Enhanced Cervical Cancer Screening Adoption and Treatment Linkage for HIV positive Women in Kenya (eCASCADE-Kenya)

加强肯尼亚艾滋病毒阳性女性的宫颈癌筛查采用和治疗联系 (eCASCADE-Kenya)

• 批准号: 10738135
• 负责人: Michael Hoonbae Chung
• 金额: $ 18.21万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-19 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10738135
• 关键词: Acceleration; Adoption; Advocate; Africa South of the Sahara; Awareness; Breast; Breast Cancer Detection; Breast Cancer Early Detection; Breast Cancer Treatment; Cancer Control; Cancer Etiology; Caring; Cervical Cancer Screening; Clinical; Communities; Complex; Consolidated Framework for Implementation Research; County; Data; Development; Diagnosis; Early Diagnosis; Early treatment; Effectiveness; Eligibility Determination; Equity; Evidence based intervention; Faculty; Focus Groups; Future; Government; HIV Seropositivity; Health Personnel; Health Resources; Health system; Healthcare Systems; Hospitals; Individual; Information Technology; Inservice Training; Institution; International; International Agency for Research on Cancer; Intervention; Interview; Kenya; Link; Malignant neoplasm of cervix uteri; Mammography; Maps; Mentors; Methods; Modeling; Morbidity - disease rate; Motivation; Nature; Oncology; Outcome; Patients; Phase; Policies; Primary Care; Primary Health Care; Process; Proctor framework; Randomized; Research; Research Personnel; Research Project Grants; Research Support; Resources; Screening for cancer; Services; Students; System; Technology; Testing; Training; Universities; Washington; Woman; base; breast exam; candidate identification; candidate selection; career; clinical research site; community engagement; cost; design; evidence base; feasibility testing; implementation evaluation; implementation intervention; implementation outcomes; implementation research; implementation science; implementation/effectiveness; improved; informant; intervention mapping; knowledge translation; mHealth; malignant breast neoplasm; mobile computing; mortality; multiphase optimization strategy; patient navigation; patient oriented; peer; pilot test; pilot trial; population based; primary care provider; programs; recruit; scale up; screening; screening program; synergism; systematic review; uptake; user-friendly; Acceleration; Adoption; Advocate; Africa South of the Sahara; Awareness; Breast; Breast Cancer Detection; Breast Cancer Early Detection; Breast Cancer Treatment; Cancer Control; Cancer Etiology; Caring; Cervical Cancer Screening; Clinical; Communities; Complex; Consolidated Framework for Implementation Research; County; Data; Development; Diagnosis; Early Diagnosis; Early treatment; Effectiveness; Eligibility Determination; Equity; Evidence based intervention; Faculty; Focus Groups; Future; Government; HIV Seropositivity; Health Personnel; Health Resources; Health system; Healthcare Systems; Hospitals; Individual; Information Technology; Inservice Training; Institution; International; International Agency for Research on Cancer; Intervention; Interview; Kenya; Link; Malignant neoplasm of cervix uteri; Mammography; Maps; Mentors; Methods; Modeling; Morbidity - disease rate; Motivation; Nature; Oncology; Outcome; Patients; Phase; Policies; Primary Care; Primary Health Care; Process; Proctor framework; Randomized; Research; Research Personnel; Research Project Grants; Research Support; Resources; Screening for cancer; Services; Students; System; Technology; Testing; Training; Universities; Washington; Woman; base; breast exam; candidate identification; candidate selection; career; clinical research site; community engagement; cost; design; evidence base; feasibility testing; implementation evaluation; implementation intervention; implementation outcomes; implementation research; implementation science; implementation/effectiveness; improved; informant; intervention mapping; knowledge translation; mHealth; malignant breast neoplasm; mobile computing; mortality; multiphase optimization strategy; patient navigation; patient oriented; peer; pilot test; pilot trial; population based; primary care provider; programs; recruit; scale up; screening; screening program; synergism; systematic review; uptake; user-friendly

CENTER OVERALL: PROGRAM SUMMARY / ABSTRACT While considerable evidence is available for screening and early treatment of breast and cervical cancers, huge gaps remain in equitable and sustainable translation of this knowledge into practice and policy, especially in sub-Saharan Africa. In Kenya, gaps in screening and linkage to treatment result in late-stage presentation of breast and cervical cancers, profound preventable morbidity and mortality, and disproportionate hindrance to women’s development. To close these gaps, the Enhanced BReast and cErvical cAncer screening in Kenya THROUGH implementation science research and training (BREAKTHROUGH) Center coalesces trans- disciplinary expertise at Kenyatta National Hospital (KNH), Emory University, University of Washington, and Queen’s University. BREAKTHROUGH will include an Administrative and Engagement Core that engages community, clinical, and government stakeholders and scientific partners, and seamlessly coordinates [Overall Aim 1] our interrelated Research Capacity Building Core and two Research Projects. Our multi-institutional, collaborative partners bring considerable breadth and depth of implementation science and oncology expertise, a substantial research base, matched resource commitments (>$125,000 in contributions), international gravitas, and >10 years of working together. To grow implementation science in women’s cancer control and conduct impactful research, BREAKTHROUGH has a training framework that engages investigators across the career spectrum (faculty, fellows, students) to sustainably strengthen capacity by supporting trainees to become mentors [Overall Aim 2]. We provide didactic training; engagement in Research Projects; and access to stakeholders, technologies, networking, and enrichment activities. BREAKTHROUGH’s projects will map and co-design (with stakeholders) strategies that overcome barriers to women’s cancer control. We then test feasibility, implementation, effectiveness, and sustainment of context-specific, theoretically-informed strategies for overcoming complex barriers to adoption and integration of breast and cervical cancer screening and referral linkages in primary care [center theme; Overall Aim 3]. We also utilize these projects as training platforms to strengthen local capacity and research administration for implementation science at KNH. Project 1 is entitled “accelerating aDoption of pAtient-centereD cervicAl cancer screening and treatment LINKage in Kenya” (DADA LINK) and Project 2 is entitled “a Multi-level strATegy for InTegrating Information technologY and mobile health to strengthen linkAges to breast caNcer screeninG and early detection among women Utilizing primary care in Kenya (MATITI YANGU). The Center, Cores, and Projects will produce actionable, mixed methods, user-friendly evidence and bidirectionally engage with key stakeholders as advisors and disseminators, maximizing reach, uptake, and sustainability. BREAKTHROUGH is well-integrated across Cores and Projects and embodies an ethos of promoting equity in our institutions, research, and our impacts.

中心总体：程序摘要 /摘要 虽然有大量证据可用于筛查和早期治疗乳腺癌和宫颈癌，但 将这种知识转化为实践和政策，特别是 在撒哈拉以南非洲。在肯尼亚，筛查和与治疗联系的差距导致晚期表现 乳腺癌和宫颈癌，可预防的发病率和死亡率，以及不成比例的障碍 妇女的发展。为了缩小这些差距，肯尼亚的乳腺癌和宫颈癌筛查增强 通过实施科学研究与培训（突破）中心汇总 华盛顿大学埃默里大学肯雅塔国家医院（KNH）的纪律专业知识和 皇后大学。突破将包括参与的行政和参与核心 社区，临床和政府利益相关者和科学伙伴，以及无缝协调[总体 目标1]我们相互关联的研究能力建设核心和两个研究项目。我们的多机构， 合作伙伴带来了实施科学和肿瘤专业知识的考虑广度和深度， 一个实质性的研究基础，匹配资源承诺（> 125,000美元的捐款），国际 重力，>十年一起工作。在女性癌症控制和 进行有影响力的研究，突破有一个培训框架，使调查人员参与 职业范围（教职员工，研究员，学生）通过支持受训者来可持续增强能力 成为导师[总体目标2]。我们提供教学培训；参与研究项目；和访问 利益相关者，技术，网络和丰富活动。突破的项目将映射 以及共同设计（与利益相关者）的策略，以克服妇女控制癌症的障碍。然后我们测试 可行性，实施，有效性和维持特定背景的，理论上知名的策略 克服采用和整合乳腺癌和宫颈癌筛查的复杂障碍以及 初级保健中的推荐联系[中心主题；总体目标3]。我们还利用这些项目作为培训 加强KNH实施科学的地方能力和研究管理的平台。项目 1的标题为“加速采用以患者为中心的宫颈癌筛查和治疗连接 肯尼亚”（DADA链接）和项目2的标题为“整合信息技术的多层次策略 和移动健康以加强与女性乳腺癌筛查和早期发现的联系 利用肯尼亚的初级保健（Matiti Yangu）。中心，核心和项目将产生可操作的 混合方法，用户友好的证据和双向与主要利益相关者作为顾问和 传播者，最大化覆盖范围，吸收和可持续性。突破已经整合 核心和项目体现了在我们的机构，研究和我们的影响中促进股权的精神。