Development of an HPV stigma assessment scale and a stigma-reducing intervention to improve cervical cancer prevention in El Salvador

制定 HPV 耻辱评估量表和减少耻辱干预措施，以改善萨尔瓦多的宫颈癌预防

• 批准号: 10844859
• 负责人: Miriam Cremer
• 金额: $ 18.03万
• 依托单位: CLEVELAND CLINIC LERNER COM-CWRU
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10844859
• 关键词: Abbreviations; Adherence; Administrative Supplement; Adoption; Age Years; Attitude; Cancer Etiology; Cervical Cancer Screening; Cessation of life; Clinic; Clinical; Communities; Comprehension; Consult; Country; Cross-Sectional Studies; Data; Development; Disclosure; Distress; Dose; Education; El Salvador; Eligibility Determination; Ensure; Factor Analysis; Focus Groups; Fright; Funding; Future; HIV; Health; Health Personnel; Health Services Accessibility; Human Papillomavirus; Human papilloma virus infection; In complete remission; Incidence; Income; Intervention; Interview; Literature; Malignant neoplasm of cervix uteri; Malignant neoplasm of lung; Measurement; Measures; Methods; Modeling; Municipalities; Perception; Population; Prevention program; Preventive service; Protocols documentation; Provider; Psychometrics; Sampling; Self Perception; Shame; Structure; Surveys; Testing; Time; Translating; Treatment Efficacy; Vaccinated; Vaccination; Woman; aged; brief intervention; cervical cancer prevention; cognitive interview; design; experience; formative assessment; health seeking behavior; improved; instrument; interest; low and middle-income countries; member; mortality; parent grant; pilot test; programs; recruit; response; screening; screening program; social stigma; socioeconomic disparity; therapy design; tool; treatment adherence; uptake

Project Abstract This application is being submitted in response to the Notice of Special Interest (NOSI) identified as “NOT-CA- 23-036”. Cervical cancer is a leading cause of cancer death for women in low and middle income countries (LMICs). Women often experience distress, fear, and shame associated with cervical cancer screening, but there is a lack of validated psychometric assessments that measure cervical cancer or HPV-related stigma. Internalized and anticipated stigma from partners, community members, or healthcare providers have been shown to reduce health-seeking behaviors in other health conditions, and it is likely that cervical cancer and HPV-related stigma impact screening rates in LMICs even when screening is offered. In El Salvador, up to 30% of women invited to screening do not attend. Thus, there is an urgent need to better understand and measure how HPV stigma is understood and manifested, and to design interventions that can reduce HPV-related stigma and increase uptake of cervical cancer preventive services. The purpose of this Administrative Supplement is to adapt an existing psychometric tool to assess HPV stigma and to design a pilot-ready stigma- reducing “brief intervention”. This proposal is aligned with the parent grant, which will clinically validate a new HPV test for use in LMICs. This Supplement will focus on the following Specific Aims: 1) Adapt the Berger Stigma Scale (BSS) to HPV and abridge it for use in El Salvador and other LMIC settings, 2) Conduct a mixed- methods formative assessment of cervical cancer and HPV-related stigma in the context of El Salvador's cervical cancer prevention program, and 3) Design a pilot-ready brief intervention (BI) to reduce HPV-related stigma and increase adherence in El Salvador cervical cancer prevention program. Milestones for this project will be a validated, short-form scale to assess HPV-related stigma in LMICs and a completed “brief intervention” protocol that is ready for testing. We plan to seek subsequent funding to test intervention efficacy. We have the tools to eliminate cervical cancer in our lifetime, but there is a critical need for improved strategies to implement vaccination, screening, and treatment efforts. Identifying and measuring HPV-related stigma is a necessary step to reduce barriers and increase adoption of cervical cancer prevention and to close the unacceptable gap in global cervical cancer incidence and mortality.

项目摘要 本申请是为了响应被标识为“NOT-CA-”的特殊利益通知 (NOSI) 而提交的。 23-036”。宫颈癌是低收入和中等收入国家女性癌症死亡的主要原因。 （中低收入国家）女性经常会经历与宫颈癌筛查相关的痛苦、恐惧和羞耻感，但是 缺乏有效的心理测量评估来衡量宫颈癌或 HPV 相关的耻辱感。 来自合作伙伴、社区成员或医疗保健提供者的内在和预期的耻辱已经被 研究表明，它可以减少其他健康状况下的寻求健康行为，并且很可能会导致宫颈癌和 即使在萨尔瓦多提供筛查，HPV 相关的耻辱也会影响中低收入国家的筛查率，高达 30%。 受邀参加筛查的女性没有参加因此，迫切需要更好地了解和衡量。 如何理解和表现 HPV 耻辱，以及设计可以减少 HPV 相关的干预措施 耻辱并提高宫颈癌预防服务的采用率 本行政管理的目的。 补充是调整现有的心理测量工具来评估 HPV 耻辱感并设计一个试点就绪的耻辱感。 减少“短暂干预”该提案与家长补助金一致，这将临床验证新的方法。 用于中低收入国家的 HPV 检测本补充文件将重点关注以下具体目标： 1) 适应 Berger。 HPV 污名量表 (BSS) 并对其进行删减，以便在萨尔瓦多和其他中低收入国家环境中使用，2) 进行混合- 萨尔瓦多背景下宫颈癌和 HPV 相关耻辱的形成性评估方法 宫颈癌预防计划，以及 3) 设计一个可试点的简短干预措施 (BI)，以减少 HPV 相关 耻辱并提高萨尔瓦多宫颈癌预防计划的依从性。 将是一个经过验证的简短量表，用于评估中低收入国家中与 HPV 相关的耻辱感，以​​及一个完整的“简短”量表 我们计划寻求后续资金来测试干预效果。 我们拥有在有生之年消除宫颈癌的工具，但迫切需要改进策略 实施疫苗接种、筛查和治疗工作是识别和衡量 HPV 相关耻辱的一项工作。 采取必要的步骤，减少障碍，提高宫颈癌预防的采用率，并关闭 全球宫颈癌发病率和死亡率存在不可接受的差距。