In the R21 phase of this project, investigators will: (1) work with key stakeholders and local and international developers to finalize the mSaada platform, building on the existing prototype to add patient and specimen tracking functionality; and (2) carry out a pilot to identify the patient, provider and health system factors necessary to design a trial to evaluate mSaada effectiveness in assisting community health volunteer-led home-based HPV screening, and implementation factors. Investigators will carry out a six-month pilot of mSaada with community units in two health facilities providing HPV-based screening, and use performance metrics including system usage rates, workflow observations and qualitative data to guide the planning of a to determine effectiveness. In the R33 phase of the project, investigators plan to: (1) conduct an 18-month c-RCT across 12 health facilities to determine the impact of mSaada on cervical cancer screening uptake, treatment acquisition and cervical cancer knowledge levels among women in the community; and (2) measure the requisite implementation factors for mSaada effectiveness, sustainability, and scale-up. The rigorous study design will allow us to determine the clinical impact of mSaada, ensure the local and regional infrastructure has the capacity necessary for sustainability and develop strategies for widespread implementation and scale-up. Collaboration with key stakeholders from the Kenya Ministry of Health will facilitate the development of a long-term sustainability plan as the country moves toward HPV-based cervical cancer screening. Investigators anticipate the mSaada platform will play a pivotal role in facilitating the introduction of HPV-based screening programs that can reach women in settings with limited health care infrastructure.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Masking
NONE
Enrollment
6,000
mSaada is an integrated digital platform to support patients, community health volunteers (CHVs), providers and health systems in an HPV-based cervical cancer screening strategy. mSaada is hosted on an open-source platform (Dimagi, CommCare) as a mobile health application to support patient data collection, protocol support and counseling aids. mSaada will include an education module, patient and specimen tracking, screening reminders, and messaging functionality.
Kenya Medical Research Institute
Kisumu, Kenya
RECRUITINGNumber of Community Health Volunteers (CHVs) reporting a usability score greater than 60
mSaada Usability Survey with a range of 20-100, where a higher score indicates a higher level of acceptability (mean scores \>60 is considered acceptable).
Time frame: 1-day
Proportion of women in each arm who complete cervical cancer screening
Calculated by dividing the number of women screened by the number of eligible women attending health facilities
Time frame: 1-day
Proportion of women in each arm who test HPV-positive and access treatment within 3 months of receiving their results
Calculated the number of women treated within 3 months of receiving their results by dividing the number of women who test HPV positive
Time frame: 1-day
Difference in women's knowledge level of cervical cancer as measured by a knowledge scale between the arms
The knowledge scale has a score range of 0 to 5, where a higher score indicates a higher level of knowledge.
Time frame: 1-day
Difference in women risk perception of cervical cancer as measured by a risk perception scale between the arms
The Risk Perception Scale has 3 Likert scale questions regarding risk perception.
Time frame: 1-day
Difference in Community Health Promoter (CHP) screening self-efficacy, knowledge, usability between the arms
Quantitative self-efficacy, knowledge and usability survey with CHPs after participating in the study..
Time frame: 1-day
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