The development of a culturally-informed cervical cancer screening and prevention mhealth intervention for African American women.

Abstract

Background: Significant strides have been made in reducing the burden of cervical cancer and HPV. Between pap smear screenings and HPV vaccinations, there has been a reduction in cervical cancer incidence in the United States. Unfortunately, those reductions have not been experienced by all ethnic groups. Cervical cancer disparities are a threat to the health of African American women, and innovation in education and the healthcare experience is needed to eliminate this threat. This study aimed to develop and evaluate a culturally tailored intervention using mHealth services to improve cervical cancer and HPV knowledge. Methods: The development and evaluation of this mHealth intervention involved two phases. The first phase included the culturally tailoring of health messages using a community advisory board of African American women. By meeting in person and virtually, the women were able to tailor twenty-four messages to be disseminated using mHealth. The second phase of this study involved testing of the intervention and evaluation. African American women were recruited and then assessed on their baseline knowledge of cervical cancer and their experiences of discrimination in medical settings. Participants were then assigned to either the control or intervention group. Those in the intervention group received health messages three times a week for four weeks on their mobile phones. After four weeks had passed, both the control and intervention group were reassessed on their cervical cancer knowledge. mHealth was evaluated for its acceptability, appropriateness, and feasibility using three evaluation measures and qualitative interviews. Results: Forty-eight women were recruited for this study, with non-random assignment of twenty-five to the intervention group and twenty-three to the control. The baseline scores on the cervical cancer awareness measure indicated a need for education in both groups. Additionally, all participants expressed having experienced some form of discrimination in medical settings. Using a paired-samples t-test the complete-case analysis shows an improvement in cervical cancer knowledge for women in the intervention group. Conclusions: mHealth intervention shows potential in educating African American women about cervical cancer and HPV. Using mobile phone technology allowed the women to be educated at their convenience and to return to the material later. Future research and practice should consider using the mHealth intervention with hard-to-reach populations or as educational material along with appointment reminders.