Informing mobile health strategies: Study of mobile phone ownership among rural women for breast cancer control in Ghana.

BACKGROUND

Breast cancer (BC) screening uptake remains low among women in rural Ghana because of structural and informational barriers. Understanding mobile phone ownership, use, and willingness to receive short message service (SMS) messages is essential for designing SMS-based mobile health interventions to improve BC awareness and uptake of clinical breast examinations.

OBJECTIVE

To examine mobile phone ownership, usage patterns, and willingness to receive SMS-based BC information among women in rural Ghana to inform the development of a future SMS-based mobile health intervention.

METHODS

We analyzed data from 708 women aged ≥25 years who participated in a community-based cross-sectional survey conducted in 14 rural communities in the Ashanti Region of Ghana. Descriptive statistics, chi-square tests, and Firth's penalized logistic regression were performed.

RESULTS

Mobile phone ownership was high (98.2%), and most women stated the willing to receive SMS messages about BC (93.9%) and clinical breast examination appointments (93.8%). Respondents who anticipated an early (same-day) response to messages had 13.91 times higher odds of being willing to receive text messages about breast cancer and screening (AOR = 13.91; 95%CI: 6.11, 31.65; p < 0.001) and 9.58 times higher odds of being willing to receive reminders for setting up CBE appointments (AOR = 9.58; 95%CI: 4.44, 20.66; p < 0.001) compared to late responders. Additionally, being comfortable with reading and receiving SMS was significantly associated with a willingness to receive general breast cancer texts (AOR = 10.93; 95%CI: 1.01, 117.70; p = 0.049).

CONCLUSION

High mobile phone ownership and willingness to receive SMS messages suggest that SMS-based mobile health interventions may be a feasible strategy for promoting BC awareness and clinical breast examination in rural Ghana. The cross-sectional design assessed stated willingness rather than actual use of an SMS-based intervention and does not permit causal inference.