CERVICAL CANCER INFORMATION NEEDS OF DISADVANTAGED, RURAL WOMEN IN TAMIL NADU, INDIA: DESIGNING A PATIENT-CENTRED INTERACTIVE VOICESITE ACCESSED VIA MOBILE PHONE

Purpose: Cervical cancer is the most common cause of cancer death in Indian women. Once-only ‘Screen and Treat’ using Visual Inspection with Acetic Acid (VIA) and cryotherapy can reduce mortality by one-third. Some states are implementing such programs but challenges remain to improve women’s cervical cancer literacy. Peer-education programs through women’s self-help groups (SHG) are effective at raising awareness about screening options but peer educators often lacked credibility and women want more informational support. This study explores the informational needs of women with view to developing an interactive audio-site accessed via mobile phones.

Method: Focus group discussions with 62 peer educators and members of SHGs in three villages of the KV Kuppam block, Tamil Nadu. Discussions about barriers and facilitators to screening and women’s information needs were audio-recorded, translated and transcribed from Tamil to English. One foreign and one local researcher independently analysed the data and identified key themes. The VoiceSite design was informed by this data.

Result: Seven core themes were found. 1) Competing priorities were a challenge for some women. 2) Information needs were the greatest barrier to cervical cancer prevention and treatment. 3) Women wanted to make an informed choice, understand the advantages and disadvantages of screening, along with available treatment options.4) Stigma was a major barrier to information-seeking. 5) Most households had at least one mobile phone; audio-information using female voices via mobile phones would provide some anonymity and be acceptable for most women. 6) Women preferred cervical cancer to be discussed in the broader context of women’s health. 7) Most household mobile phones were controlled by husbands and the VoiceSite should be clearly associated with the well-respected local hospital. The VoiceSite design has four sections 1) A story of two villages 2) A dialogue answering ten questions 3) Clinic schedules 4) An opportunity to ‘post’ questions. Uptake, patterns of use and acceptability are being tested in two villages (n=2,000).

Conclusion:  Disadvantaged, rural women want to make informed choices about cervical cancer screening and treatment. Stigma, low literacy and spouse roles are major barriers to information access. A mobile phone delivered VoiceSite is being developed and pilot tested to address these needs.