Development of Mobile App for Breast Examination Awareness Using Health Belief Model: A Qualitative Study

Abstract

Background: Mobile health technologies are widely being used for delivering health behaviour interventions. However, there is insufficient evidence that they are integrating theory and only a few researchers utilized a qualitative approach in their study. Objectives: This paper aims to identify requirements in developing a breast examination awareness mobile app based on the component of the Health Belief Model (HBM) for integration in health promotion strategy. Methods: A qualitative approach using semi-structured in-depth interview was utilized in this study. A purposive sampling method was conducted among public women attending hospital services, software and content experts in a tertiary teaching hospital in the East coast of Peninsular Malaysia. These interviews were recorded, transcribed and organized using NVIVO 11. The main themes were identified through thematic analysis of the interview transcripts. Results: A total of 37 participants recruited in this study. The themes that emerged from the analysis are vulnerability, forecasting, reactive, influence, outcome and obstacles. The sub-themes findings supported the HBM’s component in terms of the requirement for are an infographic risk factor, video (symptoms, self-examination), info (metastasis, survival, screening, triple assessment, treatment, myth and facts, benefit of early treatment, support groups), features (screening reminder, sharing button, prompt) and mobile app’s design. Conclusion: The research findings could provide a guide for future app development from public women, content and software experts. The information will be used to develop a breast examination awareness mobile app integrated with health theories.

Breast awareness mobile apps for health education and promotion for breast cancer

“…A mobile app for the women population at risk in Malaysia was developed as a new tool for BC's health education and promotion. This study has shown its usability ( 6 ). However, we do not know whether this mobile app can improve users' knowledge, attitudes, and behavioral changes on BC.…”

“…The pre and post-tests show an improvement in knowledge of BC among the women population after using the BrAware app. As Nasution et al ( 6 ) mentioned, it is best to approach their knowledge and awareness to change human behavior and promote early BC detection in the community ( 6 ). Therefore, the BrAware app can be considered feasible in a real clinical context to promote behavioral changes in the lifestyles of women in performing BSE and screening.…”

“…This result matches those observed in a study in Iran that implemented the smartphone app, which improved BSE practice and even reported abnormal findings among participants by mass palpation or visually inspected nipple retraction ( 16 ). According to the Health Belief Model (HBM), an individual's opinion that she is vulnerable to BC, the severity of BC, and the benefits, as well as a barrier to preventative action such as doing the BSE and screening at the hospital, all influence health-seeking behavior toward BC prevention ( 6 ). In addition, to our knowledge, no BC awareness support apps are targeting Malaysian women.…”

“…Furthermore, the reminder feature notifications as cues in the app improve user engagement and BSE routine in a time duration set according to the user's menstrual cycle ( 18 ). Many studies have supported mobile apps in improving the user's or patient's knowledge and awareness of the diseases ( 6 ). A study in China suggested that using a mobile app could improve the user's experience, especially on the accessibility to health information, leading to positive health outcomes ( 19 ).…”

“…The mobile app, BrAware, from the abbreviation of Breast Awareness, was developed based on the Android platform by the researchers ( 6 ). The app was user-friendly, constructed with simple point form sentences, including a share button, infographic images or video, dual language capabilities (English and Malay language), a Google Map navigator and a reminder function.…”