Mobile Phone Text Messaging Intervention for Cervical Cancer Screening

Background: Cervical cancer poses a significant threat to Korean American women, who report one of the highest cervical cancer mortality rates in the United States. Incidence and mortality rates of Korean American women due to this disease are roughly twice those of non-Latino white women. Low cervical cancer screening rates likely contribute to this pronounced disparity. Studies consistently report Korean American women having the lowest Pap test screening rates of women across U.S. ethnic groups. To respond to the urgent need to promote cervical cancer screening in this population, this study developed and tested a text message-based 7-day mScreening intervention aimed to promote Pap tests and HPV vaccinations for young Korean American women. To date, no study has evaluated whether cervical cancer screening can be motivated through daily Short Message Services and Multimedia Message Service messages transmitted through mobile phones. Objective: This study aimed to develop and assess the acceptability and feasibility of implementing a one week mScreening intervention program in promoting cervical cancer screening and to assess if the mScreening intervention increases knowledge on cervical cancer screening, intent to receive screening, and promoting a Pap test and HPV vaccine over the sample’s baseline rate. Methods: The procedure of developing mScreening was guided by the Fogg Behavior Model and consisted of three parts: (1) identifying barriers, (2) developing motivators, and (3) providing triggers. We tailored each participant’s messages and delivered them to 30 Korean American women for about 20-30 minutes each day over one week at participants’ preferred time. We used a community based participatory research approach to integrate voices from the leaders, health care professionals, and community members in developing and delivering the intervention. A quasi-experimental research design was used with pre-post-and-follow-up testing. Results: Findings revealed a significant increase in participants’ knowledge on cervical cancer, cervical cancer screening, and HPV vaccination and intent to undergo screening over time. It also reported mScreening participants had a total of a 53% increase in receiving a Pap test (23.3%) or HPV vaccine (30%) over the sample’s baseline rate. About 97% of the participants expressed satisfaction about the intervention and 97.3% of them wanted to recommend mScreening program to their friends, indicating excellent acceptability and feasibility of the intervention. Conclusion: Mobile technology can be a promising tool to increase both knowledge and receipt of cervical cancer screening. This study provides evidence on the feasibility and satisfaction of the mScreening intervention. Given the widespread use of mobile phones among young adults, a mobile phone–based health intervention could be a low cost and effective method of reaching hard-to-reach populations with tailored individual messages that cover broad content areas and overcome restrictions to place and time of delivery. Our developed model could be expanded to different age groups of Korean American women, additional types of cancer screening (such as colonoscopy or mammogram), and other underserved minority groups. The low cost and broad reach of delivering the intervention using mobile phone technology could be a valuable health promotion resource for managed care organizations. []