Poster Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Co-designing and pilot testing a text message program to support women’s health after cancer treatment in rural/remote Canada; a collaboration with community-based cancer and Indigenous organisations (#737)

Anna C Singleton 1 , Allyson R Todd 2 , Rebecca Raeside 2 , Rosanna Strong 3 , Rosemary Youngblut 3 , Jill Christensen 3 , Karice K Hyun 4 5 , Stephanie R Partridge 2 , Julie Redfern 6
  1. The Daffodil Centre, University of Sydney, Sydney, New South Wales, Australia
  2. Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, New South Wales, Australia
  3. The NWT Breast Health/Breast Cancer Action Group, Yellowknife, Northwest Territories, Canada
  4. Concord Repatriation General Hospital,, Sydney, NSW, Australia
  5. School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
  6. Institute for Evidence-Based Health, Bond University, Gold Coast, QLD, Australia

Background/rationale: In Northwest Territories (NWT) Canada (100% remote, ~44,000 residents; 49% Indigenous peoples), ~270 women finished treatment for early-stage breast, lung, colorectal, ovarian or cervical cancer ≤10 years. Locally/culturally appropriate post-treatment psychosocial support is limited. Text message interventions are accessible, useful and supportive for people in remote communities and can be co-designed. This study aimed to co-design a text message program with NWT community-based- and Indigenous organisations and pilot implementation Territory-wide.

Methods: Mixed-methods (i)co-design (focus groups, message ratings;5-point Likert Scales; score/15); (ii)pilot implementation, outcomes: uptake, fidelity, satisfaction, costs). Eligibility: (i)NWT health professionals, researchers, community members/leaders/Elders, carers or (i&ii)women  ≤10years post-treatment for early-stage breast, lung, colorectal, ovarian or cervical cancer. Recruitment: community gatherings, letters/posters, emails, phone, social media, with e-consent. Qualitative data: parallel coded and analysed thematically (inductive).

Results: (i)Participants (N=41) were 59±11years old (mean±standard deviation), 29% Indigenous peoples and 69% travelled ≥200kilometres to cancer appointments. Focus group participants wanted a 3-month program, where users choose to receive 2-4 messages/week. Message themes included mental health, navigating remote healthcare, nutrition, tips for health self-management and Indigenous health practices. One-hundred-and-eighty-six messages were co-designed; 115 (62%) rated ≥13/15; top-rated 59 messages formed the ‘TextMeHealthy’ program. (ii)Uptake: Participants (N=24) were 57±12years old (range 34-76years), 24% Indigenous peoples, 88% travel ≥200kilometres to appointments (n=4 fly in-out). Fidelity: 98% messages delivered successfully. Feedback (n=13/24; 54%): ‘strongly/agreed’ the messages were easy-to-understand (13/13;100%), useful (77%) and supportive (69%). Perceived barriers: societal (stigma of ‘healthy’ and ‘calling-in cancer’), technical (complex registration process). Cost: $AUD281; $11.7/participant.

Discussion/clinical implications: This multidisciplinary collaboration resulted in a co-designed locally/culturally-relevant psychosocial text message program that was trialled by 9% of women with these cancers in the Territory, including isolated communities. NWT Breast Health/Breast Cancer Action Group (community-based-organisation) will use feedback to improve program content, promotions and sustainable/accessible support delivery for NWT women between follow-up appointments.