PEDCan: acceptability and feasibility of a mobile application to support primary health-care workers in recognising clinical features of childhood cancer in Uganda.

Abstract

Introduction: Early diagnosis of childhood cancer depends on a high index of suspicion and timely referral by primary healthcare workers (PHCWs) to tertiary centers. This study aimed to assess the acceptability and feasibility of a mobile application among PHCWs in recognising cancer-related clinical features in children.

Methods: We developed a mobile application called (PEDCan) to support PHCWs in recognising cancer-related clinical features in children, initiating remote consultations with specialists and referring suspected cases to cancer centers when necessary. In May 2021, we conducted a cross-sectional descriptive study among consenting PHCWs in southwestern Uganda to collect data on their knowledge of childhood cancer, smartphone ownership and internet usage. After training participants on the use of the application through mock clinical vignettes, we assessed their ease of use and readiness to adopt the application. Descriptive statistics were used to calculate the proportions of participants able and willing to use the application. Ethical approval was obtained from the Research and Ethics Committee of Mbarara University of Science and Technology.

Results: A total of 44 PHCWs participated in the study; 25 (56.8%) were nurses or midwives, 8 (18.2%) were clinical officers, 3 (6.8%) were medical doctors and 8 (18.2%) belonged to other professional cadres. All participants had previously heard about childhood cancer, and 28 (63.6%) had previously encountered a child suspected to have cancer. Thirty-eight (86.4%) participants owned a smartphone and used the internet, while 12 (31.6%) reported having constant internet access. Thirty-eight (86.3%) participants found the PEDCan application very easy or easy to use, and all participants expressed willingness to use it.

Conclusion: PHCWs in the participating health facilities were able and willing to use the PEDCan mobile application to recognise childhood cancer clinical features and initiate remote expert consultations using mock vignettes. A pilot study involving real patients would further demonstrate the application's effectiveness in real-world clinical settings.