Patient- and Practice-Centered Assessment of Self-Collection

以患者和实践为中心的自取评估

基本信息

批准号：
8555412
负责人：
Andrew Louis Sussman
金额：
$ 17.08万
依托单位：
UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-09-23 至 2016-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8555412
关键词：
Address American Indians Appalachian Region Caring Cervical Cervical Cancer Screening Clinic Clinical Clinical Sensitivity Collection Communities Community Practice Complex Continuity of Patient Care Counseling Country Cytology DNA Decision Making Development Disease Documentation Effectiveness Evaluation Failure Hispanics Home environment Human Papillomavirus Income Intervention Intervention Trial Interview Life Link Malignant Neoplasms Malignant neoplasm of cervix uteri Methods Mexico Mississippi New Mexico Outcome Outcome Measure Patient Care Patients Performance Phase Population Poverty Prevention program Primary Health Care Process Provider Resources Sample Size Sampling Screening procedure Self Assessment Specimen Test Result Testing Translational Research Underserved Population Woman Work aged base cancer care cervical cancer prevention design experience innovation medically underserved novel strategies patient population primary care setting programs translational study willingness

项目摘要

Failures to screen women for cervical cancer are well documented. The current U.S. screening program fails to reach small pockets of populations living mainly in low-resource, medically underserved regions as part of a complex of diseases linked to poverty and/or racial disparities. These populations have cen/ical cancer rates that are similar to middle-income countries and contribute approximately 60% of the cervical cancer cases that occur annually in the U.S. it is reasonable to suggest that the current cervical cancer prevention program has reached its limits and innovative strategies are needed to overcome these barriers and further reduce the burden in underserved populations. HPV DNA testing offers a promising strategy to enhance cervical screening coverage and address both patient and primary care provider challenges along the care process. HPV DNA testing is highly sensitive (90-95%) for identifying women with cervical precancer and cancer when using a clinician-collected specimen, and 20-50% more sensitive than routine cytology programs. Thus, self-collection combined with HPV DNA testing can potentially be used to extend access to women who are not reached by current Pap-based programs. However, there are only limited, small studies of self-collection in the U.S. and more work is needed to determine whether self-collection is acceptable to diverse patient populations as well as potential barriers toward integration of this approach into primary care settings. This mixed method study is designed to: 1. fully describe the current cervical cancer screening and treatment care continuum, and to assess the translational potential of a promising new approach¿self-collection¿by conducting a three-phase sequential mixed-method translational study (Phase la): 2. involve American Indian and Hispanic women in the co-development of a culturally-appropriate approach to self-collection (Phase lb): 3. integrate practice assessment and patient findings (Aims 1 and 2) in an intervention to assess the feasibility and comparability of self-collection methods for HPV testing and routine cervical cytology with HPV co-testing in four purposefully selected primary care clinical settings: (Phase 2)

未能筛查宫颈癌的女性。当前的美国筛查计划未能到达主要生活在低资源，医学欠缺的地区的小口袋与贫困和/或种族分布有关的疾病复合体的一部分。这些人群具有CEN/ICAL 类似于中等收入国家的癌症率，约有60％的宫颈每年在美国发生的癌症病例是合理的，建议目前的宫颈癌预防计划已达到其限制，需要创新策略来克服这些障碍并进一步减少服务不足的人群中的伯恩。 HPV DNA测试提供了承诺增强宫颈筛查覆盖范围并解决患者和初级保健提供者的策略护理过程中的挑战。 HPV DNA测试对识别女性高度敏感（90-95％）使用宫颈预科剂和癌症，使用临床收集的标本，灵敏度增长20-50％比常规细胞学计划。那就是自我收集与HPV DNA测试相结合的可能是用于扩展对当前基于子宫颈掌计划未达到的女性的访问权限。但是，那里仅限于美国的自我收集的小型研究，需要更多的工作来确定是否是否不同的患者人群可以接受自我收集以及融合的潜在障碍这种方法中的初级保健环境。这项混合方法研究旨在： 1。充分描述当前的宫颈癌筛查和治疗护理连续体，并评估承诺新方法的转化潜力通过进行三相顺序混合方法翻译研究（LA）： 2。涉及美洲印第安人和西班牙裔妇女的共同发展自我收集方法（阶段LB）： 3。综合实践评估和患者发现（目标1和2），以评估 HPV测试的自我收集方法的可行性和兼容性和常规的宫颈细胞学 HPV在四个有目的选择的初级保健临床环境中进行的共同测试：（阶段2）