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  1. Home
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  4. The Development and Evaluation of A Mhealth, Community Education and Navigation Intervention to Improve Clinical Breast Examination Uptake in Segamat Malaysia: A Randomised Controlled Trial
 
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The Development and Evaluation of A Mhealth, Community Education and Navigation Intervention to Improve Clinical Breast Examination Uptake in Segamat Malaysia: A Randomised Controlled Trial

Journal
Plos One
Date Issued
2023
Author(s)
De´sire´e Schlieman
Aminatul Saadiah Abdul Jamil
Devi Mohan
Min Min Tan
Christopher R. Cardwell
Roshidi Ismail
Nur Aishah Taib
Tin Tin Su
Michael Donnelly
DOI
10.1371/journal.pone.0288437
Abstract
Introduction
Breast cancer (BC) screening uptake in Malaysia is low and a high number of cases present at a late stage. Community navigation and mobile health (mHealth) may increase screening attendance, particularly by women from rural communities. This randomized controlled study evaluated an intervention that used mHealth and community health workers to educate women about BC screening and navigate them to clinical breast examination (CBE) services in the context of the COVID-19 pandemic.

Methods
Women aged 40–74 years, from Segamat, Malaysia, with a mobile phone number, who participated in the South East Asian Community Observatory health survey, (2018) were randomized to an intervention (IG) or comparison group (CG). The IG received a multi-component mHealth intervention, i.e. information about BC was provided through a website, and telephone calls and text messages from community health workers (CHWs) were used to raise BC awareness and navigate women to CBE services. The CG received no intervention other than the usual option to access opportunistic screening. Regression analyses were conducted to investigate between-group differences over time in uptake of screening and variable influences on CBE screening participation.

Results
We recruited 483 women in total; 122/225 from the IG and 144/258 from the CG completed the baseline and follow-up survey. Uptake of CBE by the IG was 45.8% (103/225) whilst 3.5% (5/144) of women from the CG who completed the follow-up survey reported that they attended a CBE during the study period (adjusted OR 37.21, 95% CI 14.13; 98.00, p<0.001). All IG women with a positive CBE attended a follow-up mammogram (11/11). Attendance by IG women was lower among women with a household income ≥RM 4,850 (adjusted OR 0.48, 95% CI 0.20; 0.95, p = 0.038) compared to participants with a household income <RM 4,850.

Conclusion
The results suggested that the bespoke multicomponent mHealth intervention may be used to address the significant public health problem of low uptake of BC screening in rural Malaysia.
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