Early cancer detection through screening programs is a public health priority. However, inequalities in participation persist, with vulnerable populations systematically underrepresented, notably individuals in disadvantaged socioeconomic situations, with low health literacy, or with migrant backgrounds. These populations face multiple barriers individual, institutional, community, and structural that compromise equitable access to screening and the associated scientific research.
Overcoming these obstacles requires an integrated and coordinated approach that acts simultaneously at all levels. One of the main technical challenges is the absence of structural integration of promising strategies into routine care. Current approaches are often fragmented, resulting in ineffective communication and limited engagement of the most vulnerable populations. The implementation challenge lies in developing and applying a holistic solution that addresses the diverse needs of these groups.
Mobile health (mHealth) technologies offer promising opportunities to address these challenges. They can provide personalized and timely support for decision-making while facilitating participation in research throughout the cancer screening process. mHealth solutions can integrate various strategies, such as digital assistants, SMS services, interactive voice response, online consultations, multimedia content, decision support tools, and remote data collection.
The present study is part of the European project INSIDERS (2025–2028), funded under the European Partnership Transforming Health and Care Systems (THCS) and coordinated by Amsterdam UMC (Netherlands), in partnership with the Nursing School of Coimbra (Portugal), the Royal College of Surgeons in Ireland (Ireland), and Canary Technology and Innovation (Romania). The project aims to develop, test, and implement a mobile application (mHealth) co-built with vulnerable citizens, health professionals, and researchers, with the goal of supporting informed decision-making and promoting equitable participation in cancer screening and associated scientific research, particularly among underrepresented populations.
The project focuses on the most prevalent cancer diagnoses for which population screening programs exist in most European countries (colorectal, breast, and cervical cancer), as well as emerging screening programs (e.g., lung and stomach cancer).
The INSIDERS Project is aligned with the objectives of the Transforming Health and Care Systems (THCS) Partnership, a European initiative that aims to improve the equity, efficiency, and sustainability of health and care systems through innovative, person-centred approaches. INSIDERS contributes to these objectives by addressing disparities in access to cancer screening among vulnerable populations, through an adapted mobile application (mHealth) and participatory strategies.The overall goal of INSIDERS is to empower vulnerable populations to make informed decisions about cancer screening, promoting equitable access to health systems through the development, implementation, and evaluation of innovative digital solutions.The project involves a multidisciplinary and international consortium, bringing together the expertise of leading institutions. Together, this consortium ensures the delivery of innovative and scalable solutions while maintaining local and regional relevance
The INSIDERS project aims to address critical gaps in cancer screening and research participation among underserved populations, leveraging innovative approaches to overcome systemic inequities. It tackles multifaceted challenges that hinder access and engagement while advancing digital health solutions and interdisciplinary methodologies to create sustainable impact.
OBJECTIVES AND NOVELTY
The objectives of the INSIDERS project are ambitious, going beyond the state of the art by combining innovative digital tools, interdisciplinary collaboration, and stakeholder co-creation to achieve meaningful and scalable solutions:
1. Mapping Barriers and Facilitators: The project will conduct comprehensive research to identify individual, community, and systemic barriers to cancer screening and research participation. Using a socio-ecological framework, it will uncover actionable insights for intervention design.
2. Developing an Inclusive mHealth Platform: A multifaceted mHealth application will be co-created with underserved populations, healthcare professionals, and researchers. This platform will feature personalized decision-support tools, culturally tailored content, and mechanisms for research participation, addressing gaps in accessibility and engagement. Unlike traditional tools, this participatory approach ensures relevance to real-world needs.
3. Pilot Implementation Across Diverse Contexts: The platform will be tested in three European countries—Portugal, Ireland, and the Netherlands—providing valuable insights into its feasibility, usability, and adaptability across diverse healthcare systems and cultural settings.
4. Advancing Knowledge and Scalability: By integrating data collection and research participation into the platform, the project generates robust evidence on underserved populations’ needs and behaviors. These insights will guide future policy, scaling efforts, and innovations in cancer prevention and care.
O rastreio oncológico é essencial para a deteção e tratamento precoce do cancro, porém as populações vulneráveis continuam sub-representadas, enfrentando barreiras complexas a vários níveis (intrapessoal, institucional, comunitário e político), que comprometem tanto a sua participação nos programas de rastreio como na investigação associada.
Este projeto é inovador por procurar integrar os resultados do levantamento da evidência científica e do estudo qualitativo multinacional com processos de cocriação envolvendo cidadãos, profissionais e decisores. Esta abordagem permitirá identificar e compreender as configurações contexto–mecanismo–resultado que moldam as barreiras e, a partir disso, desenvolver estratégias adaptadas que sustentem uma solução digital mHealth.
Ao articular investigação robusta e participação ativa dos intervenientes, o projeto não só avança a ciência da implementação, como promove maior equidade no rastreio, contribuindo para diagnósticos mais precoces, melhores resultados em saúde e sistemas mais inclusivos e responsivos às necessidades das comunidades vulneráveis.
O envolvimento dos cidadãos neste projeto ocorrerá através de uma abordagem consultiva, na qual diferentes stakeholders, incluindo cidadãos em situação de vulnerabilidade, profissionais de saúde e decisores, partilharão as suas experiências, necessidades e perspetivas sobre os rastreios oncológicos. Ao criar um espaço seguro e estruturado para a escuta ativa, este processo visa assegurar que as estratégias e a solução digital mHealth sejam informadas por evidências empíricas e alinhadas com a realidade dos contextos em que serão implementadas.
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15/06/2025
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