Advancing Breast Cancer Screening Uptake, Knowledge and Attitude through Mobile Phone Text Messaging among Women in Homa Bay County, Kenya
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Date
2024-02
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Kenyatta University
Abstract
Breast cancer is responsible for many deaths globally, especially in poor countries like Kenya. This is attributed to inadequate screening services, low knowledge on breast cancer among women besides poor access to advanced and early treatment. The problem worsens in rural areas where most people dwell. Mobile health (m-health) can improve screening and has revolutionized health sector by increasing drug adherence and clinical patient management. The purpose of this research was to investigate the possibility of improving breast cancer knowledge, attitude and screening among women in Homa Bay County, Kenya through education given using mobile phone-based text messaging service. This was a quasi-experimental design using a sample size of 340 women with intervention arm and control arm each having 170 participants. Questionnaires were used to collect both baseline and end line data among women. Ten key informant interviews were also done. Descriptive and inferential statistics were used to analyze quantitative data. Qualitative data were categorized and analyzed thematically. Test difference between baseline and end line was done using independent t test. Chi square test was applied in testing association for categorical variables. Statistical significance was set at p value less < 0.05. Predictors of breast cancer was estblished using logistic regression analysis. The result was presented in tables and charts. The results revealed low breast cancer screening amongst women in Homa Bay County with 9.7% and 9.6 % of women having gone for BC screening in the intervention and control control respectively. At end line, the screening levels were 32.3% and 19.9 % in the intervention and control respectively. There was an increase in knowledge on breast cancer and breast cancer screening after the intervention with an attributable percentage of 12.4 %. The knowledge levels tested insignificant indicating that knowledge levels were not adequate at both baseline and end line (t=0.5925 df = 8, p value= 0.5699 and (t = 0.2849, df = 8, p value= 0.7829). Significant barriers to breast cancer screening were knowledge (t=5.503, df 571, p =0.000), distance to screening facilities (t=1.908, df 564, p=0.047), and screening cost (t=0.035 df 565, p=0.050). Furthermore, there was a significant change in knowledge towards breast cancer and breast cancer screening (M = 44.4, SD = 16.1) and after (M = 50.1, SD = 15), t (17) = 6, p < 0.001). there was no significance influence on mobile based education on the altitude of women towards breast cancer screening. Sociodemographic factors related to breast cancer screening at the baseline was religious affiliation (2 =9.651, p =0.048). A multiple logistic regression revealed those who take alcohol were more likely to go for screening of breast cancer (OR =2.909, P value =0.016, β=1.068) and having a family member ever diagnosed with cancer (OR =1.950, P value =0.017). The results of this study can inform public health practitioners on the possibility of using mobile health text messaging service as an education tool on breast cancer for increased knowledge and screening. This can be adopted by policy makers in cancer education, control and management.
Description
A Research Thesis Submitted for the Degree of Doctor of Philosophy in Public Health (Epidemiology and Disease Control) in the School of Health Sciences of Kenyatta University February 2024
Supervisors:
1. John Paul Oyore
2. Bonaventure Michael Okello Agina