Abstract
BackgroundCervical cancer is a major health concern in Tanzania, caused by poor attendance for cervical cancer screening and follow-up of women at risk. Mobile telephone health interventions are proven effective tools to improve health behaviour in African countries. So far, no knowledge exists on how such interventions may perform in relation to cervical cancer screening in low-income settings. This study aims to assess the degree to which a Short Message Service (SMS) intervention can increase attendance at appointments among women who have tested positive for high-risk (HR) Human Papillomavirus (HPV) during cervical cancer screening.Methods/designConnected2Care is a non-blinded, multicentre, parallel-group, randomised controlled trial. Tanzanian women testing positive to HR HPV at inclusion are randomly assigned in an allocation ratio of 1:1 to the SMS intervention or the control group (standard care). In a period of 10 months, the intervention group will receive 15 one-directional health educative text messages and SMS reminders for their appointment. The total sample size will be 700 with 350 women in each study arm. Primary outcome is attendance rate for follow-up. Secondary objectives are cost-effectiveness, measured through incremental ratios, and knowledge of cervical cancer by a 16-item true/false scale questionnaire at baseline and follow-up. Barriers against implementing the intervention will be assessed in a mixed-methods sub-population study.DiscussionThis study may provide information on the potential effects, costs, and barriers in implementing an SMS intervention targeting a group of women who are followed up after testing positive for HR HPV and are, therefore, at increased risk of developing cervical cancer. This can guide decision-makers on the effective use of mobile technology in a low-income setting. Trial status: recruiting.Trial registrationClinicalTrials.gov, ID: NCT02509702. Registered on 15 June 2015.
Highlights
Cervical cancer is a major health concern in Tanzania, caused by poor attendance for cervical cancer screening and follow-up of women at risk
This study may provide information on the potential effects, costs, and barriers in implementing an Short Message Service (SMS) intervention targeting a group of women who are followed up after testing positive for HR Human Papillomavirus (HPV) and are, at increased risk of developing cervical cancer
Cervical cancer often affects women of reproductive age and is a major health challenge in lowincome countries (LICs) such as Tanzania where it accounts for 38% (n = 7300) of all female cancers, and 34% (n = 4200) of all female cancer-related deaths [1, 4]
Summary
Cervical cancer is a major health concern in Tanzania, caused by poor attendance for cervical cancer screening and follow-up of women at risk. This study aims to assess the degree to which a Short Message Service (SMS) intervention can increase attendance at appointments among women who have tested positive for high-risk (HR) Human Papillomavirus (HPV) during cervical cancer screening. Cervical cancer screening is limited in Tanzania and the screening uptake is poor due to lack of knowledge of the disease and its prevention. These factors are contributing to the large cervical cancer burden in Tanzania, and the disease is a public health concern with enormous social and economic impact [1,2,3, 5,6,7,8,9,10]. It is yet to be estimated to which degree women, who have attended screening and have had abnormal test results, will attend follow-up screening appointments in African populations
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