Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Surulere, Lagos, Nigeria.
Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Surulere, Lagos, Nigeria.
JCO Glob Oncol. 2021 Aug;7:1418-1425. doi: 10.1200/GO.21.00258.
We assessed the impact of mHealth on Pap test screening uptake and also determined the factors that affect screening uptake among women in Lagos, Nigeria.
A randomized controlled trial was carried out among women in two tertiary health institutions in Lagos, Nigeria, between July 2020 and March 2021. Participants were randomly assigned to either a text message (mHealth) intervention or usual care arm. The main study outcome was the uptake of Pap smear testing within 6 months of enrollment in the study. We tested the associations between two groups of continuous variables using the unpooled independent-sample -test (normal distribution) and that of two groups of categorical variables with the chi-square (χ) test. Using a multinomial logistic regression model, we adjusted for relevant sociodemographic and clinical predictors of uptake of Pap smear screening. Statistical significance was defined as < .05.
There was a significantly higher rate of uptake of Pap smear screening among women in the mHealth arm compared with those in the usual care arm (51.0% 35.7%, = .031). Following adjustment in the final multivariate model, level of income (odds ratio [OR] = 5.13, 95% CI, 1.55 to 16.95), awareness of Pap smear (OR = 16.26; 95% CI, 2.49 to 76.64), General Outpatient clinic attendance, and introduction of mHealth intervention during follow-up (OR = 4.36; 95% CI, 1.44 to 13.22) were the independent predictors of Pap smear uptake.
The use of mHealth technologies intervention via short-text message services is a feasible solution for cervical cancer prevention in low- and middle-income countries, and thus, the widespread use of mHealth services by health care providers and policymakers could contribute to the implementation of cervical cancer prevention services in Nigeria and in the settings of other low- and middle-income countries.
我们评估了移动医疗对巴氏涂片检查筛查参与度的影响，并确定了影响尼日利亚拉各斯妇女筛查参与度的因素。
2020 年 7 月至 2021 年 3 月，我们在尼日利亚拉各斯的两家三级医疗机构中进行了一项随机对照试验。参与者被随机分配到短信（移动医疗）干预组或常规护理组。主要研究结果是在研究入组后 6 个月内接受巴氏涂片检查的比例。我们使用未合并的独立样本 t 检验（正态分布）检验两组连续变量之间的关联，使用卡方（χ 2 ）检验检验两组分类变量之间的关联。我们使用多项逻辑回归模型，调整了巴氏涂片筛查参与度的相关社会人口学和临床预测因素。统计学显著性定义为 <.05。
与常规护理组相比，移动医疗组中接受巴氏涂片筛查的比例明显更高（51.0%比 35.7%， =.031）。在最终的多变量模型中调整后，收入水平（比值比[OR] = 5.13，95%置信区间，1.55 至 16.95）、对巴氏涂片的认识（OR = 16.26；95%置信区间，2.49 至 76.64）、普通门诊就诊次数以及随访期间引入移动医疗干预（OR = 4.36；95%置信区间，1.44 至 13.22）是巴氏涂片筛查参与度的独立预测因素。
通过短文本消息服务使用移动医疗技术干预是中低收入国家预防宫颈癌的可行方法，因此，医疗保健提供者和政策制定者广泛使用移动医疗服务可能有助于在尼日利亚和其他中低收入国家实施宫颈癌预防服务。
