Sanchez Antelo Victoria, Kohler Racquel E, Curotto Mariana, Viswanath Kasisomayajula Vish, Paolino Melisa, Arrossi Silvina
Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina.
Cancer Health Equity, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States.
JMIR Form Res. 2020 Mar 6;4(3):e14652. doi: 10.2196/14652.
SMS interventions are effective in promoting a variety of health behaviors; however, there is limited information regarding the use of SMS for cervical cancer screening and follow-up care. The Application of Communication and Information Technologies to Self-Collection study aims to evaluate a multicomponent mobile health intervention to increase triage adherence among women with human papillomavirus (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.
This study aimed to understand the 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.
We conducted five focus groups (FGs), stratified by rural or urban residence and age. All participants were aged 30 years 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 the SMS content. Messages for both HPV-negative and HPV-positive women were validated through interviews with health authorities and 14 HPV-tested women. The final versions of the messages were pilot-tested.
A total of 48 women participated in the FGs. Participants rejected receiving both negative and positive HPV results by SMS because, for them, the delivery of results should be done in a face-to-face interaction with health professionals. They stressed the importance of the SMS content informing them that results were available for pick up and reflecting the kind of relationship that they have with the community health workers and the nearest health center. Women considered that a personalized SMS was important, as was the use of a formal yet warm tone. Owing 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 the mention of HPV infection. Results from the validation stage and pilot test showed high acceptability of the final version of the message.
The results suggest that SMS is accepted when notifying women about the availability of the HPV test result, but it should not replace the delivery of results in face-to-face, doctor-patient encounters. In addition, messages must be tailored and must have a persuasive tone to motivate women to adhere to the triage.
短信干预在促进多种健康行为方面是有效的；然而，关于使用短信进行宫颈癌筛查和后续护理的信息有限。通信和信息技术在自我采集研究中的应用旨在评估一种多成分移动健康干预措施，以提高阿根廷胡胡伊省人乳头瘤病毒（HPV）检测呈阳性的自我采集检测女性的分流依从性。在此，我们描述了用于设计将在试验中测试的短信内容的形成性结果。
本研究旨在了解文化和背景因素、女性对医疗保健系统使用短信的信念和看法以及女性对短信内容的偏好。
我们进行了五个焦点小组讨论，按农村或城市居住情况以及年龄分层。所有参与者年龄在30岁及以上，且进行过HPV自我采集。采用了包括头脑风暴、基于卡片的分类和讨论在内的参与式技术来讨论短信的优缺点。我们对讨论内容进行开放式编码，以了解关于短信内容的共识和偏好。通过与卫生当局和14名接受过HPV检测的女性进行访谈，对HPV阴性和阳性女性的短信进行了验证。对短信的最终版本进行了预测试。
共有48名女性参与了焦点小组讨论。参与者拒绝通过短信接收HPV阴性和阳性结果，因为对她们来说，结果应由卫生专业人员面对面告知。她们强调短信内容告知她们结果可供领取并反映她们与社区卫生工作者及最近的卫生中心关系的重要性。女性认为个性化短信很重要，使用正式但温暖的语气也很重要。由于保密问题，不使用“HPV”一词也是理想短信内容的关键组成部分；因此，最终短信包含“自我采集”一词，未提及HPV感染。验证阶段和预测试的结果表明短信最终版本具有较高的可接受性。
结果表明，在通知女性HPV检测结果可供领取时，短信是被接受的，但它不应取代医患面对面告知结果的方式。此外，短信必须量身定制，且必须具有说服力，以激励女性坚持分流。
