BACKGROUND
Cancer awareness is crucial for effective and satisfactory cancer care and prevention. However, cancer awareness in Uganda is low, and access to cancer information is limited.
OBJECTIVE
In this paper we describe an mHealth intervention in the form of an Interactive voice response (IVR) system for addressing the low cancer awareness in Uganda. Specifically, we (i) describe cancer information needs, (ii) describe the development of the cancer awareness messages and the IVR system for disseminating these messages, and (iii) explore user acceptance and usage of the IVR system.
METHODS
We conducted interviews and focus group discussions with cancer healthcare providers, cancer patients, caregivers and survivors, administrators and lay citizens, to understand the cancer awareness situation in Uganda (perceptions, beliefs, information needs and challenges to accessing cancer information), and opinions about IVR. We then developed an IVR system to address the cancer awareness needs, tested the system with cancer patients, caregivers and survivors during co-creation workshops, and then implemented and evaluated the system through qualitative telephone surveys and quantitative analysis of system usage data (call records).
RESULTS
The cancer messages cover general topics such as what cancer is, what causes it (risk factors), cancer screening and diagnosis, and cancer treatment. They also provide practical information on what to expect during cancer care (e.g., duration and cost of care), address myths and misconceptions that were identified, and information on COVID-19 which was added following the outbreak. The IVR system is accessible through a multi-channel toll-free telephone line. In addition to the pre-recorded voice messages, the system allows callers to leave a voicemail or to speak directly to a member of the clinical team. In the six months since go-live, 2411 calls had been made to the system, from 794 unique telephone numbers and lasting a total of 6856 minutes. Call volumes peaked following advertisement of the system and following lockdowns due to COVID-19 outbreak. Participants were generally familiar with IVR technology, and caller feedback was largely positive. Cited benefits include convenience, toll-free access, and detailed information. Recommendations for improvement of the system include adding live agents and marketing of the system to target users.
CONCLUSIONS
IVR technology provides an acceptable and accessible way for provision of cancer information to patients and the general public in Uganda, live agents who are knowledgeable about cancer should be added to the IVR if possible so that individualized questions can be answered in real time.
“To learn what cancer is, press 1”: A Descriptive study of the Implementation of an Interactive Voice Response (IVR) System for Cancer Awareness in Uganda (Preprint)
