文化适应型短信服务项目在加纳阿克拉促进宫颈癌筛查的效果：一项准实验研究。

Effectiveness of a culturally tailored text messaging program for promoting cervical cancer screening in accra, Ghana: a quasi-experimental trial.

机构信息

Department of Epidemiology and Disease Control, University of Ghana School of Public Health, Accra, Ghana.

Cellular and Clinical Research Center, Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission. Kwabenya, Accra, Ghana.

出版信息

BMC Womens Health. 2024 Jan 3;24(1):22. doi: 10.1186/s12905-023-02867-2.

DOI:10.1186/s12905-023-02867-2

PMID:38172883

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10765844/

Abstract

INTRODUCTION

Despite breakthroughs in cervical cancer detection, resource-constrained countries continue to have a disproportionately high incidence and death rate. Mhealth has been identified as an important tool for increasing cervical cancer screening rates in Sub-Saharan Africa. We determined whether sending Ghanaian women culturally tailored one-way mobile phone SMS text messages about cervical cancer would encourage the uptake of the human papillomavirus (HPV) test.

METHODS

From August to November 2016, 88 women aged 18 to 39 living or working in an urban community (Accra, Ghana) participated in a quasi-experimental study. For 8 weeks, 32 SMS messages regarding cervical cancer were developed and sent to the personal phones of intervention arm participants (n = 42). Women in the control group (n = 46) received SMS texts with general health and lifestyle advice. Fischer's exact tests were performed to assess cervical cancer screening uptake and associated reasons for non-uptake between the intervention and control groups (p < 0.05).

RESULTS

At the baseline, women differed in terms of ethnicity and wealth. After the intervention, participants' self-reported risk factors for cervical cancer, such as early menarche, usual source of medical treatment, family history of cancer, smoking, and alcohol history, changed. None of the women in the intervention group sought cervical cancer screening after the intervention, but only one (2.2%) of the control arm participants did. Almost all the women (> 95%) agreed that an HPV test was essential and that regular healthcare check-ups could help prevent cervical cancer. Some women believed that avoiding particular foods could help prevent cervical cancer (23.8% intervention vs. 58.7% control, p < 0.001). Time constraints and out-of-pocket expenses were significant barriers to cervical cancer screening.

CONCLUSION

A one-way SMS delivered to urban women did not increase cervical cancer screening attendance. The time spent in screening facilities and the lack of coverage by the National Health Insurance Scheme limited screening uptake. We urge for the establishment of screening centers in all healthcare facilities, as well as the inclusion of cervical cancer screening in healthcare programs through cost-sharing.

摘要

简介

尽管宫颈癌检测方面取得了突破，但资源有限的国家发病率和死亡率仍居高不下。移动医疗已被确定为提高撒哈拉以南非洲宫颈癌筛查率的重要工具。我们旨在确定向加纳女性发送有关宫颈癌的文化适宜的单向手机短信是否会鼓励人乳头瘤病毒（HPV）检测的采用。

方法

2016 年 8 月至 11 月，88 名年龄在 18 至 39 岁之间居住或在城市社区（加纳阿克拉）工作的女性参与了一项准实验研究。在 8 周的时间里，向干预组参与者的个人手机发送了 32 条有关宫颈癌的短信（n = 42）。对照组（n = 46）的女性收到了有关一般健康和生活方式建议的短信。使用 Fisher 确切检验评估干预组和对照组之间宫颈癌筛查的采用情况以及相关的未采用原因（p < 0.05）。

结果

在基线时，女性在种族和财富方面存在差异。干预后，参与者对宫颈癌的自我报告风险因素，如初潮早、通常的医疗治疗来源、癌症家族史、吸烟和饮酒史，发生了变化。干预组中没有女性在干预后寻求宫颈癌筛查，但对照组中有一名女性（2.2%）这样做了。几乎所有女性（> 95%）都认为 HPV 检测是必不可少的，定期进行医疗保健检查可以帮助预防宫颈癌。一些女性认为避免某些食物可以帮助预防宫颈癌（干预组 23.8%，对照组 58.7%，p < 0.001）。时间限制和自付费用是宫颈癌筛查的重要障碍。