Academic journal article Creative Nursing

Evaluation of a Nurse-Designed Mobile Health Education Application to Enhance Knowledge of Pap Testing

Academic journal article Creative Nursing

Evaluation of a Nurse-Designed Mobile Health Education Application to Enhance Knowledge of Pap Testing

Article excerpt

An experimental study was conducted using a 2-group randomized control pretest/ posttest design to determine if knowledge about Pap testing could be increased through use of a nurse-designed mobile smartphone app developed to educate individuals about the Pap test. A 14-item pretest survey of knowledge about Pap tests was distributed to women attending a university in New England. Participants in the intervention group were provided with an Android device on which a digital health education application on Pap testing had been downloaded. The control group was given a standard pamphlet on Pap testing. Paired t test results demonstrated that knowledge scores on the posttest increased significantly in both groups, but were significantly higher in the intervention group. User satisfaction with the app was high. The results of this study may enhance nursing care by informing nurses about a unique way of learning about Pap testing to recommend to patients.

Keywords: Pap; human papillomavirus; Android app; mHealth

Despite widespread agreement about the merits of the Papanicolaou (Pap) test for cervical cancer, anecdotal information and many previous studies suggest low levels of knowledge among women regarding Pap tests and the testing pro- cess (Baer, Allen, & Braun, 2000; Blake, Weber, & Fletcher, 2004; Breitkopf, Pearson, & Breitkopf, 2005; Cooper, Polonec, & Gelb, 2011; Denny-Smith, Bairan, & Page, 2006; Fry, Ferries-Rowe, Learman, & Haas, 2010; Head, Crosby, & Moore, 2009; Lyons, Lindsell, & Trott, 2004; Mays et al., 2000; Stark et al., 2008; Tiro, Meissner, Kobrin, & Chollette, 2007). Misconceptions usually involve risk factors for abnor- mal Paps, recommended frequency of Paps, the purpose of the Pap, and what the actual Pap test entails. Seeing the need to provide evidence-based and up-to-date information on Pap testing, I developed a mobile Android app called MyPapp. The objective of MyPapp is to educate women on many aspects of Pap testing, specifically focusing on common misconceptions regarding this test (Christensen & Morelli, 2012).

The number of health-related mobile apps is growing rapidly; in 2010, the num- ber of smartphone health apps on the market rose 78% (Dolan, 2010). However, few studies have been conducted to evaluate their effectiveness or the impact of this method of acquiring health information (Sherry & Ratzan, 2012). Informa- tion on user satisfaction is lacking as well. A study was conducted to determine if interfacing with a nurse-developed mobile app designed to educate women on Pap testing had an impact on levels of knowledge about Pap tests, and to assess user satisfaction with the app.


The study was a two-group randomized controlled pretest/posttest design, using a convenience sample of women aged 18-25 years attending a university in New England. Upon IRB approval, a pretest survey containing demographic questions and a 14-item Pap Knowledge Quiz were distributed to participants. There were 74 women who participated in the study, 37 in each group. After completing the pre- test, participants in the intervention group were provided with an Android device on which the health education app had been downloaded. The control group was given an American Cancer Society pamphlet on cervical cancer and HPV (Amer- ican Cancer Society, 2011) and asked to read it silently. This pamphlet was chosen because it was a credible, comprehensive, and up-to-date resource with content which most closely mirrored the content in the app. When participants had com- pleted reviewing either the app or the pamphlet, the Pap Knowledge Quiz was given again as a posttest.


Section 1 of the pretest comprises 10 questions about experiences relevant to existing knowledge of Pap tests, including familiarity with the term "Pap test," how the participant first learned about the Pap, if the participant had had a Pap test, if the participant had received information on Pap tests in a health education class and/or from her health care provider, satisfaction with previously received Pap information, confidence in existing knowledge, previous experience with health-related digital applications, and unanswered questions about Pap tests. …

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