Inserção de novas tecnologias em saúde através de um aplicativo para rastreamento de câncer oral por agentes comunitários de saúde

Abstract

Cancers diagnosed at early stages are more effectively treated, with lower treatment costs, reduced morbidity, and a higher likelihood of cure. Therefore, oral cancer screening can improve the prognosis of these lesions and significantly reduce healthcare costs and mortality rates. In an effort to reduce the costs associated with continuous training of Community Health Workers (CHWs) and to overcome geographical barriers in oral cancer diagnosis, the use of mobile applications (apps) and digital media systems appears to be a promising alternative. This study aims to promote the integration of new health technologies through a mobile application for oral cancer screening, Oral Cancer Screening (OCS), and to evaluate its use by CHWs in the municipality of Fortaleza, Ceará, Brazil. The study was conducted by installing the app on CHWs’ mobile devices, followed by their responses to the System Usability Scale (SUS) and the Technology Acceptance Model (TAM) questionnaires. The study population included CHWs from all health districts of Fortaleza, with a sample of 322 participants. Most participants (n = 280; 87%) were female, and 189 professionals (60.4%) had completed high school education. Regarding knowledge of oral cancer risk factors, 93.2% (n = 300) identified smoking as the primary associated factor, followed by alcohol consumption (90.1%) and sun exposure (86.3%). Cronbach’s alpha coefficient was 0.804 for the SUS instrument and 0.806 for TAM, indicating good internal consistency according to established psychometric parameters (α ≥ 0.70). The mean SUS score was 73.59, indicating good perceived usability. The mean acceptability score was 81.88, demonstrating a high level of acceptance among the evaluated professionals. Participants who identified smoking as a risk factor showed better usability outcomes. Those who considered poor oral hygiene as a risk factor exhibited lower acceptability (p < 0.013) and lower usability scores. Participants who indicated a high likelihood of using the app (scores 9 and 10) demonstrated better acceptability and usability. Additionally, Android and Xiaomi users showed higher usability scores compared to iOS and other platform users (p = 0.001). Data were expressed as absolute and relative frequencies and analyzed for internal consistency using Cronbach’s alpha coefficient. The scales were compared and correlated using the Wilcoxon test and Spearman’s correlation. Furthermore, after categorization based on cutoff points (≤70 and >70), Fisher’s exact test or Pearson’s chi-square test was used to assess associations with other variables. All analyses were conducted with a 95% confidence level using SPSS version 20.0 for Windows. The OCS app proved to be effective and easy to use, with excellent acceptance among Community Health Workers. The app may contribute to the early screening of oral lesions by dentists through risk-factor-based triage performed by CHWs.