JMIR Publications

ABSTRACT

Background:

The availability of mobile phones has made the dissemination of health-related information easy and accessible. With gamification, mobile apps can nudge people to make informed health choices, including attending cervical cancer screening.

Objective:

This matched retrospective cohort study examined the association between exposure to the FightHPV mobile app gamified educational content and having a cervical exam in the following year.

Methods:

Women aged 20–69 years who signed an eConsent after downloading the FightHPV app in 2017 (intervention group) were 1:6 matched with women who have had the same age and the same screening history (reference group) in 2015. To estimate the FightHPV app impact, we estimated cumulative incidence and hazard ratios (HRs) with 95% confidence intervals (CI). We used data from the Norwegian Cervical Cancer Screening database and Statistics Norway.

Results:

For 658 women in the intervention group, we matched 3860 controls. 1-year after enrollment 44.2% (95% CI 30.3–47.9%) in the intervention group and 27.0% (95% CI 25.6–28.4%) in the reference group underwent a cervical exam (p<0.01). 6 months after enrollment, women exposed to the FightHPV app were 2-times more likely to attend any type of cervical exam (adjusted HR 2.3, 95% CI 2.0–2.7) during which they were almost 13-times more likely to be diagnosed with high-grade lesions (adjusted HR 12.7, 95% CI 5.0–32.5) compared the women in the reference group.

Conclusions:

FightHPV app exposure significantly increased the number of cervical exams across the various analyses. For the first time, we demonstrated the effectiveness of gamification combined with mobile technology in cancer prevention by empowering women to make active health-related decisions. Gamification can significantly improve the understanding of complicated scientific concepts behind interventions and increase the acceptance of proposed cancer control measures.