Pragmatic Mobile Health Trial to Promote Cancer Screening and Healthy Behaviors

Overview

Cancer is the leading cause of death in Singapore, but many people who are eligible for breast, cervical, and colorectal cancer screening do not get screened on time. Many adults also have chronic health conditions such as high blood pressure, diabetes, high cholesterol, and obesity, which can often be reduced through healthier lifestyle habits. Although reminders for screening are available, they may not be enough to encourage long-term healthy behaviours. This study will evaluate whether regular health messages delivered through a mobile health (mHealth) platform can help improve cancer screening participation and promote healthier lifestyles among Singaporean women aged 50-69 years. Participants will be randomly assigned to one of two groups. The control group will receive standard cancer screening reminders every six months. The intervention group will receive monthly evidence-based health messages, including information on cancer screening, healthy eating, physical activity, and other healthy lifestyle behaviours, delivered through the NUHS App (or a similar mobile platform) or SMS. The study will compare whether more frequent and engaging health messages lead to higher participation in recommended cancer screening, greater engagement with the digital platform, and healthier lifestyle behaviours compared with standard reminders. The findings may help identify an effective and scalable digital approach to support cancer prevention and healthy ageing across Singapore.

Cancer remains the leading cause of death in Singapore despite the availability of national screening programmes for breast, cervical, and colorectal cancers. Participation in recommended cancer screening remains below desired levels, while chronic diseases associated with unhealthy lifestyle behaviours continue to increase. Existing approaches to promoting preventive health often rely on infrequent reminders and may be insufficient to support sustained behavioural change. Singapore's widespread use of smartphones and digital health platforms provides an opportunity to deliver scalable mobile health (mHealth) interventions. This pragmatic randomized trial will evaluate whether regular delivery of evidence-based health messages through the NUHS App (or a similar mobile platform) or SMS can improve participation in recommended cancer screening and promote healthier lifestyle behaviours among Singaporean women aged 50-69 years. Participants will receive either standard screening reminders or a more intensive programme of health messages covering cancer screening, healthy diet, physical activity, weight management, and other preventive health topics. The study will evaluate whether a sustained digital engagement strategy is more effective than standard reminders in encouraging long-term health behaviour change. Because the intervention is delivered using existing healthcare digital infrastructure, the findings will inform whether this approach can be implemented at scale to improve cancer prevention and support healthy ageing in Singapore.