Development of S-IMCICA_V.2: A User-Centered Educational and Decision-Support mHealth App for Early Detection of Childhood Cancer.

Early detection of childhood cancer is a key determinant of survival, as diagnostic delays result in advanced disease, higher treatment toxicity, and increased mortality. In low- and middle-income countries (LMICs), limited cancer education and awareness among primary care providers (PCPs) contribute to diagnosis delays, highlighting the need for educational interventions that support clinical decision-making. Mobile health (mHealth) tools offer a promising cancer education strategy; however, few are designed to address learning needs in local contexts. With support from the My Child Matters program and based on the Pan-American Health Organization (PAHO) Integrated Management of Childhood Illness-Cancer (IMCI-Cancer) "traffic-light" risk-stratification framework, we co-developed with PCPs S-IMCICA_V.2 (Sistema de Información para el Manejo Integral del Cáncer Infantil_Versión.2; Information System for Comprehensive Management of Childhood Cancer_Version.2), an mHealth educational and clinical decision support tool aimed at improving detection and referral of childhood cancer in Colombia. Applying user-centered design, we completed three phases: (1) app design and content development based on local educational needs, (2) participatory co-design sessions, and (3) iterative usability testing and prototype production. Seventy-nine stakeholders (37 PCPs, 8 nurses, 14 pediatric oncologists, 20 allied staff) participated. Rapid thematic analysis informed refinements in app content, usability, and functionality. The final high-fidelity prototype was perceived as intuitive and valuable for supporting cancer education and clinical reasoning, reinforcing knowledge and emphasizing timely referrals. Stakeholder input led to improvements in app personalization, navigation, clinical logic checks, educational content and referral guidance. Embedding educational content within mHealth clinical tools may enhance cancer knowledge retention and behavior change in clinical practice. Integrating S-IMCICA_V.2 into an e-learning curriculum and evaluating regional impact are underway.