Informing mobile health strategies: Study of mobile phone ownership among rural women for breast cancer control in Ghana
Adwoa Bemah Boamah Mensah, Kofi Boamah Mensah, Anita Eseenam Agbeko, Aliyu Mohammed, Joshua Okyere, Collins Dodd, Keith Horvath, Beth Virnig, Joe-Nat Clegg-Lamptey, Shalini KulasingamBackground
Breast cancer (BC) screening uptake remains low among women in rural Ghana because of structural and informational barriers. Understanding mobile phone ownership, use, and willingness to receive short message service (SMS) messages is essential for designing SMS-based mobile health interventions to improve BC awareness and uptake of clinical breast examinations.
Objective
To examine mobile phone ownership, usage patterns, and willingness to receive SMS-based BC information among women in rural Ghana to inform the development of a future SMS-based mobile health intervention.
Methods
We analyzed data from 708 women aged ≥25 years who participated in a community-based cross-sectional survey conducted in 14 rural communities in the Ashanti Region of Ghana. Descriptive statistics, chi-square tests, and Firth’s penalized logistic regression were performed.
Results
Mobile phone ownership was high (98.2%), and most women stated the willing to receive SMS messages about BC (93.9%) and clinical breast examination appointments (93.8%). Respondents who anticipated an early (same-day) response to messages had 13.91 times higher odds of being willing to receive text messages about breast cancer and screening (AOR = 13.91; 95%CI: 6.11, 31.65; p < 0.001) and 9.58 times higher odds of being willing to receive reminders for setting up CBE appointments (AOR = 9.58; 95%CI: 4.44, 20.66; p < 0.001) compared to late responders. Additionally, being comfortable with reading and receiving SMS was significantly associated with a willingness to receive general breast cancer texts (AOR = 10.93; 95%CI: 1.01, 117.70; p = 0.049).
Conclusion
High mobile phone ownership and willingness to receive SMS messages suggest that SMS-based mobile health interventions may be a feasible strategy for promoting BC awareness and clinical breast examination in rural Ghana. The cross-sectional design assessed stated willingness rather than actual use of an SMS-based intervention and does not permit causal inference.