Cancer as a death sentence: developing an initial program theory for an IVR intervention

Area of Science:

• Public Health
• Health Communication
• Digital Health Interventions

Background:

• Low- and middle-income countries face challenges with late cancer diagnosis due to poor health-seeking behaviors.
• Interactive Voice Response (IVR) systems offer a scalable digital intervention for populations with low literacy.
• Co-creation and stakeholder involvement are crucial for effective and sustainable digital health programs.

Purpose of the Study:

• To develop an initial program theory for a co-created IVR system aimed at enhancing cancer awareness in Uganda.
• To explore the potential and challenges of using IVR technology for cancer education in a resource-limited setting.

Main Methods:

• Qualitative exploratory study employing seven focus group discussions (FGDs).
• Participants included people living with cancer (PLWC), healthcare workers, and policymakers in Uganda.
• Thematic analysis was used to analyze FGD transcripts.

Main Results:

• Myths, misconceptions, and misinformation surrounding cancer were pervasive, affecting all aspects of the cancer journey for PLWC and their caregivers.
• Participants recognized the potential benefits of an IVR system for cancer awareness.
• Concerns were raised regarding the system's design, accessibility, and reach.

Conclusions:

• A context-specific IVR system can potentially improve cancer awareness in Uganda.
• Successful implementation hinges on careful consideration of language, message framing, accuracy, and user engagement.
• Addressing myths and misconceptions is key to improving health-seeking behaviors and cancer outcomes.