Pragmatic Mobile Health Trial to Promote Cancer Screening and Healthy Behaviors (mHEALTH)

July 21, 2026 updated by: National University Hospital, Singapore

Pragmatic Randomized Trial Using Mobile Health (mHealth) Technology to Change Cancer Screening Behavior and Promote Healthier Lifestyle

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.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Enrolling by invitation

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Cancer remains the leading cause of death in Singapore despite the availability of national screening programmes for breast, cervical, and colorectal cancers. Participation in recommended cancer screening remains below desired levels, while chronic diseases associated with unhealthy lifestyle behaviours continue to increase. Existing approaches to promoting preventive health often rely on infrequent reminders and may be insufficient to support sustained behavioural change.

Singapore's widespread use of smartphones and digital health platforms provides an opportunity to deliver scalable mobile health (mHealth) interventions. This pragmatic randomized trial will evaluate whether regular delivery of evidence-based health messages through the NUHS App (or a similar mobile platform) or SMS can improve participation in recommended cancer screening and promote healthier lifestyle behaviours among Singaporean women aged 50-69 years.

Participants will receive either standard screening reminders or a more intensive programme of health messages covering cancer screening, healthy diet, physical activity, weight management, and other preventive health topics. The study will evaluate whether a sustained digital engagement strategy is more effective than standard reminders in encouraging long-term health behaviour change.

Because the intervention is delivered using existing healthcare digital infrastructure, the findings will inform whether this approach can be implemented at scale to improve cancer prevention and support healthy ageing in Singapore.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
2000

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Singapore
      • Singapore, Singapore
        • National University Hospital Singapore

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

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.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Screening
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Other: Standard Messaging Arm (Arm 1)
Participants receive standard cancer screening reminders through the NUHS App or SMS according to usual practice.
Behavioral: Standard Engagement
Participants receive two standard health messages through PN via the NUHS app or similar platforms OR via SMS - one at recruitment and a subsequent reminder message after 6 months. The content will include general population cancer screening guidelines (breast, colorectal, and cervical cancers) and information pertaining to healthy lifestyle practices (including maintaining a healthy BMI, balanced diet, and sufficient exercise).
Experimental: Intensive Engagement Arm (Arm 2)
Participants receive regular evidence-based health messages through the NUHS App or SMS to promote cancer screening and healthy lifestyle.
Behavioral: Intensive Engagement
Participants will receive the standard bi-annual health messages as in Arm 1, supplemented with additional monthly messages through PN via the app OR via SMS, that provide comprehensive information on general population cancer screening guidelines, healthy lifestyle practices, motivational health messages, video links, and details about relevant events over a period of 12 months. In addition to the monthly messages, participants will be invited to attend up to 12 webinars (on women's health/screening/nutrition/lifestyle related topics) and 12 in-person or virtual group events (like simple low-intensity exercise/ walking/ basic yoga/ tai chi/nutritional cooking etc.) over 12 months. Interested participants may also be asked to join a moderated chatgroup (using Telegram app). The chatgroup is intended to promote peer support and healthy habit building.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Comparison of Screen-Adherent Participants Between Arm 1 and Arm 2
Time Frame: 24 months post-intervention

Proportion of screen-adherent participants (in %) in Arm-2 versus Arm-1 at 24 months.

Non-adherence at baseline is defined as not being fully adherent to screening guidelines for all three cancers (with cervical cancer screening excluded for those not sexually active).

Adherence following the intervention is defined as showing at least one improvement in adherence (e.g., previously adherent to only cervical cancer screening, with subsequent adherence to colorectal cancer screening).
24 months post-intervention

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Proportion of participants with BMI in the healthy range
Time Frame: 24 months post-intervention
Proportion of participants (in %) with BMI in the healthy range (18.5-22.9 kg/m2) in Arm 1 vs Arm 2
24 months post-intervention
Proportion of participants achieving a daily goal of 10,000 steps
Time Frame: 24 months post-intervention
Proportion of participants (in %) achieving a daily goal of 10,000 steps in Arm 1 vs Arm 2
24 months post-intervention
Proportion of participants with recommended moderate-intensity aerobic activity
Time Frame: 24 months post-intervention
Proportion of participants (in %) with 150-300 minutes of moderate-intensity aerobic activity in Arm 1 vs Arm 2
24 months post-intervention
Proportion of participants eating recommended servings of fruits/vegetables daily at 24 months
Time Frame: 24 months post-intervention
Proportion of participants eating at least 5 servings of fruits/vegetables daily in Arm 1 vs Arm 2
24 months post-intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
National University Hospital, Singapore

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Soo-Chin Lee, MBBS, MRCP, National University Hospital, Singapore

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
September 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
October 31, 2028

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 31, 2028

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
July 21, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 21, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
July 24, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
July 24, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 21, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
July 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 2024-4448

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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