Reducing Cervical Cancer Health Disparities among African American Women An mHealth Approach to Improving Prevention and Treatment Outcomes

African American women in the United States continue to be disproportionately burdened by cervical cancer The incidence rate is higher in black women than white women Black women are also twice as likely to die from the disease The year survival rate is for black women It is for white women And yet it does not have to be this way A multifaceted preventive approach could potentially eliminate all new cases There are a number of challenges however to implementing this preventive approach among African American women Only of black female adolescents have completed the dose HPV vaccination series Due to this suboptimal vaccination coverage promotion of safer sexual practices is another key HPV prevention tool For men increasing male latex condom use is a behavior For women it is a goal Therefore attempts to increase condom use for women must include condom negotiation and problem solving skills training Finally cervical cancer is one of the few cancers where widespread screening and proper follow up can eliminate most new cases However the time to diagnostic resolution and treatment initiation is slowest among African American women To combat this community health workers CHWs and patient navigators PNs aim to improve patient outcomes across the cancer care continuum Both have been shown to be effective The ongoing challenge is to reduce the cost of CHW PN services while tailoring them to the particular groups most in need One emerging cost effective solution is the use of mobile technology To our knowledge no mobile intervention has been developed to reduce cervical cancer health disparities among African American women We intend to fill this void Our proposed program will aim to increase HPV vaccination coverage promote safer sexual practices increase cervical cytology and improve follow up to abnormal Pap results It will be theory based targeted tailored and personalized The Health Belief Model will guide the development of an assessment of preventive barriers Users will receive three types of texts reminders for screenings and follow ups educational and supportive messages Finally the program will include three web based video components scripted vignettes unscripted peer narratives and educational instruction By developing an intervention using a technology that is part of the everyday lives of the overwhelming majority of African American women the aim is to reduce cervical cancer disparities Eight healthcare staff members will be recruited for a focus group discussion to help shape the proposed intervention Similarly African American women will be recruited for predevelopment focus group discussions When the prototype is completed the target end users will return for usability testing The usability test will include a series of tasks intended to highlight the different features of the proposed intervention Three usability metrics will be assessed efficiency accuracy and subjective satisfaction This project aims to develop a mobile phone based program designed to eliminate cervical cancer disparities among African American women In clinics without established patient navigation services the proposed intervention could be used as a stand alone product Alternatively it could be integrated into existing cancer related patient navigation to further augment these services For African American women the skills contained in this program will help them prevent cervical cancer