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

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.

Educational Intervention Using WhatsApp on Medication Adherence in Hypertension and Diabetes Patients: A Randomized Clinical Trial.

Background: Low adherence to pharmacological therapy by patients with diabetes mellitus and hypertension is frequent and represents a worldwide challenge. Introduction: This study examined the effect of an educational intervention using WhatsApp® messaging on medication adherence of patients with hypertension and diabetes. Materials and Methods: A randomized clinical trial was performed with 403 patients who had diabetes and/or hypertension and who had enrolled in the 33 Basic Health Units of Maringá-PR, Brazil. The patients were randomly assigned to either the intervention group (n = 203), which received usual care (multi-professional educational appointments according to each Unit schedule) plus 55 audio, image or text WhatsApp messages about health care promotion, with an emphasis on medication adherence, or the control group. The control group (n = 200) only received usual care. Medication adherence, as measured by the Morisky-Green Test, was compared through the chi-square test after 16 weeks. Relative risk (RR) was used as a measure of effect size. Results: After the follow-up period (4 months), 67.5% of the patients in the intervention group were adherent versus 58.5% in the control group (RR: 1.15, 95% confidence interval = 0.99-1.34, p = 0.077). Discussion: Although the effect of the intervention was not statistically significant, there was a clinically significant impact associated with a 15% increase in medication adherence. Conclusion: Given the complexity of adherence to the use of antidiabetic and antihypertensive medications, educational interventions using WhatsApp could be useful as a reinforcement to increase adherence to medication.

Is WhatsApp Effective at Increasing the Return Rate of Blood Donors?

Background: WhatsApp® is one of the most used apps in Brazil. One of its main features is the potential to overcome geographical, cultural, and socioeconomic disparities. This app is increasingly being used as a tool for mobile health (m-health) interventions; however, with regard to blood donation, scientific studies are still lacking. The recruitment, return, and loyalty of blood donors are public health challenges, especially in developing countries. Objective: To verify the effectiveness of WhatsApp as a tool to increase the return rates of blood donors (first-time and loyal donors). Methods: The study was carried out with 548 individuals who voluntarily went to a private blood bank in the city of Maringá, south of Brazil, to donate blood. The participants were divided randomly into an intervention group (IG) and a control group (CG). Four messages were created following a strategy of persuasive communication and sent using an automatic system (Bulk System) to the list of participants in the IG after they had donated blood. Results: In contrast to our expectations, after the intervention, no significant difference in the return rates was observed between the IG and the CG. Loyal donors, regardless of whether they received the messages or not, returned in higher numbers compared with the first-time and sporadic donors. Conclusion: The intervention using WhatsApp was not effective at increasing the blood donors' return rates, suggesting that the motivations of blood donors are different from those of people who are undergoing self-care interventions. Furthermore, the difference in the blood donors' return rates suggests that specific interventions should be created according to the different stages of the donors' careers.

The Head Down Generation: Musculoskeletal Symptoms and the Use of Smartphones Among Young University Students.

Background: Smartphones offer a variety of mobile applications for diverse purposes and access to services that contribute to an increased time of interaction with the device, influencing the users' health and behavior.Introduction: The time of interaction with smartphones is more intense with the younger generation, and physical, psychological, and social complications are reported. This research aims at identifying the factors associated with musculoskeletal symptoms due to the use of smartphones in university students in Brazil.Materials and Methods: The study has a quantitative transversal type approach, with 522 college students between the ages 18 and 26. A structured questionnaire was applied in 2017, to characterize the sociodemographic profile, composed of information regarding the use of smartphones added to the Nordic questionnaire of musculoskeletal symptoms.Results: One of the main results found was a tendency for participants to have symptoms of musculoskeletal pain with regards to their typing methods on smartphones. When asked about the cases when such symptoms were considered to be related to the use of the device, most cited the cervical region (43.87% of cases). It was also found that those who type on their phones with the head at 45° and 60° angles are about twice as likely to have higher scores of severe symptoms than those typing with their neck at 0° (anatomical position).Conclusion: Within the university student population the typing position on a smartphone and time of use are associated with the presence of pain in the cervical region.