Activation in Cancer Survivorship in Kenya: Results of a Cluster-Randomized Trial
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Date
2024-07
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Journal of Clinical Nursing & Reports
Abstract
Introduction: Kenya’s cancer situation, as in the rest of the developing world, is marred by treatment access deficiencies arising from multiple foci in the continuum of health care that make survival difficult. These challenges, stemming from patient, service, and service provider points of view, place the patient at an increasing need for continuous
support through the survivorship. This study, aimed at improving the patient’s knowledge, skills, and confidence in
self-care; and has been conceptualized as activation. Data on patient activation have demonstrated the positive influence of activation on different survivorship outcomes, including symptom management, adherence, and improved
quality of life. In Kenya, there is a dearth of data on the utility of SMS interventions to shape patient activation, particularly for cancer.
Methods: This multisite study evaluated the effectiveness of mobile phone SMS support on patient activation among
adult cancer patients in Kenya. Specifically, the study sought to determine the influence of individual factors and the
intervention on patient activation. Data were collected using questionnaires. Ethical approval was obtained from the
Kenyatta University Ethics Review Committee and various Hospital Ethics Review Boards. A permit to conduct the
study was obtained from the National Commission for Science, Technology, and Innovation (NACOSTI), while consent was obtained from individual participants. A DSMB was formed to address any SAE of the study.
Results: The mean age of the participants was 52.9 ±12.9 years. Most of the participants reported delayed initiation
of cancer treatment. Furthermore, the majority, 56.9% (n = 230), of the participants were activated in care. The majority of 95.7% (n-=220) of those activated in care were in the intervention arm and this was statistically significant
(χ²dd = 326.550, p=<0.001).
Conclusions: the SMS support intervention has shown superiority in influencing patient activation and several demographic factors have a significant influence on patient activation. There is a need to redesign the initiation of cancer
treatment to prevent delayed initiation of treatment.
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Citation
Nebert, K. Mchidi, John P. Oyore, and Gordon Ogweno. "Activation in Cancer Survivorship in Kenya: Results of A Cluster-Randomized Trial." J Clin Nur Rep 3 (3), 01 7 (2024).