Trial reportThe oncologist2014
An mHealth model to increase clinic attendance for breast symptoms in rural Bangladesh: can bridging the digital divide help close the cancer divide?
Trial report in The oncologist, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 9 syntheses or guidelines pooled it, 77 citations in OpenAlex.
- Application of patient navigation programs across the entire continuum of breast cancer care: a GRADE-assessed systematic review with meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Pooled it
- A systematic review of public health interventions to address breast cancer inequalities in low- and middle-income countries.Systematic reviews · 2024Pooled it
- Mobile-Based Application Interventions to Enhance Cancer Control and Care in Low- and Middle-Income Countries: A Systematic Review.International journal of public health · 2023Pooled it
- Impact of Patient Navigation on Population-Based Breast Screening: a Systematic Review and Meta-analysis of Randomized Clinical Trials.Journal of general internal medicine · 2022Pooled it
- Pooled it
- Interventions Addressing Barriers to Delayed Cancer Diagnosis in Low- and Middle-Income Countries: A Systematic Review.The oncologist · 2020Pooled it
- Mobilizing Breast Cancer Prevention Research Through Smartphone Apps: A Systematic Review of the Literature.Frontiers in public health · 2019Pooled it
- Systematic review of interventions for improving the performance of community health workers in low-income and middle-income countries.BMJ open · 2017Pooled it
- Interventions for raising breast cancer awareness in women.The Cochrane database of systematic reviews · 2017Pooled it
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- Clinical breast examination screening by trained laywomen in Malawi integrated with other health services.The Journal of surgical research · 2016Trial
- A mixed-methods evaluation of a patient navigation program for breast and cervical cancers in Rwanda.BMC public health · 2026Article
- Experience with the mobile health application 'mSaada' to facilitate home-based human papillomavirus testing in Western Kenya.BMC global and public health · 2025Article
- Challenges and facilitators in pathways to cancer diagnosis in Southern Africa: a qualitative study.BMJ open · 2025Article
- Assessing Breast Cancer Awareness Among Women in Al Baha, Saudi Arabia: A Cross-Sectional Study Using the Breast Cancer Awareness Measure (BCAM).Medical sciences (Basel, Switzerland) · 2025Article
- Co-designing and evaluation of a context-appropriate strategy to improve access to early detection and care of oral, breast and cervical cancers in rural India: a formative phase implementation research protocol.Ecancermedicalscience · 2025Article
- Task-sharing for non-communicable disease prevention and control in low- and middle-income countries in the context of health worker shortages: A systematic review.PLOS global public health · 2025Article
- Barriers to Follow-Up of an Abnormal Clinical Breast Examination in Uttar Pradesh, India: A Qualitative Study.JCO global oncology · 2024Article
- Towards women's digital health equity: A qualitative inquiry into attitude and adoption of reproductive mHealth services in Bangladesh.PLOS digital health · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo demonstrate proof of concept for a smart phone-empowered community health worker (CHW) model of care for breast health promotion, clinical breast examination (CBE), and patient navigation in rural Bangladesh.
methodsThis study was a randomized controlled trial; July 1 to October 31, 2012, 30 CHWs conducted door-to-door interviews of women aged 25 and older in Khulna Division. Only women who disclosed a breast symptom were offered CBE. Arm A: smart phone with applications to guide interview, report data, show motivational video, and offer appointment for women with an abnormal CBE. Arm B: smart phone/applications identical to Arm A plus CHW had training in "patient navigation" to address potential barriers to seeking care. Arm C: control arm (no smart phone; same interview recorded on paper). Outcomes are presented as the "adherence" (to advice regarding a clinic appointment) for women with an abnormal CBE. This study was approved by Women's College Hospital Research Ethics Board (Toronto, Ontario, Canada) and district government officials (Khulna, Bangladesh). Funded by Grand Challenges Canada.
resultsIn 4 months, 22,337 women were interviewed; <1% declined participation, and 556 women had an abnormal CBE. Control group CHWs completed fewer interviews, had inferior data quality, and identified significantly fewer women with abnormal breast exams compared with CHWs in arms A and B. Arm B had the highest adherence.
conclusionCHWs guided by our smart phone applications were more efficient and effective in breast health promotion compared with the control group. CHW "navigators" were most effective in encouraging women with an abnormal breast examination to adhere to advice regarding clinic attendance.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.