A total of 17 adults participated in this qualitative study. All participants were aged between 21 and 50 years while most of them were females (10/17), residing in the United Kingdom (8/17), married (11/17), and educated to master’s level (11/17). Depending on their geographical locations and common features, these 17 participants were divided into four focus groups: Group 1; Group 2; Group 3; and Group 4. Participants in Group 1 comprised of digital communication experts, those in Group 2 and Group 3 comprised of sexually active persons, and those in Group 4 comprised of drug (tobacco/alcohol) users. (Table 1).

Table 1 Sociodemographic characteristics of the participantsKnowledge of the meaning of oral cancer

Despite their lack of academic or professional training on oral cancer, many of the participants demonstrated a fair knowledge on the meaning of oral cancer (Table 2). For example, one of the participants indicated that oral cancer also occurs in the extraoral parts of head and neck region of the human body. Another participant also identified it as an abnormal growth in the oral cavity.

Table 2 Quotes concerning participants’ knowledge of the meaning of oral cancerFamily history of oral cancer

The participants were also asked about their family history of oral cancer, and if any of them had such family history, they were asked if they knew how it was managed. Only two participants identified that they had relatives with a history of chronic oral lump, but none of these two were certain if the lump was due to oral cancer. Also, these two participants reported cases where alternative (non-Orthodox) therapies such as the use of herbs, powder, and spiritualists were believed to be oral cancer cure among the family, friends, or acquaintances of those affected relatives (Table 3).

Table 3 Quotes from participants concerning their family history on oral cancerKnowledge of oral cancer risk factors

Majority of the participants had knowledge of the risk factors of oral cancer, especially the four major ones: tobacco consumption, alcohol drinking, areca (or betel quid) chewing, and oral human papillomavirus infection. Asides these four risk factors, genetic factors, dietary factors, immunodeficiency, exposure to ultraviolet radiation, and leukoplakia were additional risk factors identified by the participants (Table 4).

Notably, a few participants were found to have no knowledge or some misconceptions about oral cancer risk factors. Examples of the exhibited misconceptions were the belief that mouthwash and dental caries are oral cancer risk factors (Table 4).

Table 4 Quotes on participants’ knowledge of oral cancer risk factorsKnowledge of how oral cancer can be prevented

The participants had fair knowledge concerning the ways oral can be prevented. Some of the ways identified by them include avoiding tobacco use, having a healthy lifestyle, having regular oral cancer screening, using sunscreen, maintaining good oral hygiene, eating healthy diets, getting vaccinated against human papillomavirus, and getting aware about oral cancer (Table 5).

Table 5 Quotes on participants’ knowledge on how oral cancer can be preventedParticipants’ sources of information on oral cancer

The participants indicated the utilisation of diverse non-digital and digital sources to obtain their information on oral cancer (Table 6). Specific examples of these non-digital sources include labels on packaging of cigarettes, hospital personnel (e.g. dentist), family and friends, and print materials (e.g. leaflets, posters). On the other hand, the specific examples of the digital sources were online databases (e.g. PubMed), websites of governmental or public health agencies (e.g. UK’s National Health Service, UK’s government [UK.Gov]), artificial intelligence sites (e.g. Gemini [Google]), online search engines (e.g. Google), social media (e.g. Facebook), online newspaper articles, television, and journal publications. Interestingly, none of the participants mentioned mobile health application as one of their sources of information on oral cancer.

Table 6 Quotes on participants’ sources of information on oral cancerParticipants’ opinions on whether a mobile health application could improve public knowledge on oral cancer

Virtually all the participants gave positive opinions that a mobile health application could improve public knowledge on oral cancer, and the reasons they gave to support their opinions were diverse (Table 7). One of the reasons was that existing online information on oral cancer were too voluminous, complex, and not simplified for lay persons. Another reason was the paucity of information on oral cancer in the digital space. Another reason was that the information in such mobile health application will be specific and focused on oral cancer, making it easier and quicker to access, more reliable, and more trustworthy unlike an unknown or a general source.

Although the participants expressed overwhelmingly positive opinions on the usefulness of mobile health application in improving public knowledge on oral cancer; however, one of them was sceptical about the usefulness of such application, and the participant gave the reason that most people lack a mobile phone, which is needed to access such application.

Table 7 Quotes on participants’ opinions on whether a mobile health application could improve public knowledge on oral cancerParticipants’ attitudes towards personal use of an educational mobile health application on oral cancer

Majority of the participants gave an overwhelmingly positive attitude towards the personal use of an educational mobile health application on oral cancer (Table 8). Notably, there were two participants who were negative about its use.

The attitudes of the participants concerning the use (or non-use) of such application were supported with reasons on why they would use it. Among those that were positive about its use, the need to further educate self on oral cancer, the need to use the application if recommended by a physician, the need to ‘track’ health concerns, and the versatility of the application were the reasons they gave.

Among those two that were negative about its use, the reasons that they gave was that such applications were not interesting while the other did not give any specific reason.

Table 8 Quotes on participants’ attitudes towards personal use of an educational mobile health application on oral cancerParticipants’ goals of using an educational mobile health application on oral cancer

When asked about their goals if at all they want to use an educational mobile health application on oral cancer, the participants identified several goals (Table 9). These goals include to obtain information on how to take good care of the mouth, to obtain reliable and accessible information on oral cancer, and to obtain information on how to prevent oral cancer or self-examine their body for it.

Table 9 Quotes on participants’ goals of using an educational mobile health application on oral cancerTriggers that would prompt the participants to use an educational mobile health application on oral cancer

When asked about what would trigger them to use an educational mobile health application on oral cancer, the participants identified several triggers (Table 10). These triggers include the presence of oral symptoms (e.g. gingival bleeding, toothache), recommendation by a physician, having family history of oral cancer, having free access to the application, if the content of the application is legible, informative, comprehensive, and simplified, having the need for information for oral cancer, and having the need to regularly screen for oral cancer.

Table 10 Quotes on the triggers that would prompt the participants to use an educational mobile health application on oral cancerParticipants’ opinions on the least important features that an educational mobile health application on oral cancer should have

The participants gave diverse opinions on the least important features that an educational mobile health application on oral cancer should have (Table 11). Notably, while one of the participants mentioned that they could not identify any least important features until after seeing such application, others identified those features that are least important to them:

“OK, so I would like for me, I will say I will know the least important [feature] to me when I see the features they [such apps] have. So, when I open this app, I’m going to see the features that are my favourite and I’m going to see the features that I don’t ever get down to. So, maybe if I see the different features that will help me specify my lists. I might not even want to call it out, but I know the feature. I don’t go to, right.” – Participant 4; Group 1.

For those that identified those features that are least important to them, newsletter subscription, display of advertisements, payment subscription, cumbersome/high volume of information, irrelevant notifications, and social media plugins were the features mentioned.

Table 11 The least important features the mobile health application prototype should haveParticipants’ opinions on the most important features that an educational mobile health application on oral cancer should have

The participants gave diverse opinions on the most important features that an educational mobile health application on oral cancer should have. These features include having oral health tips, ability to geospatially locate dental surgeries, streak functions, user-friendliness, basic operability, inclusivity, absence of advertisements, auto-notification functions, ability to operate offline, online, and at a high speed, ability to have a personal tracker, informative content on oral cancer in diverse formats (e.g. texts, infographics, and videos), and operability in multiple languages (Table 12).

Table 12 The most important features the mobile health application prototype should haveParticipants’ history on the use of an educational mobile health application on oral cancer should have

When asked if they have ever used an educational mobile health application on oral cancer, none of the participants reported that they have never used such application before (Table 13).

Table 13 Quotes on participants’ history on the use of educational mobile health application on oral cancer