Development of a web-based intervention to improve health screening uptake in men: The ScreenMen study / Teo Chin Hai
Health screening has been shown to improve health outcomes and reduce mortality. However, its uptake remains unsatisfactory particularly in men and among those aged below 40 years old, which is a critical window period to detect and prevent diseases from progressing. High internet access and m...
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Format: | Thesis |
Published: |
2018
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Online Access: | http://studentsrepo.um.edu.my/12448/4/chin_hai.pdf http://studentsrepo.um.edu.my/12448/ |
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Summary: | Health screening has been shown to improve health outcomes and reduce mortality.
However, its uptake remains unsatisfactory particularly in men and among those aged
below 40 years old, which is a critical window period to detect and prevent diseases from
progressing. High internet access and mobile phone ownership make ICT a potential
solution to improve screening uptake among young men. This study therefore aims to
describe the development of ScreenMen, a mobile web app to improve screening uptake
in men based on theories, evidence and users’ needs. ScreenMen was developed in two
phases. In the exploratory phase, a comprehensive framework was formed based on
behavioural and masculinity theories, and literature review of barriers and facilitators to
health screening in men. A list of evidence-based screening tests was identified using
international and local clinical guidelines. A needs assessment was also conducted with
men from a banking institution in Kuala Lumpur to explore their needs when undergoing
health screening. In the development phase, findings from the exploratory phase were
synthesized to form the content of ScreenMen. ScreenMen was developed using an
iterative approach involving testing with experts and users for its utility and usability. The
prototype was first tested with experts using prospective think aloud method. The revised
prototype was then tested with men from the banking institution using retrospective think
aloud method, and evaluated using System Usability Scale (SUS) and change in intention
to screen. From the needs assessment with 31 men, misconceptions about screening, such
as ‘screen only when sick’, were the key barriers to screening. Furthermore, men were
unaware of their health risks and the screening tests they should go for. They also lacked
knowledge about the cost, when and where to screen. ScreenMen addressed these barriers
through three modules: health screening educational video, health assessment function iv
and frequently asked questions. The final ScreenMen web is male-sensitive (e.g. using
car maintenance analogy), interactive (providing personalised health advice), evidence�based and mobile-responsive. It also mimics a real-life clinical consultation by interacting
with a virtual doctor. During the testing with the experts, the contents were found to be
valid and up-to-date. The users found ScreenMen useful as they could learn more about
their health and screening without consulting a doctor. However, some users wanted
ScreenMen to be shorter; therefore a ‘Quick Assessment Mode’ was added and the
information was reordered to address this need. In addition, the importance of avoiding
unnecessary screening tests was further emphasised in the revised ScreenMen to advocate
evidence-based screening. The preliminary evaluation found ScreenMen to be user�friendly with a mean SUS score of 76.4 (good usability range: 71.4-85.5). Eight out of 23
men wanted to attend screening earlier than intended after using the ScreenMen. Of 12
men who were in pre-contemplation stage, four changed to either contemplation or
preparation stage. The ScreenMen has been developed systematically using a user�centred approach to empower men to undergo screening. The preliminary data suggest
that ScreenMen is acceptable to men and might improve their intention to screen. |
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