervention group mean of re-invitation calls of non-attenders lower than the control group (.41 vs. .65, P<.05), a pattern observed in all the categories of the independent variables, and among younger age groups, lower and middle educational levels, and previously participating women (.09 vs. .19, P=.012). CONCLUSIONS The inclusion of a mobile phone short message in a breast cancer screening programme may increase uptake rates and lead to a management improvement.
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Affiliation(s)
- M M Arcas
- Servicio de Epidemiología y Evaluación, Hospital del Mar, Barcelona, España; Unidad Docente de Medicina Preventiva y Salud Pública PSMAR-UPF-ASPB, Barcelona, España
| | - A Buron
- Servicio de Epidemiología y Evaluación, Hospital del Mar, Barcelona, España; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, España; Red de investigación en servicios sanitarios en enfermedades crónicas (REDISSEC), España.
| | - O Ramis
- Alhorasolutions S.L., Barcelona, España
| | - M Esturi
- Servicio de Epidemiología y Evaluación, Hospital del Mar, Barcelona, España
| | - C Hernández
- Servicio de Epidemiología y Evaluación, Hospital del Mar, Barcelona, España
| | - F Macià
- Servicio de Epidemiología y Evaluación, Hospital del Mar, Barcelona, España; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, España; Red de investigación en servicios sanitarios en enfermedades crónicas (REDISSEC), España
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Cooper CP, Gelb CA, Hawkins NA. How many "Get Screened" messages does it take? Evidence from colorectal cancer screening promotion in the United States, 2012. Prev Med 2014; 60:27-32. [PMID: 24333876 DOI: 10.1016/j.ypmed.2013.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 11/30/2013] [Accepted: 12/03/2013] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Colorectal cancer screening has been widely promoted in the United States. We investigated the association between reported exposure to screening information during the past year and screening participation and knowledge. METHOD Data from the 2012 HealthStyles Fall survey of U.S. adults were examined using adjusted logistic regression to examine the frequency of exposure to screening information as a predictor of screening participation and knowledge; analyses were limited to participants aged ≥50years with no history of colorectal cancer or polyps (N=1714). RESULTS Nearly half of the participants (44.9%) reported exposure to colorectal cancer screening information during the previous year. The most common sources of screening information were news reports, advertisements, and health care providers. Screening participation and knowledge consistently increased with the reported frequency of exposure to screening information, and these associations generally persisted when demographic variables were controlled. Compared with unexposed participants, significant gains in screening participation were associated with exposure to screening information 2-3 times (Adj. OR=1.84, p=0.001), 4-9 times (Adj. OR=2.00, p=0.001), and ≥10 times (Adj. OR=3.03, p<0.001) in the adjusted model. CONCLUSIONS Increasing public exposure to screening promotion messages may augment screening participation and knowledge.
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Affiliation(s)
| | - Cynthia A Gelb
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
| | - Nikki A Hawkins
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
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Smartphone Medical Applications for Women's Health: What Is the Evidence-Base and Feedback? Int J Telemed Appl 2013; 2013:782074. [PMID: 24454354 PMCID: PMC3880694 DOI: 10.1155/2013/782074] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 09/02/2013] [Accepted: 10/24/2013] [Indexed: 11/18/2022] Open
Abstract
Background. Smartphone medical applications have a major role to play in women's health with their roles being very broad, ranging from improving health behaviours to undertaking personalised tests. Objective(s). Using Medline, Web of Knowledge, and the PRISMA guidelines 15 randomized controlled trials (RCTs) were identified, with mobile interventions being tested on 1603 females, in relation to key aspects of health. Using a similar systematic approach an iPhone database search identified 47 applications (apps) developed to improve women's health. Findings. Ten RCTs used text messaging or app interventions to support weight loss, with significant improvements being observed in eight studies. For other aspects of women's health RCTs are needed to determine possible health benefits. iPhone store data analysis identified that a substantial number of women's health apps did not have star ratings or feedback comments (68 and 49 per cent, resp.), raising concerns about their validity. Conclusion. Peer-review systems, supporting statements of evidence, or certification standards would be beneficial in maintaining the quality and credibility of future health-focused apps. Patient groups should also ideally be involved in the development and testing of mobile medical apps.
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Clauson KA, Elrod S, Fox BI, Hajar Z, Dzenowagis JH. Opportunities for pharmacists in mobile health. Am J Health Syst Pharm 2013; 70:1348-52. [DOI: 10.2146/ajhp120657] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Affiliation(s)
- Kevin A. Clauson
- College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL
| | - Shara Elrod
- College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL
| | - Brent I. Fox
- Harrison School of Pharmacy, Auburn University, Auburn, AL
| | - Zaher Hajar
- College of Pharmacy, Nova Southeastern University
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Fiordelli M, Diviani N, Schulz PJ. Mapping mHealth research: a decade of evolution. J Med Internet Res 2013; 15:e95. [PMID: 23697600 PMCID: PMC3668610 DOI: 10.2196/jmir.2430] [Citation(s) in RCA: 327] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Revised: 03/05/2013] [Accepted: 03/28/2013] [Indexed: 12/19/2022] Open
Abstract
Background For the last decade, mHealth has constantly expanded as a part of eHealth. Mobile applications for health have the potential to target heterogeneous audiences and address specific needs in different situations, with diverse outcomes, and to complement highly developed health care technologies. The market is rapidly evolving, making countless new mobile technologies potentially available to the health care system; however, systematic research on the impact of these technologies on health outcomes remains scarce. Objective To provide a comprehensive view of the field of mHealth research to date and to understand whether and how the new generation of smartphones has triggered research, since their introduction 5 years ago. Specifically, we focused on studies aiming to evaluate the impact of mobile phones on health, and we sought to identify the main areas of health care delivery where mobile technologies can have an impact. Methods A systematic literature review was conducted on the impact of mobile phones and smartphones in health care. Abstracts and articles were categorized using typologies that were partly adapted from existing literature and partly created inductively from publications included in the review. Results The final sample consisted of 117 articles published between 2002 and 2012. The majority of them were published in the second half of our observation period, with a clear upsurge between 2007 and 2008, when the number of articles almost doubled. The articles were published in 77 different journals, mostly from the field of medicine or technology and medicine. Although the range of health conditions addressed was very wide, a clear focus on chronic conditions was noted. The research methodology of these studies was mostly clinical trials and pilot studies, but new designs were introduced in the second half of our observation period. The size of the samples drawn to test mobile health applications also increased over time. The majority of the studies tested basic mobile phone features (eg, text messaging), while only a few assessed the impact of smartphone apps. Regarding the investigated outcomes, we observed a shift from assessment of the technology itself to assessment of its impact. The outcome measures used in the studies were mostly clinical, including both self-reported and objective measures. Conclusions Research interest in mHealth is growing, together with an increasing complexity in research designs and aim specifications, as well as a diversification of the impact areas. However, new opportunities offered by new mobile technologies do not seem to have been explored thus far. Mapping the evolution of the field allows a better understanding of its strengths and weaknesses and can inform future developments.
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Affiliation(s)
- Maddalena Fiordelli
- Institute of Communication and Health, Faculty of Communication Sciences, University of Lugano, Lugano, Switzerland.
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Free C, Phillips G, Galli L, Watson L, Felix L, Edwards P, Patel V, Haines A. The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review. PLoS Med 2013; 10:e1001362. [PMID: 23349621 PMCID: PMC3548655 DOI: 10.1371/journal.pmed.1001362] [Citation(s) in RCA: 1053] [Impact Index Per Article: 95.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 11/16/2012] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Mobile technologies could be a powerful media for providing individual level support to health care consumers. We conducted a systematic review to assess the effectiveness of mobile technology interventions delivered to health care consumers. METHODS AND FINDINGS We searched for all controlled trials of mobile technology-based health interventions delivered to health care consumers using MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, Cochrane Library, UK NHS HTA (Jan 1990-Sept 2010). Two authors extracted data on allocation concealment, allocation sequence, blinding, completeness of follow-up, and measures of effect. We calculated effect estimates and used random effects meta-analysis. We identified 75 trials. Fifty-nine trials investigated the use of mobile technologies to improve disease management and 26 trials investigated their use to change health behaviours. Nearly all trials were conducted in high-income countries. Four trials had a low risk of bias. Two trials of disease management had low risk of bias; in one, antiretroviral (ART) adherence, use of text messages reduced high viral load (>400 copies), with a relative risk (RR) of 0.85 (95% CI 0.72-0.99), but no statistically significant benefit on mortality (RR 0.79 [95% CI 0.47-1.32]). In a second, a PDA based intervention increased scores for perceived self care agency in lung transplant patients. Two trials of health behaviour management had low risk of bias. The pooled effect of text messaging smoking cessation support on biochemically verified smoking cessation was (RR 2.16 [95% CI 1.77-2.62]). Interventions for other conditions showed suggestive benefits in some cases, but the results were not consistent. No evidence of publication bias was demonstrated on visual or statistical examination of the funnel plots for either disease management or health behaviours. To address the limitation of the older search, we also reviewed more recent literature. CONCLUSIONS Text messaging interventions increased adherence to ART and smoking cessation and should be considered for inclusion in services. Although there is suggestive evidence of benefit in some other areas, high quality adequately powered trials of optimised interventions are required to evaluate effects on objective outcomes.
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Affiliation(s)
- Caroline Free
- Clinical Trials Unit, London School of Hygiene & Tropical Medicine, London, UK.
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Lee SSS, Xin X, Lee WP, Sim EJ, Tan B, Bien MPG, Lau AST, Thumboo J. The feasibility of using SMS as a health survey tool: an exploratory study in patients with rheumatoid arthritis. Int J Med Inform 2013; 82:427-34. [PMID: 23332386 DOI: 10.1016/j.ijmedinf.2012.12.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2012] [Revised: 12/09/2012] [Accepted: 12/10/2012] [Indexed: 11/26/2022]
Abstract
AIM To explore the feasibility of using SMS to conduct health surveys in patients with rheumatoid arthritis (RA). METHODS Using a two-way SMS system, we conducted a baseline survey using a short and a long quality of life instrument, with two follow-up administrations of the short survey among patients with RA on follow-up at the Singapore General Hospital (SGH). Our outcome variables were survey response rate, question response time, proportion of replies following the format instructions, and survey administration cost. RESULTS Among 85 participants (of 99 eligible patients approached), the response rate was 67% for the long survey, 80% for the short survey at baseline, and 74% and 70% at the first and second follow-ups, respectively. Survey response rate varied with the employment status of respondents. Approximately 78% of all replies followed the format instructions. All these replies were received within the stipulated 24-h timeline and half of them were received within 29 min. Response time for the other 22% of replies that did not follow the format instructions was much longer. The average administration cost per survey was S$0.34 (equivalent of US$0.26). CONCLUSIONS Two-way SMS is a promising tool to conduct short health surveys. Evidence for implementing long surveys over SMS is still weak. The post survey interviews with survey participants suggested that sequential delivery of survey questions coupled with SMS reminders in the interim, tailoring survey questions to individual health conditions, and providing feedback on individual survey results can potentially improve the response rate of such surveys.
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Affiliation(s)
- Sharon Song Song Lee
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
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Wakadha H, Chandir S, Were EV, Rubin A, Obor D, Levine OS, Gibson DG, Odhiambo F, Laserson KF, Feikin DR. The feasibility of using mobile-phone based SMS reminders and conditional cash transfers to improve timely immunization in rural Kenya. Vaccine 2012; 31:987-93. [PMID: 23246258 DOI: 10.1016/j.vaccine.2012.11.093] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 11/29/2012] [Accepted: 11/30/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Demand-side strategies could contribute to achieving high and timely vaccine coverage in rural Africa, but require platforms to deliver either messages or conditional cash transfers (CCTs). We studied the feasibility of using short message services (SMS) reminders and mobile phone-based conditional cash transfers (CCTs) to reach parents in rural Western Kenya. METHODS In a Health and Demographic Surveillance System (HDSS), mothers with children aged 0-3 weeks old were approached to determine who had access to a mobile phone. SMS reminders were sent three days prior to and on the scheduled day of immunization for 1st (age 6 weeks) and 2nd doses (age 10 weeks) of DTP-HepB-Hib (Pentavalent) vaccine, using open-source Rapid SMS software. Approximately $2.00 USD was sent as cash using mPESA, a mobile money transfer platform (2/3 of mothers), or airtime (1/3 of mothers) via phone if the child was vaccinated within 4 weeks of the scheduled date. Follow-up surveys were done when children reached 14 weeks of age. RESULTS We approached 77 mothers; 72 were enrolled into the study (26% owned a phone and 74% used someone else's). Of the 63 children with known vaccination status at 14 weeks of age, 57 (90%) received pentavalent1 and 54 (86%) received pentavalent2 within 4 weeks of their scheduled date. Of the 61 mothers with follow-up surveys administered at 14 weeks of age, 55 (90%) reported having received SMS reminders. Of the 54 women who reported having received SMS reminders and answered the CCT questions on the survey, 45 (83%) reported receiving their CCT. Most (89%) of mothers in the mPESA group obtained their cash within 3 days of being sent their credit via mobile phone. All mothers stated they preferred CCTs as cash via mobile phone rather than airtime. Of the 9 participants who did not vaccinate their children at the designated clinic 2(22%) cited refusals by husbands to participate in the study. CONCLUSION The data show that in rural Western Kenya mobile phone-based strategies are a potentially useful platform to deliver reminders and cash transfers. Follow-up studies are needed that provide evidence for the effectiveness of these strategies in improving vaccine coverage and timeliness.
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Affiliation(s)
- Hotenzia Wakadha
- Kenya Medical Research Institute/Centers for Disease Control and Prevention Public Health and Research Collaboration, Kisumu, Kenya
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Durant KT, McCray AT, Safran C. Identifying gender-preferred communication styles within online cancer communities: a retrospective, longitudinal analysis. PLoS One 2012; 7:e49169. [PMID: 23155460 PMCID: PMC3498295 DOI: 10.1371/journal.pone.0049169] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 10/08/2012] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The goal of this research is to determine if different gender-preferred social styles can be observed within the user interactions at an online cancer community. To achieve this goal, we identify and measure variables that pertain to each gender-specific social style. METHODS AND FINDINGS We perform social network and statistical analysis on the communication flow of 8,388 members at six different cancer forums over eight years. Kruskal-Wallis tests were conducted to measure the difference between the number of intimate (and highly intimate) dyads, relationship length, and number of communications. We determine that two patients are more likely to form an intimate bond on a gender-specific cancer forum (ovarian P = <0.0001, breast P = 0.0089, prostate P = 0.0021). Two female patients are more likely to form a highly intimate bond on a female-specific cancer forum (Ovarian P<0.0001, Breast P<0.01). Typically a male patient communicates with more members than a female patient (Ovarian forum P = 0.0406, Breast forum P = 0.0013). A relationship between two patients is longer on the gender-specific cancer forums than a connection between two members not identified as patients (ovarian forum P = 0.00406, breast forum P = 0.00013, prostate forum P = .0.0003). CONCLUSION The high level of interconnectedness among the prostate patients supports the hypothesis that men prefer to socialize in large, interconnected, less-intimate groups. A female patient is more likely to form a highly intimate connection with another female patient; this finding is consistent with the hypothesis that woman prefer fewer, more intimate connections. The relationships of same-gender cancer patients last longer than other relationships; this finding demonstrates homophily within these online communities. Our findings regarding online communication preferences are in agreement with research findings from person-to-person communication preference studies. These findings should be considered when designing online communities as well as designing and evaluating psychosocial and educational interventions for cancer patients.
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Affiliation(s)
- Kathleen T Durant
- Silverlink Communications, Boston, Massachusetts, United States of America.
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