Study protocol for a cluster-randomized trial to compare human papillomavirus based cervical cancer screening in community-health campaigns versus health facilities in western Kenya.
Study protocol for a cluster-randomized trial to compare human papillomavirus based cervical cancer screening in community-health campaigns versus health facilities in western Kenya.
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DOI：
10.1186/s12885-017-3818-z
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发表时间：
2017-12-06
期刊：
影响因子：
3.8
通讯作者：
Bukusi E
中科院分区：
文献类型：
--
作者：
Huchko MJ;Kahn JG;Smith JS;Hiatt RA;Cohen CR;Bukusi E
尽管低资源国家制定了宫颈癌预防指南，但在这些环境中接受筛查的妇女比例很小，成功治疗的妇女更少。利用肯尼亚西部的试点数据和世界卫生组织的建议，我们制定了一项协议，以实施循证宫颈癌筛查，并将其与农村社区的治疗战略联系起来。我们描述了一项群集随机试验的协议，以比较两种实施策略，人乳头瘤病毒（HPV）为基础的宫颈癌筛查计划使用的指标中描述的RE-AIM（达到，疗效，适应，实施和维护）框架。这项研究是在肯尼亚西部18个社区进行的为期三年的两阶段随机分组试验。在第一阶段，6个对照社区在卫生设施进行筛查; 6个干预社区在社区卫生运动中进行筛查。通过自我收集的标本进行人乳头瘤病毒检测进行筛查。第一阶段已经结束，我们正在与社区合作，进一步制定筛查实施战略，并加强与治疗计划的联系。该计划将在第二阶段（强化干预）的另外六个社区进行测试。我们将比较实施战略的范围、效力、成本效益和适应性。有效的低成本宫颈癌预防技术在低收入和中等收入国家越来越普遍。尽管政府越来越多地支持宫颈癌预防，但在服务提供方面仍然存在相当大的差距。我们将利用实施科学来确定最有效的战略，通过制定针对具体情况的循证解决方案来填补这一空白。该方案的设计和结果可以帮助指导在类似环境中实施宫颈癌筛查，这些环境中的妇女最缺乏服务，疾病风险最高。该试验已在ClinicalTrials.gov，NCT 02124252上注册。本文的在线版本（10.1186/s12885-017-3818-z）包含补充材料，可供授权用户使用。
Despite guidelines for cervical cancer prevention in low-resource countries, a very small proportion of women in these settings undergo screening, and even fewer women are successfully treated. Using pilot data from western Kenya and World Health Organization recommendations, we developed a protocol to implement evidence-based cervical cancer screening and linkage to treatment strategies to the rural communities. We describe the protocol for a cluster-randomized trial to compare two implementation strategies for human-papillomavirus (HPV)-based cervical cancer screening program using metrics described in the RE-AIM (reach, efficacy, adaption, implementation and maintenance) framework. The study is a three-year, two-phase cluster-randomized trial in 18 communities in western Kenya. During Phase 1, six control communities were offered screening in health facilities; and six intervention communities were offered screening in community health campaigns. Screening was done with human-papillomavirus testing through self-collected specimens. Phase 1 ended and we are working in partnership with communities to further contextualize the implementation strategy for screening, and develop an enhanced linkage to treatment plan. This plan will be tested in an additional six communities in Phase 2 (enhanced intervention). We will compare the reach, efficacy, cost-effectiveness and adaptability of the implementation strategies. Effective low-cost cervical cancer prevention technologies are becoming more widely available in low- and middle-income countries. Despite increasing government support for cervical cancer prevention, there remains a sizeable gap in service availability. We will use implementation science to identify the most effective strategies to fill this gap through development of context-specific evidence-based solutions. This protocol design and results can help guide implementation of cervical cancer screening in similar settings, where women are most underserved and at highest risk for disease. This trial is registered at ClinicalTrials.gov, NCT02124252. The online version of this article (10.1186/s12885-017-3818-z) contains supplementary material, which is available to authorized users.
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影响因子：
12.7
作者：
Glasgow, RE;Vogt, TM;Boles, SM
通讯作者：
Boles, SM
影响因子：
10.3
作者：
Denny, Lynette;Kuhn, Louise;Wright, Thomas C., Jr.
通讯作者：
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影响因子：
3.7
作者：
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DOI：
10.1097/qai.0b013e3182a0a050
发表时间：
2014-02-01
影响因子：
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作者：
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影响因子：
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作者：
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