Evaluating Interventions for Breast Cancer Screening in Ghana

NCT07745517 | Not Yet Recruiting DMC

• 1 other identifier: UHudd/SREIC/2025/103
• Study Type: interventional
• Target: 828
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to implement two interventions to determine the most effective one that can improve Ghanaian women's decision to get their breasts examined by a healthcare professional. The two interventions are (1) a system where community health nurses will be leveraged to educate women on breast cancer screening; (2) a system where women will be sent text messages about breast cancer screening. Both interventions will be carried out over five months. A survey will be conducted before the intervention is introduced. Then, after the sixth month, another survey will be implemented to determine whether there have been changes. Only women who are 25 years or older will be included in the study.

Conditions

Breast Cancer Screening

Keywords

Breast cancer; Screening; Literacy; Experimental Studies

Outcome Measures

Primary Outcomes (1)

• Clinical breast examination uptake

  The proportion of women who would have had their breasts examined by a health care professional and the proportion of women who would have practiced breast self-examination.

  Five months after the intervention

Secondary Outcomes (2)

• Breast cancer literacy

  Five months after the implementation of the intervention.

• Attitude to breast cancer screening

  Five months after the implementation of the intervention.

Study Arms (3)

Arm 1

EXPERIMENTAL

Participants assigned to this arm will receive a structured community health nurse (CHN)-led breast cancer screening education programme delivered over five months. Trained CHNs will facilitate ten biweekly 60 minute interactive sessions, with each month focusing on a specific theme: understanding breast cancer and screening, risk factors, signs and symptoms, costs and benefits of screening, and building confidence and intention to undergo screening. CHNs will receive standardized training on the study protocol, educational content, and facilitation methods to ensure intervention fidelity. Sessions will incorporate group discussions and culturally appropriate take-home pamphlets to enhance engagement. Attendance will be monitored, post-session reflections conducted, and follow-up phone calls made to participants who miss sessions. Five CHNs will each facilitate five groups of eleven participants.

Other: Community Health Nurse-Led Breast Cancer Screening Education

Arm 2

EXPERIMENTAL

Participants assigned to this arm will receive a structured breast cancer screening text messaging programme over five months. Messages will be delivered twice weekly on Wednesdays and Saturdays between 6:00 a.m. and 8:00 p.m. The intervention will cover the same monthly themes as the CHN-led arm to ensure consistency: understanding breast cancer and screening, risk factors, signs and symptoms, costs and benefits of screening, and building confidence and intention to undergo screening. Message content will be evidence-informed and culturally appropriate, drawing on established breast cancer education materials and previous intervention studies. The timing and frequency of message delivery are based on evidence indicating that twice-weekly messaging within these hours enhances participant engagement and message uptake

Other: Text Messaging Breast Cancer Screening Educational Intervention

Arm 3

PLACEBO COMPARATOR

Participants assigned to the control arm will receive the standard community-based healthcare routinely provided through existing primary healthcare services, with no additional breast cancer screening intervention. Standard care consists of general health education delivered by community health workers and focuses on topics such as environmental hygiene, healthy eating, physical activity, family planning, reproductive health, and the importance of seeking timely healthcare. No structured breast cancer education or text messaging will be provided during the study period. This group will serve as the comparator for evaluating the effectiveness of the CHN-led and text messaging interventions.

Other: Control Arm - standard of care

Interventions

Control Arm - standard of care OTHER

The control group will receive standard community-level healthcare information routinely provided through existing primary healthcare services and will not receive any additional breast cancer screening-specific education, text messages, or structured intervention activities during the study period. This distinguishes the control condition from the intervention groups by maintaining usual care while allowing evaluation of the added effect of community health nurse-led education and text messaging interventions.

Arm 3

Community Health Nurse-Led Breast Cancer Screening Education OTHER

The Community Health Nurse-led intervention differs from conventional health education programmes by using trained community health nurses who are embedded within the local healthcare system to deliver structured, interactive, and culturally responsive breast cancer screening education. Unlike one-time awareness campaigns, this intervention provides repeated biweekly sessions over five months, allowing progressive learning, reinforcement of key messages, and opportunities to address participant concerns and misconceptions.

Arm 1

Text Messaging Breast Cancer Screening Educational Intervention OTHER

The text messaging intervention is distinguished by its use of a structured, evidence-informed mobile health approach to deliver breast cancer screening information directly to participants' mobile phones. Unlike generic health reminder messages, the intervention follows the same thematic structure as the CHN-led programme, ensuring delivery of comprehensive breast cancer screening education rather than isolated screening prompts.

Arm 2

Eligibility Criteria

• Age: 25 Years+
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Must be a female aged 25 years or older
• Must be resident in the Danfa community
• Must be someone who can confirm their availability for at least the next eight months after the initiation of the trial

You may not qualify if:

• Males
• Females aged \<25 years
• Women who are not resident in the study setting
• Women who cannot be available for at least the next eight months after the initiation of the trial

Sponsors & Collaborators

• University of Huddersfield: lead

Study Sites (1)

Danfa Community

Accra, Greater Accra Region, Ghana

Location

Related Publications (8)

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• Okyere J, Ayebeng C, Dickson KS. Clicks and checks: investigating the association between internet usage frequency and women's uptake of clinical breast examination in Ghana. BMC Health Serv Res. 2024 Sep 27;24(1):1113. doi: 10.1186/s12913-024-11576-x.

  PMID: 39334073 BACKGROUND

• Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O'Neal L, McLeod L, Delacqua G, Delacqua F, Kirby J, Duda SN; REDCap Consortium. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019 Jul;95:103208. doi: 10.1016/j.jbi.2019.103208. Epub 2019 May 9.

  PMID: 31078660 BACKGROUND

• Bonful HA, Addo-Lartey AA, Sefenu RS, Nwameme A, Abagre TA, Awua AK, Adu-Aryee NA, Dedey F, Adanu RMK, Okuyemi KS. Developing a culturally tailored short message service (SMS) intervention for improving the uptake of cervical cancer screening among Ghanaian women in urban communities. BMC Womens Health. 2022 May 10;22(1):154. doi: 10.1186/s12905-022-01719-9.

  PMID: 35538476 BACKGROUND

• Asare M, Obiri-Yeboah D, Enyan NIE, Nuer-Allornuvor G, Fosu ES, Ken-Amoah S, Akakpo PK. An intervention to increase cervical cancer screening among women living with HIV: A mixed methods study. Patient Educ Couns. 2024 Jan;118:107993. doi: 10.1016/j.pec.2023.107993. Epub 2023 Oct 5.

  PMID: 37844427 BACKGROUND

MeSH Terms

Conditions

Breast Neoplasms; Literacy

Condition Hierarchy (Ancestors)

Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Skin and Connective Tissue Diseases; Communication; Behavior

Study Officials

• Padam Simkhada, PhD

  University of Chester

  STUDY CHAIR

• Bibha Simkhada, PhD

  University of Huddersfield

  STUDY CHAIR

Central Study Contacts

Joshua Okyere, MPhil

CONTACT

+233249004634; joshua.okyere@hud.ac.uk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: SCREENING
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 29, 2026
• First Posted: August 4, 2026
• Study Start (Estimated): October 1, 2026
• Primary Completion (Estimated): November 30, 2027
• Study Completion (Estimated): November 30, 2027
• Last Updated: August 4, 2026

Record last verified: 2026-07

Locations

GH (1)