Mobile Phone Ownership and Use Among Women Screening for Cervical Cancer in a Community-Based Setting in Western Kenya: Descriptive Analysis (Preprint)

BACKGROUND Mobile phone ownership among women of reproductive age in western Kenya is not well-described and our understanding of its link with care-seeking behaviors is nascent. Understanding access to and use of mobile phones among this population, as well as willingness to take part in mhealth interventions, is important in improving and more effectively implementing mhealth strategies. OBJECTIVE We sought to describe patterns of mobile phone ownership and use among women attending cervical cancer screening, as well as to identify key considerations for the use of SMS-guided linkage to treatment strategies. METHODS This analysis was nested within a two-phase cluster-randomized trial evaluating varying strategies for HPV-based cervical cancer screening and prevention in a rural area of western Kenya. 3,299 women were surveyed at the time of screening and treatment. Questionnaires included items detailing demographics, health history, prior care-seeking behaviors, and patterns of mobile phone ownership and use. RESULTS Rates of mobile phone ownership and reported daily usage were high among women. The majority of women were comfortable receiving their screening results via SMS text message, although the most commonly preferred method of notification was via phone call. Higher levels of education, missing work to attend screening, and previous cervical cancer screening were significantly associated with a higher odds of attending treatment if hrHPV+. Those who shared a mobile phone were significantly less likely to attend treatment compared to those who owned a phone. CONCLUSIONS While rates of mobile phone ownership and daily use among women of reproductive age in western Kenya are high, there is a need for multi-pronged approaches to augment mhealth interventions to ensure equity for women without mobile connectivity or mobile phone access. Further research is needed in order to understand the usefulness of text-based interventions among this population as well as strategies to increase reach and appeal of text approaches.