Assessing the impact of a mHealth intervention (BreMo) on knowledge of breast cancer and breast self-examination (BSE) and evaluating the user experience among nurses in Nepal (Preprint)

BACKGROUND Mobile health (mHealth) applications represent a promising tool to bridge the healthcare gaps by enhancing knowledge and facilitating early detection practices like breast self-examination (BSE). OBJECTIVE This study aimed to evaluate the effectiveness and usability of BreMo in increasing breast cancer knowledge and practice of BSE among nurses in Nepal. METHODS We conducted a quasi-experimental study involving 92 nurses at Nepalgunj Medical College, utilizing the BreMo application over a three-month period. Pre- and post-intervention assessments were conducted to measure changes in knowledge and usability, employing the use of a self-administered BCAMAQ questionnaire. Change in mean knowledge scores and shift in first quantile of scores, Q1 after the intervention were evaluated. Using the Likert scale, BreMo’s user experience was also assessed in terms of usability, content, privacy, acceptability and satisfaction. RESULTS We found a significant increase in mean knowledge score (shift from 20.86 to 21.72, p<0.001) of participants between pre-intervention and post-intervention phases. Similarly, a significant shift in first quartile (Q1) mean knowledge score (shift from 20.68 to 21.52, p<0.001) was observed between pre- intervention and post-intervention phases. Highest scores were obtained in BSE knowledge (9.1% increase) and practice (14.3% increase). BreMo was rated highly (more than 90% rated at higher than 4, out of 7) in all categories: usability, privacy, content clarity, acceptability and satisfaction except privacy where 51% participants were found to be unsure. CONCLUSIONS We showed the valuable potential of mHealth application to enhance breast cancer knowledge and BSE practices among nurses in Nepal given that women are educated enough to read and use the application. The higher usability ratings of the application underscore its feasibility as a health education tool.