ASPO Abstracts
Adapting and implementing tailored text messaging to improve adherence to cervical cancer screening management
Category: Cancer Health Disparities
Conference Year: 2022
Abstract Body:
PURPOSE: Barriers to the management of abnormal cervical cancer screening tests remain unaddressed and contribute to disparities among underserved women. Text messaging is an accessible-though underexplored-intervention delivery channel for promoting adherence to follow-up through tailored barriers counseling. METHODS: Content from an efficacious Evidence-Based Cancer Control Program phone counseling intervention (Tailored Communication for Cervical Cancer Risk-TC3) was adapted and a user centered design approach used to test texting protocols for a text message version of TC3 while assessing feasibility. In-depth interviews were conducted with 13 patients who had been referred for colposcopy within the last 12 months as well as 12 health care team members from 2 Colposcopy Clinics in Newark and New Brunswick NJ. RESULTS: Patients' mean age was 43 years, 50% was non-Hispanic Black, and 11% was Hispanic. Staff included 67% MDs and 15% advanced practitioners; 25% were medical assistants. The majority was white (54%) and female (92%); Asian, Hispanic and non-Hispanic Black groups comprised 15% each. Both patients and clinic staff members described a need for the intervention and that texting is acceptable. Patients expressed having limited knowledge of HPV risk and colposcopy, confusion about the implications of screening results and next steps, and feelings of anxiety. They liked the concept of getting informational text messages, having additional support to answer their questions, and thought appointment reminders would be helpful. Clinicians were particularly supportive of providing education and counseling as part of screening results delivery, which nurses usually provide over the phone. Because scheduling colposcopy appointments can be challenging-especially with work and childcare conflicts-linking educational messages with appointment reminders was described as a key strength.CONCLUSIONS: Stakeholder engagement found tailored text messaging to be a potentially useful dissemination strategy for increasing cervical cancer prevention education reach and impact. Providing education and actionable content via a mHealth intervention is a feasible and scalable approach to supporting both patients and clinicians during follow-up.
Keywords: cervical cancer prevention; implementation science; tailored mHealth intervention