JMIR Publications

ABSTRACT

Background:

SMS interventions are effective in promoting a variety of health behaviors; however, there is scarce information regarding SMS use for cervical cancer screening and follow-up care. The ATICA Study (Application of Communication and Information Technologies to Self-Collection, for its initials in Spanish) aims to evaluate a multi-component mHealth intervention to increase triage adherence among women with HPV-positive self-collected tests in Jujuy, Argentina. Here, we describe the formative results used to design the content of the SMS to be tested in the trial.

Objective:

To understand cultural and contextual elements, women’s beliefs and perceptions regarding the use of SMS by the health care system, and women’s preferences about the message content.

Methods:

We conducted five focus groups, stratified by rural/urban residence and age. All participants were aged 30 or older and had performed HPV self-collection. Participatory techniques, including brainstorming, card-based classification and discussions were used to debate the advantages and disadvantages of messages. We openly coded the discussions for agreements and preferences regarding SMS content. Messages for both HPV negative and positive women were validated through interviews with health authorities and 14 HPV-tested women. The final versions of the messages were pilot tested.

Results:

Forty-eight women participated in the FGs. Participant women rejected receiving both negative and positive HPV-results by SMS, as for them delivery of results should be done in a face-to-face encounter with health professionals. They stressed the importance of SMS content informing them that results were available to pick them up while highlighting the link they had with CHWs and the nearest health center. Women considered that a personalized SMS was important, as well as the use of a formal yet warm tone. Due to confidentiality issues, not using the word HPV was also a key component of the desired SMS content; therefore the final message included the term “self-collection” without mention of HPV infection. Results from the validation stage and pilot test showed high acceptability of the final version of the message.

Conclusions:

Results suggest SMS is accepted when notifying women about HPV result availability, but it should not replace the delivery of results in face-to-face, doctor-patient encounters. Messages must be tailored and have a persuasive tone in order to motivate women to adhere to triage. Clinical Trial: ClinicalTrials.gov, NCT03478397. Registered on March 20th, 2018.