Documents

Objectives

Breast screening and early detection have positively influenced survival rates for breast cancer. We conducted a randomized-controlled trial involving 7235 eligible members of the Discovery Health Medical Scheme, who were also members of the Vitality health-promotion programme, to test whether WhatsApp messaging would increase the booking of a screening mammogram.

Methods

Participants aged 50–70 years were randomly allocated to five groups. Individuals in the control condition did not receive any messages, while the four intervention groups received WhatsApp messages with 1) a simple reminder; 2) a reminder with a link to an online booking platform; 3) a reminder with telephone numbers of radiology practices, or 4) a combination of messages 2 and 3. The primary outcome was the cumulative screening rate one month after the last of four messages. We employed logistic regression models to test the relationship between the messaging and the probability of undergoing a mammogram.

Results

Individuals who received a reminder by WhatsApp had double the odds of obtaining a mammogram compared to those members who did not receive a reminder. The inclusion of an online booking platform or providing telephone numbers of radiology practices did not increase the likelihood of having a mammogram. Two other patient variables, receipt of a past mammogram and frequency of utilization of healthcare, were predictive of mammogram uptake.

Conclusion

The results of this trial demonstrate that simple reminders, sent via an accessible social media platform such as WhatsApp, can nudge individuals eligible for a mammogram to obtain one.