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Acceptability,Utility, and Cost of a Mobile Health Cancer Screening Education Application for Training Primary Care Physicians in India
Authors:Sujha Subramanian  Regi Jose  Anoop Lal  Paul Augustine  Madeleine Jones  Bipin K. Gopal  Shinu Krishnan Swayamvaran  Veena Saroji  Resmi Samadarsi  Rengaswamy Sankaranarayanan
Affiliation:1. RTI International, Research Triangle Park, North Carolina, USA;2. Snehita Women's Health Foundation, Trivandrum, Kerala, India

Department of Community Medicine, Sree Gokulam Medical College, Trivandrum, Kerala, India;3. Centre for Preventive Health, Trivandrum, Kerala, India;4. Regional Cancer Center, Trivandrum, Kerala, India;5. Directorate of Health Services, Government of Kerala, India;6. State Health Systems Resource Center (SHSRC), Kerala, India;7. Department of Community Medicine, Sree Gokulam Medical College, Trivandrum, Kerala, India;8. International Agency for Research on Cancer (IARC), Lyon, France

Abstract:PurposeMobile health (mHealth)–based oncology education can be a powerful tool for providing cancer screening knowledge to physicians, as mobile technology is widely available and inexpensive. We developed a mobile application (M‐OncoED) to educate physicians on cancer screening and tested the acceptability, utility, and cost of two different approaches to recruit physicians.MethodsM‐OncoED was designed to perform pre‐ and postlearning assessments through the in‐built quizzes; present case studies and educational materials for cervical, breast, and oral cancer screening; collect responses to interactive queries; document module completion; send reminders and alerts; and track user metrics, including number of sessions to complete each module and time spent per session. We tested two recruitment approaches: a broad‐scale recruitment group, for which we relied on e‐mails, messaging apps (e.g., WhatsApp), and phone calls, and the targeted recruitment group, for which we conducted a face‐to‐face meeting for the initial invitation.ResultsOverall, about 35% of those invited in the targeted group completed the course compared with about 3% in the broad‐based recruitment group. The targeted recruitment approach was more cost‐efficient ($55.33 vs. $109.43 per person). Cervical cancer screening knowledge increased by about 30 percentage points, and breast cancer screening knowledge increased by 10 percentage points. There was no change in knowledge for oral cancer scorings.ConclusionThis study has demonstrated the feasibility and utility of using an mHealth app to educate physicians. A more intensive hands‐on recruitment approach is likely required to engage physicians to download and complete the app. Future studies should assess the impact of mHealth tools on physician behavior and patient outcomes.Implications for PracticeMobile health (mHealth)–based oncology education can be a powerful tool for providing cancer screening knowledge to physicians, as mobile technology is widely available and inexpensive. This study has demonstrated the feasibility and utility of using an mHealth app to educate physicians and illustrates the type of recruitment approach (face‐to‐face) that is likely required to incentivize physicians to download the app and complete the training.
Keywords:Early detection of cancer  Mobile applications  Uterine cervical neoplasms  Breast neoplasms  Feasibility studies
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