Visual Inspection with Acetic acid (VIA) and cryotherapy is effective for cervical cancer screening in low-resource settings. Its implementation poses many challenges, including engaging women with low levels of literacy to participate through informed choice.
To assess the feasibility of a mobile phone-delivered VoiceSite to increase informed choice
Two villages in KV Kuppam block, Tamil Nadu, India were selected for a non-randomised controlled trial of a Voice site, providing pre-recorded information about cervical cancer, patient stories, clinic information and the ability to record questions and concerns. An adapted version of the multi-dimensional measure of informed choice (MMIC) and a modified scale of involvement preferences was administered at baseline via a quasi-random door-to-door community survey to 100 women in each village. The Voicesite number was disseminated to village (A) through women’s self-help groups and posters from October 2013 until March 2014. Useage patterns of the Voicesite, informed choice, involvement preferences and awareness of the Voicesite were measured at the end of the six-month period.
At baseline, mean age was 38 and 36 years; mean knowledge was 4.0 and 4.7 (out of 16 maximum); mean attitude 4.8 and 4.7 (where 7 is negative attitude) with 6% and 10% women ever-screened in Village A and B respectively. Involvement preferences were significantly different between villages, with strong perceived roles for husbands in decision-making. Approximately 25% eligible women accessed the Voicesite over the six-month period. The post-intervention survey data collection will be completed by June 2014.
Women had very low levels of informed participation in cervical cancer screening at baseline. The Voicesite was accessed by a substantial proportion of women. An adapted measure of the MMIC was feasible via a door-to-door survey. Our results will inform the design of a phase 3 efficacy trial of the Voicesite on informed choice in ow-resource settings.