A new study has demonstrated that SMS based screening intervention in Korean American women significantly increased their knowledge of cervical cancer and cervical cancer screening as well as encouraged them to obtain pap test. Korean American women have one of the highest cervical cancer mortality rates in the United States and the lowest Pap test screening rates.
The study leveraged BJ Fogg’s Behavior Model to create three sequential elements in this SMS intervention – identify barriers, develop motivators, and provide triggers to effect a behavior change.
The researchers at the University of Minnesota, Twin Cities, Minneapolis conducted this study among 30 Korean American women aged 21 to 29 years who had not received a Pap test. The researchers used 7-day text message-based mScreening intervention, which covered topics such as – information about cervix and cervical cancer, including cervical cancer incidence and mortality; introduction to Pap test to prevent cervical cancer; introduction of cultural barriers; availability of local clinics and cost of Pap test; testimony of a Korean American woman who had gone through the Pap test experience; testimony of Korean American cervical cancer survivor who found cervical cancer at later stage and had no previous receipt of a Pap test
Messages were also customized to the strengths and weaknesses of individual participants. For example, participants with weaknesses on culture-based health beliefs on cervical cancer screening at baseline, were sent additional messages designed to reduce cultural barriers – messages such as “We understand it is a bit embarrassing to get it done. But do it for you! Your happy cervix will appreciate it!”
After 7-day mScreening intervention, the researchers observed significant improvements in women’s general knowledge about cervical cancer, Pap test, beliefs about and attitudes toward the Pap test, knowledge about risk factors of cervical cancer and its screening as well as significant reduction in socio-cultural barriers to cervical cancer screening. Most impressively one woman reported receiving the Pap test within 1 week after completing the mScreening program and 6 women reported receiving the Pap test by the 3-month follow-up visit.
Despite the fact that the study has multiple limitations – small sample size, lack of design to investigate optimum length of mhealth intervention or SMS vs other messaging channels and privacy of data, the study provides promising data that mobile technology can improve cervical cancer screening in a vulnerable population.