The CHESS (Community, Home-based Education, Screening Services) Strategy to increase cervical cancer control access for HIV positive women in Nigeria

CHESS（社区、家庭教育、筛查服务）战略旨在增加尼日利亚艾滋病毒阳性妇女获得宫颈癌控制的机会

• 批准号: 10693963
• 负责人: Olutosin Awolude
• 金额: $ 56.14万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10693963
• 关键词: AIDS related cancer; Adherence; Administrator; Adoption; Aftercare; Age; Anti-Retroviral Agents; Attitude; Belief; Cancer Control; Cancer Intervention; Caring; Cervical; Cervical Cancer Screening; Characteristics; Clinic; Clinical; Communities; Consensus; Consolidated Framework for Implementation Research; Data; Decision Making; Diagnostic Reagent Kits; Disadvantaged; Education; Effectiveness; Eligibility Determination; Ensure; Evaluation; Female; Focus Groups; HIV; HIV Seronegativity; HIV Seropositivity; HIV/AIDS; HPV-High Risk; Health Status; High Prevalence; Highly Active Antiretroviral Therapy; Home; Human Papillomavirus; Human papilloma virus infection; Impact evaluation; Incidence; Individual; Infrastructure; Intervention; Interview; Lesion; Maintenance; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Measures; Mentors; Methodology; Methods; Modeling; Monitor; Mothers; Nigeria; Nigerian; Participant; Persons; Pharmaceutical Preparations; Phase; Policy Maker; Prevention; Prevention program; Process; Professional counselor; Published Comment; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Records; Recurrence; Resources; Risk; Rural Community; Sampling; Shapes; Structure; Support Groups; System; Training; Vertical Disease Transmission; Viral; Viral Load result; Woman; cancer risk; evidence base; experience; follow-up; health service use; home test; implementation evaluation; implementation fidelity; implementation framework; implementation process; innovation; insight; low and middle-income countries; male; mortality; outreach; peer; peer support; post implementation; premalignant; primary health center; process evaluation; program costs; programs; routine practice; scale up; screening; screening program; screening services; social stigma; symposium; systematic review; treatment program

Abstract Despite the increased risk of cervical cancer (CC) for women living with HIV (WLWH), access to CC screening in Nigeria is limited. Access to screening, prevention programs, and highly active antiretroviral therapy has contributed to dramatic declines in the incidence of many AIDS-associated malignancies but have not lowered CC risk in WLWH. Therefore, we seek to leverage the existing HIV treatment infrastructure in Nigeria to integrate home-based CC (HCC) screening for WLWH and evaluate the implementation and sustainability of this model. We will weave HCC activities into the successful, long-standing MoMent (MOther MENTor) peer- based HIV support program and evaluate the implementation of this adapted program for adoption, integration, sustainability, and potential for national scale-up. The Consolidated Framework for Implementation Research (CFIR) and Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) conceptual frameworks will guide our implementation and impact evaluation. In this project, we will pursue three specific aims: 1) use a stakeholder deliberation conference methodology to adapt the successful MoMent program to promote home-based HPV CC screening and follow-up treatment for women who are HIV positive; 2) implement the MoMent HIV+HCC screening program and assess program reach, effectiveness, adoption, and fidelity; and 3) conduct post-implementation process evaluation of barriers and enablers to program maintenance and sustainability. Stakeholder input from WLWH, peer counselors, clinical managers, and federal/state policymakers will shape the adapted program and promote its successful implementation in a sample of 1,500 WLWH. We will be among the first to apply recent systematic review findings that the “characteristics of systems” construct of CFIR is particularly relevant in low/middle income countries. We ensure scalability by focusing on national and state policymaker perspectives in the pre-implementation, implementation, and maintenance phases of the adapted program. In this project, we will advance CC control for WLWH in Nigeria and generate data that can inform effective adaptation and implementation of evidence- based cancer control strategies for people living with HIV in low/middle income countries worldwide.

抽象的 尽管感染艾滋病毒的女性 (WLWH) 患宫颈癌 (CC) 的风险增加，但接受 CC 筛查 在尼日利亚，获得筛查、预防计划和高效抗逆转录病毒治疗的机会有限。 导致许多与艾滋病相关的恶性肿瘤的发病率急剧下降，但并未降低 因此，我们寻求利用尼日利亚现有的艾滋病毒治疗基础设施来降低 WLWH 的 CC 风险。 整合针对 WLWH 的家庭 CC (HCC) 筛查，并评估其实施情况和可持续性 我们将把 HCC 活动融入到成功的、长期存在的 MoMent (MOther MENTor) 同行中。 基于艾滋病毒支持计划，并评估该适应计划的实施情况，以促进采用、整合、 可持续性以及国家推广的潜力。实施研究综合框架。 (CFIR) 和范围、有效性、采用、实施和维护 (RE-AIM) 概念 框架将指导我们的指导和实施影响评估。在这个项目中，我们将追求三个具体目标。 目标：1) 使用利益相关者审议会议方法来调整成功的 MoMent 计划 促进对 HIV 阳性女性进行家庭 HPV CC 筛查和后续治疗 2)； 实施 MoMent HIV+HCC 筛查计划并评估计划的范围、有效性、采用率和 保真度；以及 3) 对计划的障碍和推动因素进行实施后流程评估 来自 WLWH、同行顾问、临床经理和利益相关者的意见。 联邦/州政策制定者将制定调整后的计划并促进其成功实施 我们将成为第一批应用最近的系统审查结果的国家之一。 CFIR 的“系统特征”结构在低/中等收入国家尤其重要。 通过在实施前关注国家和州政策制定者的观点来确保可扩展性， 在该项目中，我们将推进CC控制。 为尼日利亚的 WLWH 提供数据，并生成可以为有效适应和实施证据提供信息的数据 为全球低/中等收入国家的艾滋病毒感染者制定基于癌症控制策略。