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Trials
Published in: Trials 1/2022

Open Access 01-12-2022 | Cervical Cancer | Study protocol

Improve the cervical cancer prevention behaviors through mobile-based educational intervention based on I-CHANGE model: study protocol for a randomized controlled trial

Authors: Sara Kazemi, Fatemeh Zarei, Alireza Heidarnia, Fatemeh Alhani

Published in: Trials | Issue 1/2022

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Abstract

Background

Applications of mobile technologies (mHealth) have the potential to reduce health inequalities, give patients more control over their health, and improve health care’s cost-effectiveness. The widespread use of mobile phones offers us a new way to prevent cervical cancer. The objective of the study was to design and develop a mobile phone application (app) that aims to conduct a behavioral intervention for women and to evaluate the efficacy of the app-based intervention.

Methods

This study involves 5 phases. In the first phase, understanding women’s perspectives will be identified using a qualitative approach based on the I-Change model. In phase 2, the results from the qualitative approach and requirement prioritization through providing experts’ perspectives will be done. The main outputs of this phase will be resulted in prioritizing the main measurable effective variables of the I-Change model. Phase 3 will be processed for the development and psychometric of an assessment tool regarding selected constructs. In phase 4, the App framework and content development will be performed. In phase 5, a three-armed, parallel-design randomized controlled trial will be conducted on women. Two hundred ten women will be randomly assigned to three groups including two intervention groups and one control group. The intervention groups included the following: (1) a mobile application and (2) a digital book. The data will be evaluated using tools designed and constructed in phase 3 of the study at baseline in 3-month follow-up assessments. The impact of the two interventions on cervical cancer prevention behaviors through mobile-based educational intervention will then be evaluated.

Discussion

A theory-based health education program using a mobile app to improve cervical cancer-preventive behaviors will be implemented for the first time in Iran. With an effective health mobile-based educational design, it is very important to determine whether Iranian women will be motivated to adhere to preventive behavior related to CC.

Trial registration

Iranian Clinical Trial Register IRCT20181205041861N3. Registered V2.0 on 26 October 2021.
Literature
1.
World Health Organization. Global strategy towards eliminating cervical cancer as a public health problem. Geneva: WHO; 2019.
2.
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.PubMedCrossRef
3.
World Health Organization. ICO Information Centre on HPV and Cervical Cancer (HPV Information Centre). Summary report on HPV and cervical cancer statistics in Brazil. 2014.
4.
Parra S, Carranza E, Coole J, Hunt B, Smith C, Keahey P, et al. Development of low-cost point-of-care technologies for cervical cancer prevention based on a single-board computer. IEEE J Transl Eng Health Med. 2020;8:1–10.CrossRef
5.
Lancet. The moving cancer up the global health agenda. Elsevier. 2010:2051.
6.
World Health Organization. Comprehensive cervical cancer prevention and control—a healthier future for girls and women: WHO guidance note. Geneva. WHO recommended the use of HPV test for primary screening and also recommended prolongation of screening interval to up to. 2013;10.
7.
Alfaro K, Maza M, Cremer M, Masch R, Soler M. Removing global barriers to cervical cancer prevention and moving towards elimination. Nat Rev Cancer. 2021;21(10):607–8.PubMedPubMedCentralCrossRef
8.
Kosha A. A set of essential interventions non-communicable diseases in the primary health care system of Iran, IraPEN. In: ed. t. Tehran: Mojasameh Publisher; 2017.
9.
Yogeshkumar S, Anderson J, Lu E, Kenyi E, Mensa M, Thaler K, et al. Safety and efficacy of the new CryoPop® cryotherapy device for cervical dysplasia in low-and middle-income countries: study protocol for a multicenter open-label non-inferiority clinical trial with historical controls. Trials. 2021;22(1):1–9.CrossRef
10.
Khorasanizadeh F, Hassanloo J, Khaksar N, Taheri SM, Marzaban M, Rashidi BH, et al. Epidemiology of cervical cancer and human papilloma virus infection among Iranian women—analyses of national data and systematic review of the literature. Gynecol Oncol. 2013;128(2):277–81.PubMedCrossRef
11.
Riahi S, Mokhtari AM, Vali M, Abdzadeh E, Mohseni S, Salehiniya H, et al. Incidence and mortality rate of cervix cancer in Iran from 1990 to 2016: a systematic review and meta-analysis. J Contemp Med Sci. 2019;5(1):1–7.CrossRef
12.
Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, et al. GLOBOCAN 2012 v1. 0. Cancer incidence and mortality worldwide. IARC CancerBase. 2013;11.
13.
Farshbaf-Khalili A, Salehi-Pourmehr H, Shahnazi M, Yaghoubi S, Gahremani-Nasab P. Cervical cancer screening in women referred to healthcare centres in Tabriz, Iran. Nigerian Med J. 2015;56(1):28.CrossRef
14.
Do HH, Taylor VM, Yasui Y, Jackson JC, Tu S-P. Cervical cancer screening among Chinese immigrants in Seattle, Washington. J Immigrant Health. 2001;3(1):15–21.CrossRef
15.
Babazadeh T, Ghaffari-Fam S, Oliaei S, Sarbazi E, Shirdel A, Mostafa-Gharabaghi P, et al. Predictors of Pap smear screening behavior among rural women in Tabriz, Iran: An application of health belief model. Int J Cancer Management. 2019;12(5).
16.
farzane E, Heydari H, Shekarchi A, Kamran A. Breast and cervical cancer-screening uptake among females in Ardabil, Northwest Iran: a community-based study. OncoTargets Ther. 2017;10:985.CrossRef
17.
Ghalavandi S, Heidarnia A, Zarei F, Beiranvand R. Knowledge, attitude, practice, and self-efficacy of women regarding cervical cancer screening. Obstetr Gynecol Sci. 2020;64(2):216–25.CrossRef
18.
World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem, vol. 52; 2020.
19.
Aghajani H, Eatemad K, Goya M, Ramezani R, Modirian MNF, Nadali F. Iranian annual of national cancer registration report 2008-2009. Center for disease Control; 2011.
20.
Mohebi S, Sharifirad G, Gharlipour Z, Kamran A. The study of pap smear conduction and its related factors based on health belief model in women referring to health care centers in Qom during 2014. J Educ Community Health. 2016;2(4):25–33.CrossRef
21.
Huchko MJ, Kahn JG, Smith JS, Hiatt RA, Cohen CR, Bukusi E. Study protocol for a cluster-randomized trial to compare human papillomavirus based cervical cancer screening in community-health campaigns versus health facilities in western Kenya. BMC Cancer. 2017;17(1):1–12.CrossRef
22.
World telecommunications ITUI. The world in 2014:ICT facts and figures. Geneva Switzerland 2014.
23.
Yan J, Zhang A, Zhou L, Huang Z, Zhang P, Yang G. Development and effectiveness of a mobile phone application conducting health behavioral intervention among men who have sex with men, a randomized controlled trial: study protocol. BMC Public Health. 2017;17(1):1–8.CrossRef
24.
Kuhns LM, Garofalo R, Hidalgo M, Hirshfield S, Pearson C, Bruce J, et al. A randomized controlled efficacy trial of an mHealth HIV prevention intervention for sexual minority young men: MyPEEPS mobile study protocol. BMC Public Health. 2020;20(1):1–6.CrossRef
25.
Rich E, Miah A, Lewis S. Is digital health care more equitable? The framing of health inequalities within England's digital health policy 2010–2017. Sociol Health Illness. 2019;41:31–49.CrossRef
26.
De La Torre-Díez I, López-Coronado M, Vaca C, Aguado JS, de Castro C. Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: a systematic review. Telemed e-Health. 2015;21(2):81–5.CrossRef
27.
Zhao J, Freeman B, Li M. Can mobile phone apps influence people’s health behavior change? An evidence review. J Med Internet Res. 2016;18(11):e5692.CrossRef
28.
Lee M, Lee H, Kim Y, Kim J, Cho M, Jang J, et al. Mobile app-based health promotion programs: a systematic review of the literature. Int J Environ Res Public Health. 2018;15(12):2838.PubMedCentralCrossRef
29.
Free C, Phillips G, Galli L, Watson L, Felix L, Edwards P, et al. The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review. PLoS Med. 2013;10(1):e1001362.PubMedPubMedCentralCrossRef
30.
Shirzad M, Shakibazadeh E, Foroushani AR, Abedini M, Poursharifi H, Babaei S. Effect of “motivational interviewing” and “information, motivation, and behavioral skills” counseling interventions on choosing the mode of delivery in pregnant women: a study protocol for a randomized controlled trial. Trials. 2020;21(1):1–10.CrossRef
31.
Kazemi S, Tavousi M, Zarei F. A mobile-based educational intervention on STI-related preventive behavior among Iranian women. Health Educ Res. 2021;36(2):212–23.PubMedCrossRef
32.
De Vries H. An integrated approach for understanding health behavior; the I-change model as an example. Psychol Behav Sci Int J. 2017;2(2):555–85.CrossRef
33.
Vaidya OS, Kumar S. Analytic hierarchy process: an overview of applications. Eur J Oper Res. 2006;169(1):1–29.CrossRef
34.
Abiodun OA, Olu-Abiodun OO, Sotunsa JO, Oluwole FA. Impact of health education intervention on knowledge and perception of cervical cancer and cervical screening uptake among adult women in rural communities in Nigeria. BMC Public Health. 2014;14(1):1–9.CrossRef
35.
Krefting L. Rigor in qualitative research: the assessment of trustworthiness. Am J Occup Ther. 1991;45(3):214–22.PubMedCrossRef
36.
Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12.PubMedCrossRef
37.
Amin R, Kolahi A-A, Jahanmehr N, Abadi A-R, Sohrabi M-R. Disparities in cervical cancer screening participation in Iran: a cross-sectional analysis of the 2016 nationwide STEPS survey. BMC Public Health. 2020;20(1):1–8.CrossRef
38.
Ghahramani S, Kasraei H, Shahabi S, Lankarani KB. Facilitating factors and barriers of women's cancer screening in Iran: a systematic review. International journal of. Prev Med. 2020;11.
39.
Hyacinth HI, Adekeye OA, Ibeh JN, Osoba T. Cervical cancer and pap smear awareness and utilization of pap smear test among federal civil servants in North Central Nigeria; 2012.CrossRef
40.
Khazaee-Pool M, Yargholi F, Jafari F, Ponnet K. Exploring Iranian women’s perceptions and experiences regarding cervical cancer-preventive behaviors. BMC Womens Health. 2018;18(1):1–14.CrossRef
41.
Parsa P, Sharifi F, Shobeiri F, Karami M. Effects of group counseling based on health belief model on cervical cancer screening beliefs and performance of rural women in Kaboudrahang, Iran. Asian Pac J Cancer Prev. 2017;18(6):1525.PubMedPubMedCentral
42.
Ebrahim Mahmoud A, Abdelhakeem Aboud S, Kamal AF. Effect of the educational package based on health belief model on nursing students’ knowledge and attitude regarding human papillomavirus and cervical cancer. J Nursing Sci Benha Univ. 2021;2(2):809–28.CrossRef
43.
Black E, Hyslop F, Richmond R. Barriers and facilitators to uptake of cervical cancer screening among women in Uganda: a systematic review. BMC Womens Health. 2019;19(1):1–12.CrossRef
44.
Marashi T, Irandoost SF, Yoosefi Lebni J, Soofizad G. Exploring the barriers to pap smear test in Iranian women: a qualitative study. BMC Womens Health. 2021;21(1):1–12.CrossRef
45.
Nazari S, Keshavarz Z, Afrakhte M, Riazi H. Barriers to cervical cancer screening in HIV positive women: a systematic review of recent studies in the world. Iran J Epidemiol. 2019;15(1):87–94.
46.
Islam RM, Billah B, Hossain MN, Oldroyd J. Barriers to cervical cancer and breast cancer screening uptake in low-income and middle-income countries: a systematic review. Asian Pac J Cancer Prev. 2017;18(7):1751.PubMedPubMedCentral
47.
Ruco A, Dossa F, Tinmouth J, Llovet D, Jacobson J, Kishibe T, et al. Social media and mHealth technology for cancer screening: systematic review and meta-analysis. J Med Internet Res. 2021;23(7):e26759.PubMedPubMedCentralCrossRef
Metadata
Title
Improve the cervical cancer prevention behaviors through mobile-based educational intervention based on I-CHANGE model: study protocol for a randomized controlled trial
Authors
Sara Kazemi
Fatemeh Zarei
Alireza Heidarnia
Fatemeh Alhani
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Trials / Issue 1/2022
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-022-06744-5

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