Improving Uptake of Cervical Cancer Prevention Services in Appalachia

提高阿巴拉契亚地区宫颈癌预防服务的利用率

• 批准号: 10524070
• 负责人: Roger T. Anderson
• 金额: $ 13.24万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-11 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10524070
• 关键词: Address; Age; Appalachian Region; Area; Attention; Biometry; Cervical Cancer Screening; Child; Client; Clinic; Clinical Sciences; Clinical Trials Data Monitoring Committees; Communities; Community Health Systems; Data; Data Collection; Economically Deprived Population; Effectiveness; Effectiveness of Interventions; Evaluation; Female; Goals; Health system; Human Papilloma Virus Vaccination; Human papilloma virus infection; Incidence; Individual; Intervention; Kentucky; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Measures; Modeling; Names; National Cancer Institute; Nature; Ohio; Outcome; Pap smear; Participant; Patients; Prevention program; Process; Proctor framework; Program Evaluation; Provider; Randomized; Recording of previous events; Reduce health disparities; Research; Safety; Services; Special Population; Surveys; Testing; Tobacco smoking behavior; Tobacco use; United States; Use Effectiveness; West Virginia; Woman; Work; base; cancer health disparity; cervical cancer prevention; community based participatory research; community partnership; cost; cost effectiveness; design; dissemination strategy; effectiveness testing; follow-up; health disparity; implementation evaluation; implementation framework; implementation intervention; implementation science; improved; innovation; intervention refinement; medically underserved; mortality; novel; operation; population based; prevention service; programs; recruit; rural area; satisfaction; self testing; social; social health determinants; theories; therapy design; underserved community; uptake; young adult

PROJECT SUMMARY - OVERALL The goal of this Program Project is to address the burden of cervical cancer incidence and mortality in Appalachia through the delivery of a clinic-based integrated prevention program that focuses on the major causes of cervical cancer (tobacco smoking, Human Papillomavirus (HPV) infection, and lack of cervical cancer screening) designed to target individual, social and community, health system and broader contextual-level barriers related to the burden of cervical cancer. Building upon our long history of collaborative research and community partnerships, the Program will test the effectiveness of health system-based interventions focused on tobacco use, HPV vaccination and cervical cancer screening (Pap test and/or self-testing with follow-up of positive tests), as part of an integrated clinic-based cervical cancer prevention program. The multi-level interventions (directed to three levels of influence – clinic, provider and patient) will be offered to eligible female patients and age-eligible children and young adults in four Appalachian states (Ohio, Kentucky, West Virginia and Virginia). Our research process is guided by a socio-ecological model based on the Social Determinants of Health, the Proctor Model for Implementation Science and a Community-Based Participatory Research (CBPR) framework. The aims of this Program Project are to: 1) Test the effectiveness of an integrated cervical cancer prevention program, consisting of three established interventions, designed to address three causes of cervical cancer in a region with one of the highest cervical cancer incidence and mortality rates in the United States; and 2) Evaluate the impact of the cervical cancer prevention program, including implementation, and acceptability, with attention to both short- and long-term impact and sustainability at the clinics. Four cores – Intervention and Consortium, Survey and Data Collection, Biostatistics and Evaluation, and Administrative – will facilitate the smooth and integrated operation of all projects. Integration and interaction of the projects in this Program is evident in several ways: 1) all projects focus on one health disparity; 2) participants will be recruited from the same health systems; 3) a core set of measures is being used by all projects; 4) all projects include transdisciplinary teams; 5) all projects build upon and extend findings from our long history of collaborative research and community partnerships; 6) all projects focus on multi-level assessment and/or interventions using the Warnecke model as a framework and utilize the Proctor et al. Implementation Science Framework; 7) all projects involve interaction with the community in some way, thus enhancing the CBPR nature of the Program; and 8) evaluation will assess implementation, service and client outcomes at the project and overall Program levels including: cost, satisfaction, effectiveness, sustainability, and safety, to name a few outcomes. If successful, this Program Project will provide evidence for a novel and innovative approach to address disparities in underserved communities with plans for sustainability and dissemination, as well as cost-effectiveness data.

项目概要 - 总体 该计划项目的目标是解决阿巴拉契亚地区宫颈癌发病率和死亡率的负担 通过提供以临床为基础的综合预防计划，重点关注颈椎病的主要原因 癌症（吸烟、人乳头瘤病毒 (HPV) 感染和缺乏宫颈癌筛查） 旨在针对个人、社会和社区、卫生系统以及更广泛的相关障碍 以我们长期合作研究和社区的历史为基础。 合作伙伴关系，该计划将测试基于卫生系统的针对烟草的干预措施的有效性 使用、HPV 疫苗接种和宫颈癌筛查（巴氏涂片检查和/或阳性检查后续的自我检测）， 作为基于临床的综合宫颈癌预防计划的一部分。 将为符合条件的女性患者和符合年龄条件的患者提供三个级别的影响力（诊所、提供者和患者） 我们的研究涉及四个阿巴拉契亚州（俄亥俄州、肯塔基州、西弗吉尼亚州和弗吉尼亚州）的儿童和年轻人。 该过程以基于健康的社会决定因素的社会生态模型（Proctor 模型）为指导 实施科学和基于社区的参与性研究（CBPR）框架。 该计划项目旨在： 1) 测试综合宫颈癌预防计划的有效性， 包括三项既定干预措施，旨在解决一个地区宫颈癌的三个原因 是美国宫颈癌发病率和死亡率最高的国家之一；2) 评估 宫颈癌预防计划的影响，包括实施和可接受性，并关注 诊所的短期和长期影响以及可持续性。四个核心——干预和联盟， 调查和数据收集、生物统计和评估以及行政——将促进顺利和 所有项目的一体化运作。 方式：1) 所有项目都集中于一种健康差异；2) 参与者将从同一卫生系统招募； 3) 所有项目均采用一套核心措施； 4) 所有项目均包含跨学科团队； 项目建立在我们长期合作研究和社区历史的基础上并扩展了研究成果 6) 所有项目都侧重于使用 Warnecke 模型进行多层次评估和/或干预 框架并利用 Proctor 等实施科学框架 7) 所有项目都涉及交互； 以某种方式与社区合作，从而增强该计划的 CBPR 性质，并且 8) 评估将进行评估； 项目和总体计划层面的实施、服务和客户成果，包括：成本、 满意度、有效性、可持续性和安全性等等。如果成功，该计划项目将取得成功。 将为解决服务欠缺社区的差异提供新颖和创新方法的证据 包括可持续性和传播计划以及成本效益数据。