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

Enrolling by invitation

Conditions

Intervention / Treatment

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

Interventional

Enrollment (Estimated)

2000

Phase

  • 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

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
Intervention / Treatment
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

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

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

National University Hospital, Singapore

Investigators

  • 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)

September 1, 2026

Primary Completion (Estimated)

October 31, 2028

Study Completion (Estimated)

December 31, 2028

Study Registration Dates

First Submitted

July 21, 2026

First Submitted That Met QC Criteria

July 21, 2026

First Posted (Actual)

July 24, 2026

Study Record Updates

Last Update Posted (Actual)

July 24, 2026

Last Update Submitted That Met QC Criteria

July 21, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID 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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