THE EFFECT OF A VOICE-SITE ON INFORMED CHOICE FOR WOMEN CONSIDERING CERVICAL CANCER SCREENING IN RURAL INDIA: A PHASE II CONTROLLED TRIAL

Wednesday, October 22, 2014
Poster Board # PS4-55

Lyndal Trevena, MBBS, MPH, PhD1, Rita Isaac, PhD2, Ian Olver, MBBS, PhD1, Madelon Finkel, PhD3, Paul Biswajit, MBBS, PhD4 and HR Prashanth, MBBS, PhD4, (1)University of Sydney, Sydney, Australia, (2)Christian Medical College, Vellore, India, Vellore, India, (3)Weil Cornel Medical College, New York, NY, (4)CMC Vellore, Vellore, India
Purpose: Low-tech screening using Visual Inspection with Acetic acid (VIA) and cryotherapy is an effective intervention for reducing the incidence and mortality of cervical cancer in low-resource settings. The implementation of this evidence poses many challenges, including engaging women with low levels of literacy to participate through informed choice. 

Method: 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, information about clinics and the ability to record questions and concerns. An adapted version of the multi-dimensional measure of informed choice 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 phone number was disseminated to one village (A) through women’s self-help groups and posters from October 2013 until March 2014. Useage patterns of the Voicesite were captured and informed choice, involvement preferences and awareness of the Voicesite were measured in a different quasi-random sample of 100 women in each village at the end of the six-month period. 

Result: 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 and 1 is positive) with 6% and 10% women ever-screened in Village A and B respectively. Involvement preferences were significantly different between villages, with particularly 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 late May 2014 and the feasibility of the intervention and potential impact on informed choice will be assessed. 

Conclusion: Women in these two villages had very low levels of informed participation in cervical cancer screening at baseline. A Voicesite delivered via mobile phones was accessed by a substantial proportion of the population. An adapted measure of the multi-dimesnional measure of informed choice was feasible to deliver via a door-to-door survey. Our results will be used to inform the design of a phase 3 efficacy trial of this novel intervention on informed choice in a low-resource setting.