Reducing Urban Cervical Cancer Disparities Using a Tailored Mobile Health Intervention to Improve Colposcopy Attendance in Underserved Women

What this Trial Is About

Researchers are evaluating the Health Enhancement Resource System (HERS), a mobile health intervention designed to improve follow-up attendance after abnormal cervical cancer screening results among urban, underserved women. The study targets women referred for colposcopy after abnormal cervical tests and aims to address the persistent disparities in cervical cancer mortality by increasing attendance at follow-up appointments. This hybrid Type 1 effectiveness-implementation trial adapts a prior telephone counseling intervention to a text message-based system combined with optional health coaching. Participants are randomized to receive either Standard of Care or the HERS intervention, which includes text message appointment reminders and barrier counseling. Women who miss their appointments may receive supplemental telephone health coaching calls. The study uses a sequential, multiple assignment, randomized trial (SMART) design over multiple stages, including baseline colposcopy and a 12-month follow-up appointment, with interventions adjusted based on attendance. Text messages and coaching calls are scheduled flexibly, and participants receive barriers assessments via text or online surveys depending on their group. Participants complete surveys at baseline and one week after appointments, with barriers assessments and qualitative interviews conducted with both patients and providers. The primary outcome is attendance at the baseline colposcopy appointment within three months. The study takes place at three urban clinic sites serving predominantly low-income, minority women and includes ongoing monitoring through the 12-month follow-up and exit interviews to assess intervention impact and implementation.

Reducing Urban Cervical Cancer Disparities