Pragmatic Mobile Health Trial to Promote Cancer Screening and Healthy Behaviors

Cancer is the leading cause of death in Singapore, but many people who are eligible for breast, cervical, and colorectal cancer screening do not get screened on time. Many adults also have chronic health conditions such as high blood pressure, diabetes, high cholesterol, and obesity, which can often be reduced through healthier lifestyle habits. Although reminders for screening are available, they may not be enough to encourage long-term healthy behaviours. This study will evaluate whether regular health messages delivered through a mobile health (mHealth) platform can help improve cancer screening participation and promote healthier lifestyles among Singaporean women aged 50-69 years. Participants will be randomly assigned to one of two groups. The control group will receive standard cancer screening reminders every six months. The intervention group will receive monthly evidence-based health messages, including information on cancer screening, healthy eating, physical activity, and other healthy lifestyle behaviours, delivered through the NUHS App (or a similar mobile platform) or SMS. The study will compare whether more frequent and engaging health messages lead to higher participation in recommended cancer screening, greater engagement with the digital platform, and healthier lifestyle behaviours compared with standard reminders. The findings may help identify an effective and scalable digital approach to support cancer prevention and healthy ageing across Singapore.

Inclusion Criteria: 1. If using app for message delivery: Registered NUHS App users or HealthHub App users OR if using SMS for message delivery: Participants must have a mobile number recorded in electronic medical records (EPIC). 2. Female 3. Singapore citizen 4. Aged 50-69 years 5. With or without prior diagnosis of cancer Exclusion Criteria: 1. Participants unable to provide informed consent and take surveys, such as those with cognitive impairments or severe mental health conditions. 2. Participants with terminal illness or serious comorbidities that preclude them from participating in preventive health programs. 3. Pregnant women: Given the target age group (50-69 years), the prevalence of pregnancy is expected to be extremely low.