Effectiveness of a multi-component mhealth intervention for triage after HPV self-collection: preliminary results of the ATICA cluster randomized trial

SILVINA ARROSSI; VISWANATH, KASISOMAYAJULA; PAOLINO M; LUZCUBIR PABLO; UGARTE MARCOS; CAMPANERA ALICIA; JULIETA ZALACAÍN-COLOMBO; THOUYARET, LAURA; CUBERLI, MILCA; KOHLER, RACQUEL E.; ORELLANA, LILIANA

Congreso; 33 Conference of the International Papillomavirus Society; 2020

IntroductionHigh adherence to triage by HPV+ women with self-collected tests is challenging. The ATICA study (Application of Communication and Information Technologies to Self-Collection, for its initials in Spanish), is a hybrid type I trial aimed at evaluating the effectiveness/implementation of a multi-component mHealth intervention aimed at increasing triage adherence among HPV+ women with self-collected tests, compared to usual care. We report preliminary results from the clustered randomized trial. MethodsDesign: 219 community health workers (CHWs) offering self-collection during home visits were randomized (3:2) to the intervention (IG) or the control group (CG). The Multi-component mHealth intervention was weekly SMS messages for 4 weeks, notifying HPV+ women that test results were available and encouraging them to attend the health center, and an e-mail and SMS message sent to CHWs notifying them of women without cytology 60 days after the HPV-test result. Outcomes: Proportion of women with Pap at 60/120 days (post report of the HPV test) Analysis: Generalized estimating equations (GEE) approach to account for the within-CHW (cluster) correlation. ResultsThe trial is underway, all women have been recruited and follow-up will finish by November 2019. By 30 June 2019, 4938 women enrolled in the study had a test result; 685 were HPV+ (13.7%) (IG: 411; CG: 274). Analysis of the 220 HPV+ women with follow-up time long enough to measure the primary outcome showed that 59.4% of women in the IG (n=133) had a triage Pap, versus 32.2% in CG (n=87) (RR: 1.78, CI: 1.26, 2.51, p-value=0.0002). Considering the 435 women with at least 60 days follow-up, 42.3% of women in IG had triage versus 24.4% in CG (RR: 1.75, CI: 1.26, 2.43, p-value=0.0002). ConclusionsATICA preliminary results indicate that the mHealth intervention is highly effective to increase triage among HPV+ women. Final results will be presented at the Conference.