Effects of a WhatsApp-Delivered Education Intervention to Enhance Breast Cancer Knowledge in Women: Mixed-Methods Study

Abstract

Background Breast cancer is the leading cause of cancer-related death in the female population. Health education interventions based on the use of mobile technologies enable the development of health self-care skills and have emerged as alternative strategies for the control of breast cancer. In previous studies, WhatsApp has stood out as a useful tool in health education strategies; however, it has not yet been applied for breast cancer education. Objective This study aimed to analyze the potential of WhatsApp as a health education tool used to improve women's knowledge on the risk reduction of breast cancer. It also aimed to understand how women feel sensitized within the WhatsApp group throughout the intervention and how they incorporate information posted to improve knowledge about early detection and risk reduction methods. Methods The study involved a pre-post health educational intervention with 35 women (aged 45-69 years) included in a WhatsApp group to share information (audio, video, text, and images) over 3 weeks on the early detection and risk reduction of breast cancer. Data were collected through questionnaires on topics related to risk reduction, as well as qualitative content analysis of group interactions. Effectiveness and feasibility were analyzed through conversations and the comparison of the scores obtained in the questionnaires before and after the intervention. Results A total of 293 messages were exchanged (moderator 120 and users 173). The average scores of the participants were 11.21 and 13.68 points before and after the educational intervention, respectively, with sufficient sample evidence that the difference was significant (P<.001). The intervention enabled women to improve their knowledge on all topics addressed, especially “myths and truths,” “incidence,” “clinical manifestations,” and “protective factors.” Some themes emerged from the interactions in the group, including group dynamics, general doubts, personal narratives, religious messages, daily news, and events. Conclusions The use of groups for women in WhatsApp for health education purposes seems to be a viable alternative in strategies on breast cancer control, especially as it provides a space for the exchange of experiences and disinhibition. However, the need for a moderator to answer the questions and the constant distractions by members of the group represent important limitations that should be considered when improving this strategy.

A WhatsApp-Based Intervention to Improve Maternal Social Support and Maternal–Child Health in Southern Brazil: The Text-Message Intervention to Enhance Social Support (TIES) Feasibility Study

“…A recent WhatsApp-based study implemented among Brazilian women to increase breast cancer awareness also pointed out that the interaction between participants was a challenge. 25 The authors noted that women adopted a passive posture for receiving health information, always waiting for the moderator (“expert voice”) to have the final say. 25 …”

Educational interventions on breast cancer in men and women: a necessity in primary healthcare

“…After analysing the data, it can be said that the level of awareness in individuals who participated in the studies contained in the research shown increased significantly [43] as a result of the various educational interventions on BC, particularly in aspects concerning new information and early detection methods. This indicates that the educational interventions are effective, managing to significantly increase the level of awareness in all their variants, leading to future quality of life through timely detection, linked with prevention and control of the disease and with improvements in life styles [33,37,[46][47][48][49][50][51][52][53][54][55][56][57][58][59][60].…”

“…It was found that in interventions in the 30–65 years age range, there is insufficient knowledge about BC. However, after the educational intervention, there was generally a very good level and following the intervention no women were found to have a poor level of knowledge [ 42 , 43 ].…”

WhatsApp-assisted health education intervention

“…Educational interventions through mobile technologies help promote health due to its simplicity, accessibility, and minimization of the distance, cost, and time barriers (Bradway et al 2017;Oreskovic, Huang, and Moon 2015). A study conducted by (Pereira et al 2020)) showed the benefits of the educative intervention on breast cancer. According to the authors, it is the first study to use WhatsApp as a health education tool destined for Brazilian women on Brazil's public health system that focused on risk reduction and early detection of this disorders.…”