Considerations in the development of an mHealth approach to increase cervical screening participation in primary care in Victoria, Australia
Claire Zammit
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Abstract
Short message service (SMS) messages are an effective means of delivering health interventions, including promoting cancer screening. SMS offers opportunities to remind people about cervical screening and promote the self-collection option available in Australia’s National Cervical Screening Program. This research aimed to explore the acceptability of SMS reminders sent by general practices to eligible patients promoting the option of self-collection for cervical screening.
We conducted a cross-sectional survey (n = 221) with women and people with a cervix, and focus group discussions (n = 5) with women aged ≥50 years (n = 7), regional/rural residents (n = 6) and bicultural health educators (n = 10) in Victoria, Australia. We examined awareness of self-collection, current receipt and acceptability of health promotion SMSs, and preferences for SMS content promoting cervical screening.
Most survey respondents (83%) found SMS reminders for cervical screening acceptable, stating a preference for their first name (71%) and clinic’s name (58%) to be included. Focus group participants had varying awareness of self-collection, with concerns about accuracy, sample collection and accessibility. Clear communication about clinician- and self- collection options was considered crucial. Most participants were hesitant to click embedded links. SMS acceptability may be affected by limited knowledge of self-collection, accessibility for people with disabilities, differing English or digital literacy, and privacy concerns.
SMS messages appear to be an appropriate way to raise awareness about the choice of self-collection, but SMS may not be suitable as a population-based strategy. Leveraging general practitioner endorsement through SMS may improve participation, particularly for people who may prefer self-collection, but are unaware of this option
Keywords: acceptability, cervical screening, general practice, mHealth, primary health, self-collection, self-sampling, text-messaging (SMS) reminders.
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