scholarly journals Impact of Mobile Technologies on Cervical Cancer Screening Practices in Lagos, Nigeria (mHealth-Cervix): A Randomized Controlled Trial

2021 ◽  
pp. 1418-1425
Author(s):  
Kehinde S. Okunade ◽  
Adaiah Soibi-Harry ◽  
Sarah John-Olabode ◽  
Adebola A. Adejimi ◽  
Matthew J. Allsop ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Controlled Trial ◽  
Text Message ◽  
Cervical Cancer Prevention ◽  
Middle Income ◽  
Mhealth Intervention ◽  
Middle Income Countries ◽  
Randomized Controlled ◽  
Pap Smear Screening

PURPOSE We assessed the impact of mHealth on Pap test screening uptake and also determined the factors that affect screening uptake among women in Lagos, Nigeria. MATERIALS AND METHODS A randomized controlled trial was carried out among women in two tertiary health institutions in Lagos, Nigeria, between July 2020 and March 2021. Participants were randomly assigned to either a text message (mHealth) intervention or usual care arm. The main study outcome was the uptake of Pap smear testing within 6 months of enrollment in the study. We tested the associations between two groups of continuous variables using the unpooled independent-sample t-test (normal distribution) and that of two groups of categorical variables with the chi-square (χ2) test. Using a multinomial logistic regression model, we adjusted for relevant sociodemographic and clinical predictors of uptake of Pap smear screening. Statistical significance was defined as P < .05. RESULTS There was a significantly higher rate of uptake of Pap smear screening among women in the mHealth arm compared with those in the usual care arm (51.0% v 35.7%, P = .031). Following adjustment in the final multivariate model, level of income (odds ratio [OR] = 5.13, 95% CI, 1.55 to 16.95), awareness of Pap smear (OR = 16.26; 95% CI, 2.49 to 76.64), General Outpatient clinic attendance, and introduction of mHealth intervention during follow-up (OR = 4.36; 95% CI, 1.44 to 13.22) were the independent predictors of Pap smear uptake. CONCLUSION The use of mHealth technologies intervention via short-text message services is a feasible solution for cervical cancer prevention in low- and middle-income countries, and thus, the widespread use of mHealth services by health care providers and policymakers could contribute to the implementation of cervical cancer prevention services in Nigeria and in the settings of other low- and middle-income countries.

'Have a Pap smear!' – doctors, their clients, and opportunistic cervical cancer screening

2005 ◽  
Vol 16 (3) ◽  
pp. 233-236 ◽  
Author(s):  
L C Chingang ◽  
U Bischof ◽  
G Andall-Brereton ◽  
O Razum
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Pap Smear ◽  
Cervical Screening ◽  
Pap Test ◽  
Community Members ◽  
Middle Income ◽  
Middle Income Countries ◽  
High Incidence

In many middle-income countries with a high incidence of cervical cancer, organized screening programmes with the Pap test are being planned. We assessed the knowledge of, and attitudes towards, cervical screening among 63 doctors and 102 randomly selected community members in Trinidad where screening is still opportunistic. Doctors were well informed about cervical cancer, but not all knew the approximate specificity of the Pap test. Many did not routinely discuss the benefits and disadvantages of screening with their clients. Most women had heard of the Pap test, but only 56% knew its purpose; 25% would not participate in screening, stating reasons such as being in menopause or not having symptoms. More information about the aim of screening and the purpose of the Pap test must be communicated. Doctors need to keep their knowledge on screening up-to-date, and offer counselling that helps women to make an informed decision whether or not to participate in screening.

scholarly journals SMS education for the promotion of diabetes self-management in low & middle income countries: a pilot randomized controlled trial in Egypt

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Haitham Abaza ◽  
Michael Marschollek
Keyword(s):  
Glycemic Control ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Self Management ◽  
Chi Square ◽  
Middle Income ◽  
Middle Income Countries ◽  
Randomized Controlled ◽  
Secondary Outcomes ◽  
Management Behaviors

Abstract Background Due to the ubiquity of mobile phones in low and middle income countries, we aimed to examine the feasibility of SMS education among diabetic patients in Egypt, and assess the impact of educational text messages, compared to traditional paper-based methods, on glycemic control and self-management behaviors. Methods We conducted a 12-week randomized controlled trial at Misr University for Science & Technology hospital in Cairo-Egypt. Known as MUST diabetes awareness program, patients were included if they had diabetes, owned a mobile phone, and could read SMS messages or lived with someone that could read for them. Intervention patients received daily messages and weekly reminders addressing various diabetes care categories. We expected greater improvement in their glycemic control compared to controls who only received paper-based educational material. The primary outcome was the change in HbA1c, measured by the difference between endpoint and baseline values and by the number of patients who experienced at least 1% reduction from baseline to endpoint. Key secondary outcomes included blood glucose levels, body weight, treatment and medication adherence, self-efficacy, and diabetes knowledge. Data were analyzed using ANCOVA, chi-square, and t-tests. Results Thirty four intervention and 39 control patients completed the study. Over 12 weeks, 3880 messages were sent. Each intervention patient received 84 educational and 12 reminder messages plus one welcome message. Our primary outcome did not differ significantly (Δ 0.290; 95% CI -0.402 to 0.983; p = 0.406) between groups after 3 months, demonstrating a mean drop of −0.69% and −1.05% in the control and intervention group respectively. However, 16 intervention patients achieved the targeted 1% drop versus only 6 controls, suggesting clear association between study group and 1% HbA1c reductions (chi-square = 8.655; df = 1; p = 0.003). Secondary outcomes seemed in favor of intervention patients at endpoint, with considerable improvements in treatment and medication adherence, self-efficacy, and knowledge scores. Participants also indicated full satisfaction with the program. Conclusions SMS education is a feasible and acceptable method for improving glycemic control and self-management behaviors among Egyptian diabetics. However, whether it is more effective than traditional paper-based methods needs further investigation. Trial registration ClinicalTrials.govNCT02868320. Registered 9 August 2016. Retrospectively registered.

scholarly journals Parenting Support: Mediation Pathways for Reduced Substance Use Among Parents and Their Children: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Adeem Massarwi ◽  
Lucie Cluver ◽  
Fraziska Meinck ◽  
Jamie Lachman ◽  
Jenny Doubt ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Controlled Trial ◽  
Parental Mental Health ◽  
Parenting Programme ◽  
Middle Income ◽  
Middle Income Countries ◽  
Randomized Controlled ◽  
Parental Substance Use ◽  
Family Based

Abstract Background: Substance use is a major public health concern worldwide. Alcohol and drug use have risen over recent decades in many low and middle-income countries, with South Africa among the highest globally.Despite effectiveness of family-based interventions on reducing substance use among adolescents, less is known about the effectiveness of family-based programs on substance use among parents and caregivers, in particular, among families in low- and middle-income countries (LMIC).This study investigated mediators of change in a parenting programme (Parenting for Lifelong Health -PLH) on reduction of substance use among parents and their children through three potential mediators: parental depression, parenting stress and family poverty. In addition, the study examined the correlation between parental substance use and adolescent substance use.Methods: The current study draws on a pragmatic cluster randomized controlled trial design; the total sample comprised 552 parents\caregiver and adolescent dyads (parents\caregivers M = 49.37; SD = 14.69 and adolescents M = 13.84; SD = 2.38) who were recruited from 40 communities in South Africa’s Eastern Cape. Participants completed a structured confidential self-report questionnaire, at baseline and follow-up test (5–9 months following the intervention). Structural equation modeling (SEM) was conducted to investigate direct and indirect effects. Results: Mediation analysis indicated that PLH intervention impact on parental substance use reduction among parents ran through one indirect pathway: Improvement in parental mental health (reduction in parental depression levels). There were no pathways from PLH intervention to parental substance use through parenting stress or family poverty. Furthermore, findings showed a significant positive correlation between parental substance use and adolescents' substance use.Conclusions: The findings of the study highlight the fact that PLH parenting intervention has a significant effect on secondary outcomes, including substance use and depression among parents\caregivers in LMIC. These findings emphasize the need for creating supportive environments and systems for parents who suffer from emotional strain and mental health problems, in particular among families in adversity. Supporting parental mental health as part of a parenting programme serves as a significant pathway for reducing substance use among parents and their children.Trial registration: Pan-African Clinical Trials Registry PACTR201507001119966. Registered on 27 April 2015. It can be found by searching for the key word ‘Sinovuyo’ on their website or via the following link:http://www.pactr.org/ATMWeb/appmanager/atm/atmregistry_nfpb=true&_windowLabel=BasicSearchUpdateController_1&BasicSearchUpdateController_1_actionOverride=%2Fpageflows%2Ftrial%2FbasicSearchUpdate%2FviewTrail&BasicSearchUpdateController_1id=1119

scholarly journals mHealth Messaging to Motivate Quitline Use and Quitting: Protocol for a Community-Based Randomized Controlled Trial in Rural Vietnam (Preprint)

2021 ◽  
Author(s):  
Celine Larkin ◽  
Jessica Wijesundara ◽  
Hoa L Nguyen ◽  
Duc Anh Ha ◽  
Anh Vuong ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Text Messaging ◽  
Health Workers ◽  
Controlled Trial ◽  
Text Messages ◽  
Community Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Randomized Controlled

BACKGROUND Tobacco kills more than 8 million people each year, mostly in low- and middle-income countries. In Vietnam, 1 in every 2 male adults smokes tobacco. Vietnam has set up telephone Quitline counseling that is available to all smokers, but it is underused. We previously developed an automated and effective motivational text messaging system to support smoking cessation among US smokers. OBJECTIVE The aim of this study is to adapt the aforementioned system for rural Vietnamese smokers to promote cessation of tobacco use, both directly and by increasing the use of telephone Quitline counseling services and nicotine replacement therapy. Moreover, we seek to enhance research and health service capacity in Vietnam. METHODS We are testing the effectiveness of our culturally adapted motivational text messaging system by using a community-based randomized controlled trial design (N=600). Participants were randomly allocated to the intervention (regular motivational and assessment text messages) or control condition (assessment text messages only) for a period of 6 months. Trial recruitment took place in four communes in the Hung Yen province in the Red River Delta region of Vietnam. Recruitment events were advertised to the local community, facilitated by community health workers, and occurred in the commune health center. We are assessing the impact of the texting system on 6-month self-reported and biochemically verified smoking cessation, as well as smoking self-efficacy, uptake of the Quitline, and use of nicotine replacement therapy. In addition to conducting the trial, the research team also provided ongoing training and consultation with the Quitline during the study period. RESULTS Site preparation, staff training, intervention adaptation, participant recruitment, and baseline data collection were completed. The study was funded in August 2017; it was reviewed and approved by the University of Massachusetts Medical School Institutional Review Board in 2017. Recruitment began in November 2018. A total of 750 participants were recruited from four communes, and 700 (93.3%) participants completed follow-up by March 2021. An analysis of the trial results is in progress; results are expected to be published in late 2022. CONCLUSIONS This study examines the effectiveness of mobile health interventions for smoking in rural areas in low- and middle-income countries, which can be implemented nationwide if proven effective. In addition, it also facilitates significant collaboration and capacity building among a variety of international partners, including researchers, policy makers, Quitline counselors, and community health workers. CLINICALTRIAL ClinicalTrials.gov NCT03567993; https://clinicaltrials.gov/ct2/show/NCT03567993. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/30947

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