Remote Resilience: Novel Applications of mHealth in Nicaragua's Cancer Control Program

PROJECT SUMMARY / ABSTRACT Cervical cancer, though preventable, remains a significant cause of cancer mortality in the US. The World Health Organization (WHO) adopted an elimination strategy for cervical cancer within the next 100 years, and outlined specific targets to meet by 2030: vaccination (90% of girls before age 15); screening/early detection (70% of women get a high-quality screen by 35 and again at 45); and treatment (90% of pre-cancerous and cancerous lesions treated). Significant research into the development, implementation, and cost-effectiveness of community-based cervical cancer screening models using HPV primary screening has developed a strong evidence-base for the acceptability and feasibility of this modality. However, cervical cancer incidence and mortality continue. There is a demonstrated need for locally relevant innovations in evidence-based HPV primary cervical screening programs to improve outcomes. Based on the University of Virginia Comprehensive Cancer Center’s long history of community collaboration, outreach, and navigation, researchers have identified the unique role mHealth (mobile health) interventions may play in improving health outcomes when integrated into an HPV primary screening program. Innovations presented herein include the development and adaptation of a mHealth platform that combines a patient-centered mobile application (app) with a provider-focused portal. Through developing this regionally relevant mHealth intervention for under-screened participants and healthcare providers (year 4) and then pilot testing the impact of this intervention when integrated into a community-based HPV-based primary cervical cancer screening program (year 5), this study will provide important evidence relative to the potential for novel mHealth interventions to improve cervical cancer screening follow-up and treatment.