xml: <clinical_study>
    <!-- This xml conforms to an XML Schema at:
      https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
    <required_header>
      <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
      <link_text>Link to the current ClinicalTrials.gov record.</link_text>
      <url>https://clinicaltrials.gov/ct2/show/NCT05992792</url>
    </required_header>
    <id_info>
      <org_study_id>AP-0176-2018</org_study_id>
      <nct_id>NCT05992792</nct_id>
    </id_info>
    <brief_title>Evaluation of the International Diffusion of the European Code Against Cancer Through Mobile Telephony</brief_title>
    <acronym>CECC-OMS</acronym>
    <official_title>Evaluation of the International Diffusion of the European Code Against Cancer (ECAC) Through Mobile Telephony. CECC-WHO Study</official_title>
    <sponsors>
      <lead_sponsor>
        <agency>Hospital Universitario Reina Sofia de Cordoba</agency>
        <agency_class>Other</agency_class>
      </lead_sponsor>
      <collaborator>
        <agency>International Agency for Research on Cancer</agency>
        <agency_class>Other</agency_class>
      </collaborator>
    </sponsors>
    <source>Hospital Universitario Reina Sofia de Cordoba</source>
    <oversight_info>
      <has_dmc>No</has_dmc>
      <is_fda_regulated_drug>No</is_fda_regulated_drug>
      <is_fda_regulated_device>No</is_fda_regulated_device>
      <is_us_export>No</is_us_export>
    </oversight_info>
    <brief_summary>
      <textblock>
        We conducted an implementation research pilot study to assess the adoption, fidelity,&#xD;
        appropriateness and acceptability on an intervention to effectively disseminate cancer&#xD;
        prevention messages to the public throught a mHealth implementation strategy&#xD;
      </textblock>
    </brief_summary>
    <detailed_description>
      <textblock>
        A type-2 hybrid effectiveness-implementation study was designed to primarily test the impact&#xD;
        of a mHealth implementation strategy on implementation outcomes (e.g., adoption, fidelity of&#xD;
        intervention delivery) while simultaneously gathering information on the effectiveness of the&#xD;
        intervention. The feasibility single-blind randomised controlled trial has been carried out&#xD;
        on a sample of the general population in the Autonomous Community of Andalusia, the most&#xD;
        populated region of Spain, with more than 8.5 million residents (17.9%). The Andalusian&#xD;
        Health Service (SAS, acronym in Spanish) is the main healthcare provider of the Andalusian&#xD;
        Public Health System (SSPA, acronym in Spanish), part of the decentralised Spanish National&#xD;
        Health System, which provides free universal health insurance. The SAS oversees &quot;Salud&#xD;
        Responde&quot; (SR, acronym in Spanish), a multi-channel platform that provides a broad online&#xD;
        portfolio of services to respond to health-related issues and administrative management needs&#xD;
        of citizens and health professionals, complementing the care provided by the health care&#xD;
        units. It allows 24 hours a day access to the services and benefits of the SSPA, from any&#xD;
        point in Andalusia, through telephone, e-mail, short message system (SMS) and a mobile&#xD;
        application (app) to manage appointments and reminders, and to disseminate personalized&#xD;
        health information. The app has a high coverage with more than 5.7 million users (67% of the&#xD;
        Andalusian's population) registered in its system in 2023; yet the SR platform maintains the&#xD;
        information system service via SMS for specific campaigns to those users who do not have or&#xD;
        want the app installed on their mobile phone (around 9700 registered users).&#xD;
  &#xD;
        The inclusion criteria were being 18 years or over, being entitled to health care benefits in&#xD;
        SSPA, having a mobile phone, and being able to read messages on them. A sample of 1991 users&#xD;
        from the User Database (BDU, in Spanish) of the SSPA, that in 2019 included more than 8.5&#xD;
        million users (REF), was used to randomly assign subjects to the different groups. The first&#xD;
        randomization was performed according to the recruitment procedure (users registered or not&#xD;
        in the SR platform) and the technology used to disseminate the messages (app or SMS). Group 1&#xD;
        (G1), subjects registered in the SR app service platform, and Group 2 (G2) subjects&#xD;
        registered in the SR SMS service platform, were recruited through phone call. The rest of&#xD;
        subjects needed to reach the target sample size were recruited from those included in the BDU&#xD;
        database through a phone call. A maximum of eight attempts were done before considering no&#xD;
        response. To be able to calculate participation rate (positive response rate + acceptance to&#xD;
        participate), no replacement was performed.&#xD;
  &#xD;
        For those not registered in the SR platform who accepted to participate in the study, a&#xD;
        further distribution was done based on a discriminatory question: those users with internet&#xD;
        connection in their mobile phone both through 3G/4G and Wi-Fi were allocated in Group 3 (G3)&#xD;
        and encouraged to download the app to receive messages, and those without internet were&#xD;
        allocated in Group 4 (G4) to receive messages by SMS. Informed consent to participate was&#xD;
        requested for tehe investigators and the voluntary and anonymous nature of the participation&#xD;
        was ensured. The simple randomisation to the different study groups was performed using the&#xD;
        EPIDAT 4.0 programme. The second randomization was performed based on the messages' delivery&#xD;
        frequency: frequency of 2 SMS or 2 app notifications (&quot;push&quot;) per week, or frequency of 7 SMS&#xD;
        or 7 app notifications per week.&#xD;
  &#xD;
        Intervention After the second randomisation, an intervention was conducted for 4 weeks where&#xD;
        participants were sent app push notifications or SMS messages via the SR platform. Each push&#xD;
        notification or SMS message included a cancer prevention recommendation from the ECAC 4th&#xD;
        edition (in Spanish) from the following list: &quot;Don't smoke. Do not use any type of tobacco&quot;;&#xD;
        &quot;Maintain a healthy weight&quot;; &quot;Exercise daily. Limit time spent sitting&quot;; &quot;Eat lots of whole&#xD;
        grains, legumes, fruits and vegetables&quot;; &quot;Limit high-calorie foods (foods rich in sugar or&#xD;
        fat) and avoid sugary drinks&quot;; &quot;Avoid processed meat; limit consumption of red meat and&#xD;
        salt-rich foods&quot;; &quot;Limit alcohol consumption, although it is best for cancer prevention to&#xD;
        avoid alcoholic beverages&quot;; and the URL link to visit the Spanish version of the ECAC's&#xD;
        website to consult additional information, through the mobile phone or other digital device.&#xD;
        All messages were endorsed and signed by the Head of the Andalusian Regional Ministry of&#xD;
        Health.&#xD;
  &#xD;
        Data collection was conducted for the investigators at two time points: at baseline during&#xD;
        the recruitment call, a pre-intervention survey was performed to gather basic&#xD;
        socio-demographic and patterns of use of new technologies (e.g., type of mobile device,&#xD;
        internet access from phone or computer, etc.); at the end of the intervention, from one week&#xD;
        to one month after receiving the last message, a post-intervention survey was carried out by&#xD;
        telephone to all participants.&#xD;
  &#xD;
        Variables and categorization The sample was described for the investigators according to the&#xD;
        following socio-demographic variables of the participants: sex, age, employment status, level&#xD;
        of education, living alone or not, and province of residence. The mHealth-related variables&#xD;
        included were the type of mobile phone, access to the Internet through the mobile phone or&#xD;
        other digital device, permanent access to Internet data or only through Wi-Fi, ability to&#xD;
        browse on the Internet and from which type of device, and willingness to receive messages in&#xD;
        the future (acceptability of a future intervention). The survey questions were structured for&#xD;
        the investigators to estimate intervention-related variables: the adoption of the innovation&#xD;
        (number of messages read) for the participants, the fidelity to the mHealth implementation&#xD;
        strategy (receiving and reading the number of messages expected), the preferred frequency and&#xD;
        time to receive messages, willingness to seek further information (number of visits to the&#xD;
        ECAC website), and perceived utility and understandability of the messages.&#xD;
  &#xD;
        Statistical analysis The sample size was calculated for the investigators considering a&#xD;
        confidence level of 95% (5% alpha error), a precision of 5% (width of the confidence&#xD;
        interval), an expected proportion of 50% (maximum indeterminacy) in the main variables from&#xD;
        the Conceptual Framework for Implementation Outcomes (adoption, fidelity, appropriateness,&#xD;
        and acceptability), and a non-response rate of 5%.&#xD;
  &#xD;
        Participation rate was considered for the investigators an outcome and therefore calculated&#xD;
        as the rate of those who accepted participate in the study among all those who responded to&#xD;
        the recruitment call. A descriptive analysis was performed for the investigators to assess&#xD;
        homogeneity across groups by sociodemographic data by means of relative frequencies, using&#xD;
        Chi-square test for categorical covariates and t-tests for continuous covariates, in the&#xD;
        univariate analysis. The sample was also described at follow-up, according to&#xD;
        socio-demographic data and patterns of mHealth use by messaging channel. The implementation&#xD;
        research outcomes of adoption, fidelity, appropriateness, and acceptability, and willingness&#xD;
        to visit the ECAC's website (coded as a form of adoption) for the participants, were&#xD;
        calculated with relative frequencies by dissemination channel and intervention group.&#xD;
        Finally, a multivariate logistic regression was conducted to characterize the participant&#xD;
        socio-demographic characteristics associated with having read at least one message weekly.&#xD;
        Crude and adjusted Odds Ratios (cOR and aOR) and its 95% confidence intervals (95% CI) were&#xD;
        calculated. Significant association was defined with p≤0.05. STATA 17.0 and SPSS V.21.0. were&#xD;
        used in the analysis.&#xD;
      </textblock>
    </detailed_description>
    <overall_status>Terminated</overall_status>
    <why_stopped>
      The field work was extended over time, mainly due to the COVID-19 pandemic and due to changes&#xD;
      in the structure of the institution in charge of it.&#xD;
    </why_stopped>
    <start_date type="Actual">January 1, 2018</start_date>
    <completion_date type="Actual">July 10, 2022</completion_date>
    <primary_completion_date type="Actual">January 10, 2021</primary_completion_date>
    <phase>N/A</phase>
    <study_type>Interventional</study_type>
    <has_expanded_access>No</has_expanded_access>
    <study_design_info>
      <allocation>Randomized</allocation>
      <intervention_model>Parallel Assignment</intervention_model>
      <intervention_model_description>Controlled Clinical Trial</intervention_model_description>
      <primary_purpose>Prevention</primary_purpose>
      <masking>None (Open Label)</masking>
    </study_design_info>
    <primary_outcome>
      <measure>Acceptability of preventive intervention</measure>
      <time_frame>3 months</time_frame>
      <description>Rate of acceptability of a future intervention through a telephone survey (ad hoc questionnaire, created by the researchers).</description>
    </primary_outcome>
    <primary_outcome>
      <measure>Adoption of the innovation</measure>
      <time_frame>3 months</time_frame>
      <description>Number of messages expected</description>
    </primary_outcome>
    <primary_outcome>
      <measure>Fidelity to the mHealth implementation strategy</measure>
      <time_frame>3 months</time_frame>
      <description>To assess this outcome measure, the participants will be asked through a telephone survey (questionnaire, created by the researchers) how many messages they have received and if they have read them</description>
    </primary_outcome>
    <primary_outcome>
      <measure>Willingness to seek further information</measure>
      <time_frame>3 months</time_frame>
      <description>Number of visits to the ECAC website</description>
    </primary_outcome>
    <primary_outcome>
      <measure>Perceived utility of the messages</measure>
      <time_frame>3 months</time_frame>
      <description>Rate of participants who consider the received messages useful and understandable. To assess this outcome measure, the participants be asked, by means of a telephone survey (questionnaire, created by the researchers), if they have found the messages they read useful and if they were well understood.</description>
    </primary_outcome>
    <number_of_arms>4</number_of_arms>
    <enrollment type="Actual">1990</enrollment>
    <condition>Prevention</condition>
    <condition>Health Behavior</condition>
    <arm_group>
      <arm_group_label>App Salud Responde</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>Subjects register in the &quot;Salud Responde&quot; (SR) app services de platform</description>
    </arm_group>
    <arm_group>
      <arm_group_label>SMS Salud Responde</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>Subjects register in SR SMS services platform</description>
    </arm_group>
    <arm_group>
      <arm_group_label>Internet</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>Subjects users with internet in their mobile phone</description>
    </arm_group>
    <arm_group>
      <arm_group_label>Whitout internet</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>Subjects whitout internet to recibe message by SMS</description>
    </arm_group>
    <intervention>
      <intervention_type>Behavioral</intervention_type>
      <intervention_name>App message</intervention_name>
      <description>Participantes push App message cancer prevention from the recomendations ECAC. 2 SMS notifications (push) per week or frequency of app notifications per week.</description>
      <arm_group_label>App Salud Responde</arm_group_label>
    </intervention>
    <intervention>
      <intervention_type>Behavioral</intervention_type>
      <intervention_name>SMS message</intervention_name>
      <description>Participants push SMS message cancer prevention from the ECAC. Second randomization for received 2 notifications (push) per week or frequency of 7 SMS notifications per week.</description>
      <arm_group_label>SMS Salud Responde</arm_group_label>
    </intervention>
    <intervention>
      <intervention_type>Behavioral</intervention_type>
      <intervention_name>Internet</intervention_name>
      <description>Internet connection in their mobile phone and WI-Fi. Participants push message cancer prevention from the recomendations ECAC. Second randomization for received 2 notifications (push) per week or frequency of 7 SMS notifications per week.</description>
      <arm_group_label>Internet</arm_group_label>
      <other_name>internet connection</other_name>
    </intervention>
    <intervention>
      <intervention_type>Behavioral</intervention_type>
      <intervention_name>Whithout internet</intervention_name>
      <description>Second randomization for received 2 notifications (push) per week or frequency of 7 SMS notifications per week.</description>
      <arm_group_label>Whitout internet</arm_group_label>
    </intervention>
    <eligibility>
      <criteria>
        <textblock>
          Criteria&#xD;
  &#xD;
          Inclusion Criteria:&#xD;
  &#xD;
          -18 years or over, being entitled to health care benefits in Public Andaluz Sanitary System&#xD;
          (SSPA in Spanish), user from the User Database (BDU in Spanish) having a mobile phone, and&#xD;
          being able to read messages on them.&#xD;
  &#xD;
          Exclusion Criteria:&#xD;
  &#xD;
          -Failing to give informed consent to participate in the trial.&#xD;
        </textblock>
      </criteria>
      <gender>All</gender>
      <minimum_age>18 Years</minimum_age>
      <maximum_age>N/A</maximum_age>
      <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
    </eligibility>
    <overall_official>
      <last_name>Carolina Espina</last_name>
      <role>Principal Investigator</role>
      <affiliation>World Health Organization</affiliation>
    </overall_official>
    <location>
      <facility>
        <name>University of Cordoba</name>
        <address>
          <city>Córdoba</city>
          <zip>14011</zip>
          <country>Spain</country>
        </address>
      </facility>
    </location>
    <location_countries>
      <country>Spain</country>
    </location_countries>
    <verification_date>August 2023</verification_date>
    <study_first_submitted>July 12, 2023</study_first_submitted>
    <study_first_submitted_qc>August 11, 2023</study_first_submitted_qc>
    <study_first_posted type="Actual">August 15, 2023</study_first_posted>
    <last_update_submitted>August 11, 2023</last_update_submitted>
    <last_update_submitted_qc>August 11, 2023</last_update_submitted_qc>
    <last_update_posted type="Actual">August 15, 2023</last_update_posted>
    <responsible_party>
      <responsible_party_type>Principal Investigator</responsible_party_type>
      <investigator_affiliation>Hospital Universitario Reina Sofia de Cordoba</investigator_affiliation>
      <investigator_full_name>Luis A Perula</investigator_full_name>
      <investigator_title>Principal investigator</investigator_title>
    </responsible_party>
    <keyword>Cancer prevention</keyword>
    <keyword>mHealth</keyword>
    <keyword>European Code Against Cancer</keyword>
    <keyword>Health Promotion</keyword>
    <!-- Results have not yet been posted for this study                                          -->
  </clinical_study>
  
  
text: download date: ClinicalTrials.gov processed this data on September 20, 2023
  link text: Link to the current ClinicalTrials.gov record.
  url: https://clinicaltrials.gov/ct2/show/NCT05992792
  org study id: AP-0176-2018
  nct id: NCT05992792
  lead sponsor: 
  collaborator: 
  has dmc: No
  is fda regulated drug: No
  is fda regulated device: No
  is us export: No
  We conducted an implementation research pilot study to assess the adoption, fidelity,
        appropriateness and acceptability on an intervention to effectively disseminate cancer
        prevention messages to the public throught a mHealth implementation strategy
  A type-2 hybrid effectiveness-implementation study was designed to primarily test the impact
        of a mHealth implementation strategy on implementation outcomes (e.g., adoption, fidelity of
        intervention delivery) while simultaneously gathering information on the effectiveness of the
        intervention. The feasibility single-blind randomised controlled trial has been carried out
        on a sample of the general population in the Autonomous Community of Andalusia, the most
        populated region of Spain, with more than 8.5 million residents (17.9%). The Andalusian
        Health Service (SAS, acronym in Spanish) is the main healthcare provider of the Andalusian
        Public Health System (SSPA, acronym in Spanish), part of the decentralised Spanish National
        Health System, which provides free universal health insurance. The SAS oversees "Salud
        Responde" (SR, acronym in Spanish), a multi-channel platform that provides a broad online
        portfolio of services to respond to health-related issues and administrative management needs
        of citizens and health professionals, complementing the care provided by the health care
        units. It allows 24 hours a day access to the services and benefits of the SSPA, from any
        point in Andalusia, through telephone, e-mail, short message system (SMS) and a mobile
        application (app) to manage appointments and reminders, and to disseminate personalized
        health information. The app has a high coverage with more than 5.7 million users (67% of the
        Andalusian's population) registered in its system in 2023; yet the SR platform maintains the
        information system service via SMS for specific campaigns to those users who do not have or
        want the app installed on their mobile phone (around 9700 registered users).
  
        The inclusion criteria were being 18 years or over, being entitled to health care benefits in
        SSPA, having a mobile phone, and being able to read messages on them. A sample of 1991 users
        from the User Database (BDU, in Spanish) of the SSPA, that in 2019 included more than 8.5
        million users (REF), was used to randomly assign subjects to the different groups. The first
        randomization was performed according to the recruitment procedure (users registered or not
        in the SR platform) and the technology used to disseminate the messages (app or SMS). Group 1
        (G1), subjects registered in the SR app service platform, and Group 2 (G2) subjects
        registered in the SR SMS service platform, were recruited through phone call. The rest of
        subjects needed to reach the target sample size were recruited from those included in the BDU
        database through a phone call. A maximum of eight attempts were done before considering no
        response. To be able to calculate participation rate (positive response rate + acceptance to
        participate), no replacement was performed.
  
        For those not registered in the SR platform who accepted to participate in the study, a
        further distribution was done based on a discriminatory question: those users with internet
        connection in their mobile phone both through 3G/4G and Wi-Fi were allocated in Group 3 (G3)
        and encouraged to download the app to receive messages, and those without internet were
        allocated in Group 4 (G4) to receive messages by SMS. Informed consent to participate was
        requested for tehe investigators and the voluntary and anonymous nature of the participation
        was ensured. The simple randomisation to the different study groups was performed using the
        EPIDAT 4.0 programme. The second randomization was performed based on the messages' delivery
        frequency: frequency of 2 SMS or 2 app notifications ("push") per week, or frequency of 7 SMS
        or 7 app notifications per week.
  
        Intervention After the second randomisation, an intervention was conducted for 4 weeks where
        participants were sent app push notifications or SMS messages via the SR platform. Each push
        notification or SMS message included a cancer prevention recommendation from the ECAC 4th
        edition (in Spanish) from the following list: "Don't smoke. Do not use any type of tobacco";
        "Maintain a healthy weight"; "Exercise daily. Limit time spent sitting"; "Eat lots of whole
        grains, legumes, fruits and vegetables"; "Limit high-calorie foods (foods rich in sugar or
        fat) and avoid sugary drinks"; "Avoid processed meat; limit consumption of red meat and
        salt-rich foods"; "Limit alcohol consumption, although it is best for cancer prevention to
        avoid alcoholic beverages"; and the URL link to visit the Spanish version of the ECAC's
        website to consult additional information, through the mobile phone or other digital device.
        All messages were endorsed and signed by the Head of the Andalusian Regional Ministry of
        Health.
  
        Data collection was conducted for the investigators at two time points: at baseline during
        the recruitment call, a pre-intervention survey was performed to gather basic
        socio-demographic and patterns of use of new technologies (e.g., type of mobile device,
        internet access from phone or computer, etc.); at the end of the intervention, from one week
        to one month after receiving the last message, a post-intervention survey was carried out by
        telephone to all participants.
  
        Variables and categorization The sample was described for the investigators according to the
        following socio-demographic variables of the participants: sex, age, employment status, level
        of education, living alone or not, and province of residence. The mHealth-related variables
        included were the type of mobile phone, access to the Internet through the mobile phone or
        other digital device, permanent access to Internet data or only through Wi-Fi, ability to
        browse on the Internet and from which type of device, and willingness to receive messages in
        the future (acceptability of a future intervention). The survey questions were structured for
        the investigators to estimate intervention-related variables: the adoption of the innovation
        (number of messages read) for the participants, the fidelity to the mHealth implementation
        strategy (receiving and reading the number of messages expected), the preferred frequency and
        time to receive messages, willingness to seek further information (number of visits to the
        ECAC website), and perceived utility and understandability of the messages.
  
        Statistical analysis The sample size was calculated for the investigators considering a
        confidence level of 95% (5% alpha error), a precision of 5% (width of the confidence
        interval), an expected proportion of 50% (maximum indeterminacy) in the main variables from
        the Conceptual Framework for Implementation Outcomes (adoption, fidelity, appropriateness,
        and acceptability), and a non-response rate of 5%.
  
        Participation rate was considered for the investigators an outcome and therefore calculated
        as the rate of those who accepted participate in the study among all those who responded to
        the recruitment call. A descriptive analysis was performed for the investigators to assess
        homogeneity across groups by sociodemographic data by means of relative frequencies, using
        Chi-square test for categorical covariates and t-tests for continuous covariates, in the
        univariate analysis. The sample was also described at follow-up, according to
        socio-demographic data and patterns of mHealth use by messaging channel. The implementation
        research outcomes of adoption, fidelity, appropriateness, and acceptability, and willingness
        to visit the ECAC's website (coded as a form of adoption) for the participants, were
        calculated with relative frequencies by dissemination channel and intervention group.
        Finally, a multivariate logistic regression was conducted to characterize the participant
        socio-demographic characteristics associated with having read at least one message weekly.
        Crude and adjusted Odds Ratios (cOR and aOR) and its 95% confidence intervals (95% CI) were
        calculated. Significant association was defined with p≤0.05. STATA 17.0 and SPSS V.21.0. were
        used in the analysis.
  allocation: Randomized
  intervention model: Parallel Assignment
  intervention model description: Controlled Clinical Trial
  primary purpose: Prevention
  masking: None (Open Label)
  measure: Acceptability of preventive intervention
  time frame: 3 months
  description: Rate of acceptability of a future intervention through a telephone survey (ad hoc questionnaire, created by the researchers).
  measure: Adoption of the innovation
  time frame: 3 months
  description: Number of messages expected
  measure: Fidelity to the mHealth implementation strategy
  time frame: 3 months
  description: To assess this outcome measure, the participants will be asked through a telephone survey (questionnaire, created by the researchers) how many messages they have received and if they have read them
  measure: Willingness to seek further information
  time frame: 3 months
  description: Number of visits to the ECAC website
  measure: Perceived utility of the messages
  time frame: 3 months
  description: Rate of participants who consider the received messages useful and understandable. To assess this outcome measure, the participants be asked, by means of a telephone survey (questionnaire, created by the researchers), if they have found the messages they read useful and if they were well understood.
  arm group label: App Salud Responde
  arm group type: Experimental
  description: Subjects register in the "Salud Responde" (SR) app services de platform
  arm group label: SMS Salud Responde
  arm group type: Experimental
  description: Subjects register in SR SMS services platform
  arm group label: Internet
  arm group type: Experimental
  description: Subjects users with internet in their mobile phone
  arm group label: Whitout internet
  arm group type: Experimental
  description: Subjects whitout internet to recibe message by SMS
  intervention type: Behavioral
  intervention name: App message
  description: Participantes push App message cancer prevention from the recomendations ECAC. 2 SMS notifications (push) per week or frequency of app notifications per week.
  arm group label: App Salud Responde
  intervention type: Behavioral
  intervention name: SMS message
  description: Participants push SMS message cancer prevention from the ECAC. Second randomization for received 2 notifications (push) per week or frequency of 7 SMS notifications per week.
  arm group label: SMS Salud Responde
  intervention type: Behavioral
  intervention name: Internet
  description: Internet connection in their mobile phone and WI-Fi. Participants push message cancer prevention from the recomendations ECAC. Second randomization for received 2 notifications (push) per week or frequency of 7 SMS notifications per week.
  arm group label: Internet
  other name: internet connection
  intervention type: Behavioral
  intervention name: Whithout internet
  description: Second randomization for received 2 notifications (push) per week or frequency of 7 SMS notifications per week.
  arm group label: Whitout internet
  criteria: 
  gender: All
  minimum age: 18 Years
  maximum age: N/A
  healthy volunteers: Accepts Healthy Volunteers
  last name: Carolina Espina
  role: Principal Investigator
  affiliation: World Health Organization
  facility: 
  country: Spain
  responsible party type: Principal Investigator
  investigator affiliation: Hospital Universitario Reina Sofia de Cordoba
  investigator full name: Luis A Perula
  investigator title: Principal investigator