Evaluation of acceptance and perceived barriers to mobile health applications among breast cancer patients and caregivers in a low- to middle-income country

Mobile health (m-health) applications offer the potential to enhance breast cancer care by improving medication adherence, symptom management, and communication between patients and healthcare providers. However, in low- and middle-income countries (LMICs) like Egypt, the adoption of these technologies faces several challenges, including low digital literacy, limited awareness, and concerns about privacy. This cross-sectional study aimed to evaluate the acceptance (defined as willingness to use) and perceived barriers to m-health applications among breast cancer patients and caregivers at the Breast Cancer Comprehensive Center, National Cancer Institute, Cairo University. Most participants (91%) owned a smartphone, with 87% using their devices daily. A high overall acceptance rate for m-health applications was observed, with 86% of participants (approximately 84% of patients and 91% of caregivers) expressing willingness to use these technologies for managing breast cancer care. Preferred features included medication reminders (65%), instructions for use (60%), side effect management (54%), and access to specialist support (48%), and nutritional tips (44%). However, significant barriers to adoption were identified, including lack of awareness (58%), limited digital literacy (43%), and privacy and data security concerns (32%). Educational level was a significant predictor of m-health acceptance, with participants holding a bachelor’s or master’s degree showing a higher likelihood of adopting these tools (98% vs. 41.4% among those with minimal education, p < 0.001). m-health applications have the potential to improve breast cancer care in Egypt, but addressing barriers such as digital literacy, awareness, and privacy concerns will be crucial for widespread adoption. Educational interventions and user-centered app designs that cater to the needs of patients with varying levels of digital literacy are essential. Incorporating low-literacy-friendly features and caregiver engagement can enhance usability and reach. Future research should focus on developing and piloting m-health applications tailored to the specific needs of breast cancer patients in LMICs to ensure equitable access and improve health outcomes.