Community-Engaged Approaches to Cervical Cancer Prevention and Control in Sub-Saharan Africa: A Scoping Review.
Community-Engaged Approaches to Cervical Cancer Prevention and Control in Sub-Saharan Africa: A Scoping Review.
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DOI：
10.3389/fgwh.2021.697607
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Jacobs ET
中科院分区：
文献类型：
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作者：
Habila MA;Kimaru LJ;Mantina N;Valencia DY;McClelland DJ;Musa J;Madhivanan P;Sagay A;Jacobs ET
背景：宫颈癌仍然是非洲女性癌症死亡的主要原因之一。宫颈癌筛查以及癌前病变的早期发现和治疗是降低发病率和死亡率的循证干预措施之一。美国已采用基于社区的参与性研究（CBPR）来提高筛查的参与度并减少宫颈癌的差异。然而，尚不清楚这些参与方法是否已在撒哈拉以南非洲地区使用，以解决与宫颈癌死亡率相关的差异。目标：强调撒哈拉以南非洲 (SSA) 社区参与宫颈癌预防和控制的情况，描述目前正在使用的社区参与工作，并描述社区参与实现宫颈癌预防和控制最终目标的最佳实践。方法：我们检索了PubMed、Embase、CINHAL、African Journals Online (AJOL)和African Index Medicus-WHO，从建库到2020年6月8日。筛选了620篇标题和摘要，并根据纳入和排除标准审查了56篇全文，其中9篇符合选择标准并被纳入。从纳入的文章中提取相关数据变量并进行叙述综合。结果：2005 年至 2019 年间，纳入了 9 篇描述加纳、肯尼亚、赞比亚、塞内加尔、南非和尼日利亚研究的文章。这些文章描述的工作主要发生在农村地区，主要是 15 至 65 岁的女性。利用社区卫生工作者、宗教组织、传统领袖和教育机构等社区网络提高对宫颈癌的认识。在现有社会结构内开展工作并通过研究工作培训社区成员是解决社区之间宫颈癌发病率和死亡率差异的有希望的方法。讨论：本次范围审查的结果有助于了解哪些基于社区的实践新方法可用于解决疾病负担过重的 SSA 社区之间的宫颈癌差异。社区参与研究过程虽然需要付出努力，但已证明对研究人员及其所服务的社区有益，并为解决 SSA 宫颈癌差异的努力提供了有价值的后续步骤。
Background: Cervical cancer remains one of the top causes of cancer mortality among African women. Cervical cancer screening and early detection and treatment of precancer is one of the evidence-based interventions to reduce incidence and mortality. The application of community-based participatory research (CBPR) has been used in the United States to improve participation in screening and reduce cervical cancer disparities. However, it is unclear whether these engaged approaches have been used in sub-Saharan African to address disparities related to cervical cancer mortality. Objectives: Highlight community engagement in cervical cancer prevention and control in Sub-Saharan Africa (SSA), describe the community engagement efforts that are currently being used, and to describe the best practices for community engagement toward the end-goal of cervical cancer prevention and control. Methods: We searched PubMed, Embase, CINHAL, African Journals Online (AJOL), and African Index Medicus-WHO from inception until June 8, 2020. After screening 620 titles and abstracts, and reviewing 56 full-text articles according to inclusion and exclusion criteria, 9 articles met the selection criteria and were included. Relevant data variables were extracted from the included articles and a narrative synthesis was performed. Results: Between 2005 and 2019, 9 articles describing research in Ghana, Kenya, Zambia, Senegal, South Africa, and Nigeria were included. These articles described work that largely took place in rural settings predominantly among women age 15–65 years. Leveraging community networks such as community health workers, religious organizations, traditional leaders, and educational institutions increased awareness of cervical cancer. Working within existing social structures and training community members through the research effort were promising methods for addressing the disparities in cervical cancer incidence and mortality among communities. Discussion: The findings of this scoping review have contributed to the understanding of which novel approaches to community-based practices can be used to address cervical cancer disparities among SSA communities that carry a disproportionate disease burden. Community engagement in the research process, while effortful, has shown to be beneficial to researchers and to the communities that they serve, and provides valuable next steps in the effort to address cervical cancer disparities in SSA.