Multicomponent mhealth interventions for healthcare providers and the community to increase cancer screening in India

PROJECT SUMMARY/ABSTRACT Given that a large proportion of cancers are detected at a late stage in India, approaches to increase screening uptake could have a significant impact on cancer outcomes. There is low level of awareness of cancer risk factors, symptoms, and importance of screening for early detection of cancers among individuals

in the community. Additionally, there is limited cancer screening knowledge and capacity among primary care providers, who often have competing priorities leaving limited time to focus on cancer screening. Mobile Health (mHealth)-based education can serve as a powerful tool for offering e-learning opportunities on

cancer screening and can provide the connectivity required to link community and health care settings, as mobile technology is widely available and inexpensive. First, we will develop an innovative mHealth platform, the Integrated Cancer Awareness Network (ICAN), which will apply theory-driven concepts to educate

individuals eligible for colorectal, breast, or cervical cancer screening (referred to as “patients”) and health care providers through apps accessed on their own mobile devices. ICAN will connect patients and providers with screening support staff at tertiary medical colleges who will provide coordination and navigation via an

interactive dashboard. Second, we will use implementation science methods to evaluate the effectiveness, processes, and cost-effectiveness of the ICAN mHealth platform. We propose the following aims: R21-1. Develop ICAN mHealth platform to educate primary care providers and patients on cancer risk factors, symptoms, screening tests, and benefits of early detection via apps and create dashboard for hubs.

R21-2. Perform quality and usability assessment with key stakeholders, including providers, patients, and hub staff to evaluate the ease of use, informational content, perceived usefulness, and interface agility. R21-3. Conduct a pilot study to evaluate and finalize the ICAN multicomponent intervention platform.

R33-1. Conduct a cluster randomized trial to assess the impact of the ICAN mHealth multicomponent intervention platform on cancer screening uptake compared to an education app offered only to providers. R33-2. Use a mixed-methods approach to compare implementation outcomes of the two strategies used in

the trial, including accessibility, usability, acceptability, feasibility, affordability, fidelity, and sustainability. R33-3. Perform economic evaluations to assess cost-effectiveness and return-on-investment scenarios of the ICAN mHealth platform compared to provider education app alone. This study will provide data-driven evidence on the utility of mHealth multicomponent interventions in

creating an interconnected infrastructure to offer organized population-based screening to increase uptake of cancer screening. The state and central governments in India can use the new evidence generated to design optimal approaches to scale up the implementation of cancer screening recommendations. The lesson

learned can be applied to other limited-resource settings.