Research Project 1

研究项目1

基本信息

批准号：
10738442
负责人：
Juliet Iwelunmor
金额：
$ 25.55万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
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/10738442
关键词：
15 year old Address Affect Africa Area Awareness Behavior Cancer Control Characteristics Charge Climate Clinical Communities Community Participation Consolidated Framework for Implementation Research Country Data Death Rate Decentralization Development Dose Effectiveness Elements Eligibility Determination Equity Evaluation Evidence based intervention Friends Geography Guidelines HIV Health Health Services Human Papilloma Virus Vaccination Human Papilloma Virus Vaccine Human Papilloma Virus-Related Malignant Neoplasm Human Papillomavirus Hybrids Improve Access Incidence Individual Intervention Leadership Malignant Neoplasms Medical Research Mentorship Methods Modeling Nigeria Nigerian Policies Private Sector Randomized, Controlled Trials Records Research Research Project Grants Resources Risk Sampling Services Social support Testing Time Training Translations Vaccination Vaccines Youth aged apprenticeship cancer prevention community based participatory research community clinic community setting cost crowdsourcing effectiveness/implementation design evidence base experimental study girls implementation facilitators implementation outcomes implementation process implementation science implementation strategy implementation/effectiveness improved innovation policy recommendation post implementation preference prevent prevention service primary outcome programs recruit scale up secondary outcome self testing skills social supportive environment tool treatment as usual uptake vaccine acceptance vaccine access

项目摘要

1 Nigerians make up a significant proportion of individuals in Africa dying from human papillomavirus-(HPV) 2 associated cancers. However, they do not access essential cancer prevention services such as evidence- 3 based HPV vaccination to prevent cancer. This is partly explained by barriers that are individual (low 4 awareness), social (insufficient social support), and structural (poor access to vaccines). Implementation of 5 HPV vaccine programs can mitigate some of these barriers by decentralizing vaccine access to reduce the 6 incidence and death rate of HPV-associated cancers. We propose to expand youth-friendly HPV vaccines, 7 informed by a youth participatory action research framework (YPAR), the PEN-3 cultural model, and the 8 Consolidated Framework for Implementation Science (CFIR). Unlike projects targeting youth as passive 9 recipients, the YPAR considers youth to be partners in creating and leading solutions to problems that affect 10 them. PEN-3 cultural model leverages local resources and partnerships from an equity mindset to improve 11 health, while CFIR enables an evaluation of the barriers and facilitators of implementation effectiveness. The 12 proposed Innovative Tools to Expand youth-friendly Services and Translation of HPV services (I-TEST HPV) 13 will draw on two participatory methods, crowdsourcing (i.e., open calls and designathons) and apprenticeships, 14 to increase HPV vaccine uptake among girls aged 9-15 years old per national guidelines. We hypothesize that 15 these two approaches (open challenges and apprenticeships) will increase the uptake of HPV vaccine 16 campaigns in Nigeria. Using a hybrid type II effectiveness implementation design to simultaneously assess 17 both clinical and implementation outcomes, our aims are: 1) To use participatory approaches (crowdsourcing 18 and apprenticeships) to develop new HPV vaccine campaigns; 2) To determine whether the final 19 crowdsourced campaign increases HPV vaccination uptake among girls aged 9-15 years, and evaluate 20 intervention sustainment, one-year post implementation. We will recruit 1,120 girls from 32 communities to a 21 stepped-wedge randomized control trial of the finalist campaign versus usual care. A total of sixty-four trained 22 youth research facilitators from each setting (2 per setting) will implement the final HPV vaccination campaign. 23 The primary outcome is the initial HPV dose vaccine uptake among girls ascertained by vaccination records at 24 community clinics. The secondary outcomes include the second vaccine dose, percent sustainment of core 25 program elements with sustained benefits (uptake of HPV vaccines), and sustained capacity at participating 26 communities at one year after the trial; and 3) To use mixed-methods to explore multilevel factors that 27 influence the uptake of the HPV campaigns. This research aligns with the RFA-CA-11-019 request for research 28 and the US Cancer Moonshot Initiative. The project builds on a strong relationship with the Nigerian Institute 29 for Medical Research (NIMR) to implement a sustainable and scalable community-based model for equitable 30 cancer control. 31 32 33 34 .

1 在非洲死于人乳头瘤病毒 (HPV) 的人中，尼日利亚人占很大比例 2 相关癌症。然而，他们无法获得基本的癌症预防服务，例如证据- 3.基于HPV疫苗接种可预防癌症。这部分是由于个人障碍（低 4 意识）、社会性（社会支持不足）和结构性（疫苗获取渠道不佳）。实施 5 HPV 疫苗计划可以通过分散疫苗获取来减少其中一些障碍 6 HPV相关癌症的发病率和死亡率。我们建议扩大适合青少年的 HPV 疫苗， 7 依据青年参与行动研究框架 (YPAR)、PEN-3 文化模型和 8 实施科学综合框架 (CFIR)。与针对年轻人的被动项目不同 9 接受者，YPAR 认为青年人是创造和领导解决影响影响的问题的合作伙伴 10 个。 PEN-3 文化模型以公平的心态利用当地资源和合作伙伴关系来改善 11 健康，而 CFIR 可以评估实施有效性的障碍和促进因素。这 12 项拟议的创新工具，以扩大青年友好型服务和 HPV 服务的翻译（I-TEST HPV） 13 将利用两种参与方法：众包（即公开征集和指定马拉松）和学徒制， 14 根据国家指南，增加 9-15 岁女孩的 HPV 疫苗接种率。我们假设 15 这两种方法（公开挑战和学徒期）将增加 HPV 疫苗的使用在尼日利亚开展了 16 场活动。使用混合 II 型有效性实施设计来同时评估 17 无论是临床还是实施结果，我们的目标是： 1) 采用参与式方法（众包） 18 和学徒）开发新的 HPV 疫苗活动； 2) 判断是否最终 19 众包活动提高了 9-15 岁女孩的 HPV 疫苗接种率，并评估 20 次干预维持，实施一年后。我们将从 32 个社区招募 1,120 名女孩加入决赛入围活动与常规护理的 21 项阶梯式楔形随机对照试验。共培训六十四名来自每个机构的 22 名青年研究协调员（每个机构 2 名）将实施最终的 HPV 疫苗接种活动。 23 主要结果是通过疫苗接种记录确定的女孩初始 HPV 疫苗接种情况。 24个社区诊所。次要结果包括第二剂疫苗、核心疫苗维持百分比 25 个具有持续效益（HPV 疫苗的接种）和持续参与能力的计划要素试验一年后26个社区； 3）使用混合方法探索多层次因素 27 影响 HPV 活动的开展。这项研究符合 RFA-CA-11-019 的研究请求 28 和美国癌症登月计划。该项目建立在与尼日利亚研究所的牢固关系之上 29 医学研究 (NIMR) 实施可持续且可扩展的基于社区的模型，以实现公平 30 癌症控制。 31 32 33 34.