TY - JOUR
T1 - Cancer as a death sentence
T2 - developing an initial program theory for an IVR intervention
AU - Ilozumba, Onaedo
AU - Kabukye, Johnblack
AU - De Keizer, Nicolet
AU - Cornet, Ronald
AU - Broerse, Jacqueline E.W.
N1 - Funding Information: We thank the Uganda Cancer Institute for their support of the project. Our deep appreciation to members of the research team: Primrose Namubiru and Aroma Rhone for your assistance with participant recruitment and Barbara Nabiryo, Constance Namirembe and Ruth Nakuya for their recruitment, moderation, translation, and transcription expertise. Special thanks to all our participants for their time and valuable contributions. Publisher Copyright: © 2022 The Author(s). Published by Oxford University Press.
PY - 2022/6/1
Y1 - 2022/6/1
N2 - To address current trends in poor health-seeking behaviour and late cancer diagnosis in many low- and middle-income countries, like Uganda, it is important to explore innovative awareness building interventions. One possible intervention is a common digital format, an interactive voice response (IVR) system, which is suitable for individuals with low technological and reading literacy. It is increasingly acknowledged that developing digital interventions requires co-creation with relevant stakeholders and explication of program developers' assumptions, to make them effective, sustainable, and scalable. To this end, we sought to develop an initial program theory for a co-created IVR system for cancer awareness in Uganda. Utilising principles of the realist approach, a qualitative exploratory study was conducted through seven focus group discussions (FGDs) with people living with cancer (PLWC), health workers, and policy makers. Thematic analysis of the transcripts resulted in the emergence of four major themes. Through all themes the most consistent finding was that myths, misconceptions, and misinformation about cancer were related to every aspect of the cancer journey and influenced the experiences and lives of PLWC and their caregivers. Participants were positive about the potential of an IVR system but also had reservations about the design and reach of the system. The resulting initial program theory proposes that a context-specific IVR system has the potential to improve awareness on cancer, provided attention is given to aspects such as language, message framing, and accuracy.
AB - To address current trends in poor health-seeking behaviour and late cancer diagnosis in many low- and middle-income countries, like Uganda, it is important to explore innovative awareness building interventions. One possible intervention is a common digital format, an interactive voice response (IVR) system, which is suitable for individuals with low technological and reading literacy. It is increasingly acknowledged that developing digital interventions requires co-creation with relevant stakeholders and explication of program developers' assumptions, to make them effective, sustainable, and scalable. To this end, we sought to develop an initial program theory for a co-created IVR system for cancer awareness in Uganda. Utilising principles of the realist approach, a qualitative exploratory study was conducted through seven focus group discussions (FGDs) with people living with cancer (PLWC), health workers, and policy makers. Thematic analysis of the transcripts resulted in the emergence of four major themes. Through all themes the most consistent finding was that myths, misconceptions, and misinformation about cancer were related to every aspect of the cancer journey and influenced the experiences and lives of PLWC and their caregivers. Participants were positive about the potential of an IVR system but also had reservations about the design and reach of the system. The resulting initial program theory proposes that a context-specific IVR system has the potential to improve awareness on cancer, provided attention is given to aspects such as language, message framing, and accuracy.
KW - cancer
KW - health promotion
KW - low resource settings
KW - mHealth
KW - participatory research
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U2 - https://doi.org/10.1093/heapro/daac070
DO - https://doi.org/10.1093/heapro/daac070
M3 - Article
C2 - 35913900
SN - 0957-4824
VL - 37
SP - 1
EP - 12
JO - Health promotion international
JF - Health promotion international
IS - 3
M1 - daac070
ER -