Mixed-Methods approach to evaluate a mHealth intervention to increase adherence to triage of HPV+ women who have performed self-collection

采用混合方法评估移动医疗干预措施，以提高对自行采集 HPV 的女性进行分诊的依从性

• 批准号: 9365804
• 负责人: Silvina Arrossi
• 金额: $ 40.72万
• 依托单位: CENTER FOR THE STUDY OF STATE / SOCIETY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-01 至 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9365804
• 关键词: Acquired Immunodeficiency Syndrome; Address; Adherence; Adoption; Argentina; Cancer Control; Cancer Etiology; Categories; Cervical; Cervical Intraepithelial Neoplasia; Cessation of life; Cluster randomized trial; Collection; Colon Carcinoma; Colposcopy; Communication; Communities; Community Health; Community Health Aides; Counseling; Country; Cytology; DNA; Data Analyses; Data Collection; Detection; Developing Countries; Development; Diagnosis; Diagnostic; Diagnostic Procedure; Disease; Effectiveness; Electronic Mail; Evaluation; Factor Analysis; Family; Fright; Gender; Health; Health Promotion; Health system; Healthcare; Home visitation; Household; Human Papillomavirus; Human Resources; Hybrids; Incidence; Inequality; Intervention; Latin America; Lesion; Link; Localized Malignant Neoplasm; Maintenance; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Methodology; Methods; Modeling; Pap smear; Patients; Premalignant; Prevention; Procedures; Process; Public Health; Regional Cancer; Reporting; Research Design; Risk; Sampling; Screening for cancer; Structure; System; Techniques; Test Result; Testing; Transportation; Triage; Trust; Visit; Woman; Work; Workload; base; follow-up; implementation research; implementation science; improved; innovation; innovative technologies; mHealth; malignant breast neoplasm; member; mortality; new technology; novel; population health; programs; research study; scale up; screening; social; treatment as usual

7. Project summary/abstract PROJECT: Mixed-Methods approach to evaluate a mHealth intervention to increase adherence to triage of HPV+ women who have performed self-collection Cervical cancer is a serious public health problem reflecting social and gender inequalities in health. It is the third cause of cancer death among women in the world, with more than 85% of cases occurring in developing countries. Currently, the development of new technologies based on HPV DNA detection allows HPV self- collection, increasing screening coverage. In a self-collection based strategy, triage becomes a key step in the prevention process, as it is the first method to identify HPV+ women who will need diagnostic and treatment procedures. However, high adherence to triage is difficult to obtain, which is not surprising given that adherence to follow-up and treatment is a generalized problem in cervical cancer programs. Specific aims of the study are: 1. To evaluate the effectiveness of an innovative multi-component mHealth intervention to increase adherence to triage among women with HPV+ self-collected tests compared to usual care. 2. To evaluate the implementation strategy and identify barriers and facilitators to implementation of the multi-component mHealth intervention. The research study design will follow the structure of an effectiveness-implementation hybrid type I trial, and will use mix-method approach. A cluster randomized trial including 200 CHWs (clusters) and 4000 women will be used to evaluate the effectiveness of the multi-component mHealth intervention to increase adherence to cytology triage at 120 days after positive HPV testing. The mHealth intervention will include SMS messages sent to HPV+ women to inform them when results are available, and subsequent SMS messages as reminders. In addition, for those HPV+ women who did not had a triage cytology result within 60 days of the HPV test result, CHWs will receive an e-mail and SMS message so they can contact these women during home visits for specific counseling and support. For the implementation evaluation, the Consolidated Framework for Implementation Research (CFIR) will be used to guide qualitative data collection and analysis of factors that influence implementation. RE-AIM will be used to assess the Reach, Effectiveness, Adoption, Implementation and Maintenance of the Intervention. Results of this project will provide evidence on the effectiveness of the multi-component mHealth intervention to increase triage of HPV+ women, but it could be adapted to increase compliance of diagnoses/ treatment of cervical cancer and other health problems. Findings from the implementation evaluation will be highly applicable to programs that use or are planning to incorporate HPV self-collection in different settings and countries. In addition, the use of CFIR and RE-AIM in this innovative study will serve as a model of work, constituting an important advance in the use of Implementation Science in the Region.

7。项目摘要/摘要 项目：评估MHealth干预措施的混合方法方法，以增加对分类的依从性 HPV+自我收集的女性 宫颈癌是一个严重的公共卫生问题，反映了健康中的社会和性别不平等。是 世界上女性癌症死亡的第三个原因，其中85％以上发生在发展中 国家。当前，基于HPV DNA检测的新技术的开发允许HPV自我 收集，增加筛选范围。在基于自我收集的策略中，分类成为 预防过程，因为这是识别需要诊断和治疗的HPV+女性的第一种方法 程序。但是，很难获得高度依从性，这并不奇怪 遵守随访和治疗是宫颈癌计划中的一个普遍问题。 该研究的具体目的是：1。评估创新的多组分MHealth的有效性 与往常相比 关心。 2。评估实施策略并确定障碍和促进者的实施 多组分MHealth干预。 研究设计设计将遵循有效性实施I型试验的结构，以及 将使用混合方法方法。一项群集随机试验，包括200个CHW（集群）和4000名女性 用于评估多组分MHealth干预措施的有效性，以提高依从性 HPV阳性测试后120天的细胞学分类。 MHealth干预将包括SMS消息 发送给HPV+妇女在可用结果时通知她们，随后将SMS消息作为 提醒。此外，对于那些在60天内没有分类细胞学结果的HPV+女性 HPV测试结果，CHW将收到一封电子邮件和SMS消息，以便他们可以在这些女性中与这些女性联系 进行特定咨询和支持的家庭访问。对于实施评估，合并 实施研究框架（CFIR）将用于指导定性数据收集和分析 影响实施的因素。 Re-Aim将用于评估覆盖范围，有效性，采用， 干预的实施和维护。 该项目的结果将提供有关多组件MHealth干预效果的证据 增加HPV+女性的分类，但可以适应于提高诊断/治疗的依从性 宫颈癌和其他健康问题。实施评估的发现将是高度的 适用于使用或计划在不同的设置和 国家。此外，在这项创新研究中使用CFIR和RE-AIM将是一种工作模型， 在该地区使用实施科学方面构成了重要的进步。