Pragmatic Mobile Health Trial to Promote Cancer Screening and Healthy Behaviors

Condition(s) studied

Investigational drug(s) / intervention(s)

Intensive Engagement: Participants will receive the standard bi-annual health messages as in Arm 1, supplemented with additional monthly messages through PN via the app OR via SMS, that provide comprehensive information on general population cancer screening guidelines, healthy lifestyle practices, motivational health messages, video links, and details about relevant events over a period of 12 months. In addition to the monthly messages, participants will be invited to attend up to 12 webinars (on women's health/screening/nutrition/lifestyle related topics) and 12 in-person or virtual group events (like simple low-intensity exercise/ walking/ basic yoga/ tai chi/nutritional cooking etc.) over 12 months. Interested participants may also be asked to join a moderated chatgroup (using Telegram app). The chatgroup is intended to promote peer support and healthy habit building.

Standard Engagement: Participants receive two standard health messages through PN via the NUHS app or similar platforms OR via SMS - one at recruitment and a subsequent reminder message after 6 months. The content will include general population cancer screening guidelines (breast, colorectal, and cervical cancers) and information pertaining to healthy lifestyle practices (including maintaining a healthy BMI, balanced diet, and sufficient exercise).

Study summary

Cancer is the leading cause of death in Singapore, but many people who are eligible for breast, cervical, and colorectal cancer screening do not get screened on time. Many adults also have chronic health conditions such as high blood pressure, diabetes, high cholesterol, and obesity, which can often be reduced through healthier lifestyle habits. Although reminders for screening are available, they may not be enough to encourage long-term healthy behaviours.

This study will evaluate whether regular health messages delivered through a mobile health (mHealth) platform can help improve cancer screening participation and promote healthier lifestyles among Singaporean women aged 50-69 years. Participants will be randomly assigned to one of two groups. The control group will receive standard cancer screening reminders every six months. The intervention group will receive monthly evidence-based health messages, including information on cancer screening, healthy eating, physical activity, and other healthy lifestyle behaviours, delivered through the NUHS App (or a similar mobile platform) or SMS.

The study will compare whether more frequent and engaging health messages lead to higher participation in recommended cancer screening, greater engagement with the digital platform, and healthier lifestyle behaviours compared with standard reminders. The findings may help identify an effective and scalable digital approach to support cancer prevention and healthy ageing across Singapore.

Eligibility

Primary outcome measure(s)

• Comparison of Screen-Adherent Participants Between Arm 1 and Arm 2 — 24 months post-intervention
  Proportion of screen-adherent participants (in %) in Arm-2 versus Arm-1 at 24 months. Non-adherence at baseline is defined as not being fully adherent to screening guidelines for all three cancers (with cervical cancer screening excluded for those not sexually active). Adherence following the intervention is defined as showing at least one improvement in adherence (e.g., previously adherent to only cervical cancer screening, with subsequent adherence to colorectal cancer screening).

Trial sites (1)

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