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

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.

中心总体情况：项目摘要/摘要 虽然有大量证据可用于乳腺癌和宫颈癌的筛查和早期治疗， 在将这些知识公平和可持续地转化为实践和政策方面仍然存在巨大差距，特别是 在撒哈拉以南非洲地区，筛查和与治疗的联系方面的差距导致了晚期病例的出现。 乳腺癌和宫颈癌、严重的可预防的发病率和死亡率，以及不成比例的障碍 为了缩小这些差距，肯尼亚加强了乳腺癌和宫颈癌筛查。 通过科学研究和培训（突破）中心联合实施跨 肯雅塔国家医院 (KNH)、埃默里大学、华盛顿大学的学科专业知识 女王大学的突破将包括一个行政和参与核心。 社区、临床和政府利益相关者以及科学合作伙伴，并无缝协调[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。 合作伙伴带来了广泛而深入的实施科学和肿瘤学专业知识， 庞大的研究基础、配套的资源承诺（捐款 > 125,000 美元）、国际 严肃的态度，以及超过 10 年的共同努力，发展女性癌症控制和治疗领域的实施科学。 进行有影响力的研究，BREAKTHROUGH 拥有一个培训框架，可以吸引来自各个领域的研究人员 职业范围（教师、研究员、学生）通过支持受训者来可持续地增强能力 成为导师[总体目标 2]。 BREAKTHROUGH 的项目将向利益相关者、技术、网络和丰富活动进行映射。 并与利益相关者共同设计克服女性癌症控制障碍的策略，然后我们进行测试。 针对具体情况、有理论依据的战略的可行性、实施、有效性和维持 克服乳腺癌和宫颈癌筛查采用和整合的复杂障碍， 初级保健中的转诊联系[中心主题；总体目标 3]。 加强 KNH 项目实施科学的地方能力和研究管理的平台。 1 的标题是“加速采用以患者为中心的宫颈癌筛查和治疗链接” 肯尼亚”（DADA LINK），项目 2 的标题为“整合信息技术的多层次战略” 和移动医疗加强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)，该中心、核心和项目将产生可操作的、 混合方法、用户友好的证据以及作为顾问和关键利益相关者的双向参与 传播者、最大限度地扩大影响力、吸收率和可持续性在各个领域得到了很好的整合。 核心和项目，体现了促进我们的机构、研究和影响公平的精神。