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 该申请是根据特殊利益通知（NOSI）提交的 23-036”。宫颈癌是低收入国家妇女癌症死亡的主要原因 （LMIC）。妇女经常经历与宫颈癌筛查相关的困扰，恐惧和羞耻，但 缺乏测量宫颈癌或与HPV相关的污名的经过验证的心理测量评估。 合作伙伴，社区成员或医疗保健提供者的内在化和预期的污名 证明可以减少其他健康状况中寻求健康的行为，宫颈癌和 LMICS中与HPV相关的污名筛查率即使提供了筛查。在萨尔瓦多，最多30％ 邀请筛查的妇女不参加。那迫切需要更好地理解和衡量 如何理解和表现HPV污名，并设计可以减少HPV相关的干预措施 污名和增加宫颈癌预防服务的吸收。此行政的目的 补充是为了调整现有的心理测量工具来评估HPV污名并设计可准备的污名 - 减少“简短干预”。该建议与父母赠款一致，该赠款将在临床上验证新的 HPV测试用于LMICS。该补充将重点介绍以下特定目的：1）适应Berger 污名量表（BSS）用于HPV并删除其用于El Salvador和其他LMIC设置，2）进行混合 在El Salvador的背景下，方法对宫颈癌和HPV相关的污名进行了形成评估 宫颈癌预防计划和3）设计了预防性准备的简短干预（BI），以减少与HPV相关的 El Salvador宫颈癌预防计划的污名和增加依从性。这个项目的里程碑 将是经过验证的短形式量表，以评估LMIC中与HPV相关的污名和完整的“摘要” 准备进行测试的干预协议。我们计划寻求随后的资金来测试干预效率。 我们拥有消除一生中宫颈癌的工具，但是需要改进策略的迫切需要 实施疫苗接种，筛查和治疗工作。识别和测量与HPV相关的污名是一个 减少障碍并增加宫颈癌预防并关闭的必要步骤 全球宫颈癌的发病率和死亡率中的不可接受的差距。