Abstract

BackgroundBreast cancer is the leading cause of cancer-related death in the female population. Health education interventions based on the use of mobile technologies enable the development of health self-care skills and have emerged as alternative strategies for the control of breast cancer. In previous studies, WhatsApp has stood out as a useful tool in health education strategies; however, it has not yet been applied for breast cancer education.ObjectiveThis study aimed to analyze the potential of WhatsApp as a health education tool used to improve women's knowledge on the risk reduction of breast cancer. It also aimed to understand how women feel sensitized within the WhatsApp group throughout the intervention and how they incorporate information posted to improve knowledge about early detection and risk reduction methods.MethodsThe study involved a pre-post health educational intervention with 35 women (aged 45-69 years) included in a WhatsApp group to share information (audio, video, text, and images) over 3 weeks on the early detection and risk reduction of breast cancer. Data were collected through questionnaires on topics related to risk reduction, as well as qualitative content analysis of group interactions. Effectiveness and feasibility were analyzed through conversations and the comparison of the scores obtained in the questionnaires before and after the intervention.ResultsA total of 293 messages were exchanged (moderator 120 and users 173). The average scores of the participants were 11.21 and 13.68 points before and after the educational intervention, respectively, with sufficient sample evidence that the difference was significant (P<.001). The intervention enabled women to improve their knowledge on all topics addressed, especially “myths and truths,” “incidence,” “clinical manifestations,” and “protective factors.” Some themes emerged from the interactions in the group, including group dynamics, general doubts, personal narratives, religious messages, daily news, and events.ConclusionsThe use of groups for women in WhatsApp for health education purposes seems to be a viable alternative in strategies on breast cancer control, especially as it provides a space for the exchange of experiences and disinhibition. However, the need for a moderator to answer the questions and the constant distractions by members of the group represent important limitations that should be considered when improving this strategy.

Highlights

  • Breast cancer represents the main cause of death by cancer among women around the world [1]

  • The use of groups for women in WhatsApp for health education purposes seems to be a viable alternative in strategies on breast cancer control, especially as it provides a space for the exchange of experiences and disinhibition

  • A 3-week pre-post intervention study was conducted among women enrolled in the Brazilian Unified Health System, and a breast cancer screening control study design was adopted to evaluate the feasibility of WhatsApp as an educational tool to increase women's knowledge about the risk reduction and early detection of breast cancer

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Summary

Introduction

Breast cancer represents the main cause of death by cancer among women around the world [1]. The mortality rates associated with this malignancy are higher in low- and middle-income countries owing to early diagnosis deficiencies and low access to treatment [2,3]. Considering financial constraints, it is suggested that the most prudent action to be applied in cancer control is the guarantee of early diagnosis and access to treatment without delay [9,10]. Educational interventions mediated by mobile technologies represent alternatives to be explored in the practice of health promotion for their convenience and ubiquity, and for minimizing the barriers of distance, cost, and time [14,15,16]. Health education interventions based on the use of mobile technologies enable the development of health self-care skills and have emerged as alternative strategies for the control of breast cancer. WhatsApp has stood out as a useful tool in health education strategies; it has not yet been applied for breast cancer education

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