Ramin Asgary1, Philip Baba Adongo, Adanna Nwameme, Helen V S Cole, Ernest Maya, Mengling Liu, Karen Yeates, Richard Adanu, Olugbenga Ogedegbe. 1. 1Departments of Medicine and Population Health, NYU School of Medicine, New York, NY; 2Department of Social and Behavioral Sciences, University of Ghana School of Public Health, Legon, Ghana; 3Doctorate Program in Public Health, CUNY Graduate Center and CUNY School of Public Health, New York, NY; 4Population, Family and Reproductive Health Department, University of Ghana School of Public Health, Accra, Ghana; 5Division of Biostatistics, Department of Population Health, NYU School of Medicine, New York, NY; and 6Department of Medicine, Queen's University, Kingston, Ontario, Canada.
Abstract
OBJECTIVE: There is a shortage of trained health care personnel for cervical cancer screening in low-/middle-income countries. We evaluated the feasibility and limited efficacy of a smartphone-based training of community health nurses in visual inspection of the cervix under acetic acid (VIA). MATERIALS AND METHODS: During April to July 2015 in urban Ghana, we designed and developed a study to determine the feasibility and efficacy of an mHealth-supported training of community health nurses (CHNs, n = 15) to perform VIA and to use smartphone images to obtain expert feedback on their diagnoses within 24 hours and to improve VIA skills retention. The CHNs completed a 2-week on-site introductory training in VIA performance and interpretation, followed by an ongoing 3-month text messaging-supported VIA training by an expert VIA reviewer. RESULTS: Community health nurses screened 169 women at their respective community health centers while receiving real-time feedback from the reviewer. The total agreement rate between all VIA diagnoses made by all CHNs and the expert reviewer was 95%. The mean (SD) rate of agreement between each CHN and the expert reviewer was 89.6% (12.8%). The agreement rates for positive and negative cases were 61.5% and 98.0%, respectively. Cohen κ statistic was 0.67 (95% CI = 0.45-0.88). Around 7.7% of women tested VIA positive and received cryotherapy or further services. CONCLUSIONS: Our findings demonstrate the feasibility and efficacy of mHealth-supported VIA training of CHNs and have the potential to improve cervical cancer screening coverage in Ghana.
OBJECTIVE: There is a shortage of trained health care personnel for cervical cancer screening in low-/middle-income countries. We evaluated the feasibility and limited efficacy of a smartphone-based training of community health nurses in visual inspection of the cervix under acetic acid (VIA). MATERIALS AND METHODS: During April to July 2015 in urban Ghana, we designed and developed a study to determine the feasibility and efficacy of an mHealth-supported training of community health nurses (CHNs, n = 15) to perform VIA and to use smartphone images to obtain expert feedback on their diagnoses within 24 hours and to improve VIA skills retention. The CHNs completed a 2-week on-site introductory training in VIA performance and interpretation, followed by an ongoing 3-month text messaging-supported VIA training by an expert VIA reviewer. RESULTS: Community health nurses screened 169 women at their respective community health centers while receiving real-time feedback from the reviewer. The total agreement rate between all VIA diagnoses made by all CHNs and the expert reviewer was 95%. The mean (SD) rate of agreement between each CHN and the expert reviewer was 89.6% (12.8%). The agreement rates for positive and negative cases were 61.5% and 98.0%, respectively. Cohen κ statistic was 0.67 (95% CI = 0.45-0.88). Around 7.7% of women tested VIA positive and received cryotherapy or further services. CONCLUSIONS: Our findings demonstrate the feasibility and efficacy of mHealth-supported VIA training of CHNs and have the potential to improve cervical cancer screening coverage in Ghana.
Authors: S Bomfim-Hyppólito; E Santana Franco; R Gomes de Matos Meneses Franco; C Matos de Albuquerque; G C Nunes Journal: Int J Gynaecol Obstet Date: 2005-11-02 Impact factor: 3.561
Authors: Mulindi H Mwanahamuntu; Vikrant V Sahasrabuddhe; Sharon Kapambwe; Krista S Pfaendler; Carla Chibwesha; Gracilia Mkumba; Victor Mudenda; Michael L Hicks; Sten H Vermund; Jeffrey S A Stringer; Groesbeck P Parham Journal: PLoS Med Date: 2011-05-17 Impact factor: 11.069
Authors: Lauren G Johnson; Doreen Ramogola-Masire; Anne M Teitelman; John B Jemmott; Alison M Buttenheim Journal: Cancer Prev Res (Phila) Date: 2019-12-18
Authors: Ayomide Owoyemi; Joanne I Osuchukwu; Clark Azubuike; Ronald Kelechi Ikpe; Blessing C Nwachukwu; Cassandra B Akinde; Grace W Biokoro; Abisoye B Ajose; Ezechukwu Ikenna Nwokoma; Nehemiah E Mfon; Temitope O Benson; Anthony Ehimare; Daniel Irowa-Omoregie; Seun Olaniran Journal: Front Digit Health Date: 2022-06-03
Authors: Lauren G Johnson; Allison Armstrong; Caroline M Joyce; Anne M Teitelman; Alison M Buttenheim Journal: Implement Sci Date: 2018-02-09 Impact factor: 7.327
Authors: Molly Lieber; Omara Afzal; Kathryn Shaia; Adrienne Mandelberger; Christine Du Preez; Ann Marie Beddoe Journal: Ann Glob Health Date: 2019-04-15 Impact factor: 2.462
Authors: Ramin Asgary; Helen Cole; Philip Adongo; Ada Nwameme; Ernest Maya; Amanda Adu-Amankwah; Hannah Barnett; Richard Adanu Journal: BMJ Open Date: 2019-07-16 Impact factor: 2.692