Mediators and moderators of the effect of the game changers for cervical cancer prevention intervention on cervical cancer screening among previously unscreened social network members in Uganda.
Mediators and moderators of the effect of the game changers for cervical cancer prevention intervention on cervical cancer screening among previously unscreened social network members in Uganda.
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在乌干达以前未筛查的社交网络成员中，宫颈癌预防干预的游戏规则改变者对宫颈癌筛查的影响的调解人和主持人。
DOI：
10.1186/s12885-023-10924-0
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发表时间：
2023-05-11
期刊：
影响因子：
3.8
通讯作者：
Wanyenze, Rhoda K. K.
中科院分区：
文献类型：
--
作者：
Matovu, Joseph K. B.;Wagner, Glenn J. J.;Juncker, Margrethe;Namisango, Eve;Bouskill, Kathryn;Nakami, Sylvia;Beyeza-Kashesya, Jolly;Luyirika, Emmanuel;Wanyenze, Rhoda K. K.
乌干达的宫颈癌（CC）发病率很高，但CC筛查率却很低。我们的同伴倡导小组干预，宫颈癌预防的游戏规则改变者（GC-CCP），被证明可以增加社交网络成员中的CC筛查。在这个次要分析中，我们检查了这种效应的中介者和调节者，以更好地了解干预如何以及对谁最成功地促进了CC筛查。我们于2021年9月至2022年4月在乌干达东部Namayingo地区进行了一项GC-CCP的试点随机对照试验。40名在过去一年中筛查过CC的成年女性（指数参与者）在基线时登记：20名被随机分配接受7次干预，以使妇女能够参与CC预防宣传，20名被分配到候补名单控制;从这些指数参与者中，103名未经筛查的社交网络成员（改变者）也登记。所有参与者在基线和6个月随访时进行评估。认知和行为CC相关结构从基线到第6个月的变化作为介质进行了检查，使用多元线性回归分析。索引和改变人口统计学和索引CC治疗状态作为调节因素进行了检查。增加参与CC预防宣传完全介导的干预效果改变摄取CC筛查，并与改变CC筛查的可能性增加。指数参与者的CC治疗状态是干预效果的唯一调节因素，因为干预组中筛选阳性并接受癌前病变治疗的人更有可能在第6个月接受CC筛选。GC-CCP对改变CC筛查的影响更大时，改变报告增加参与她自己的倡导CC预防与他人。增加参与CC预防宣传指数和改变参与者之间的干预效果表明宣传的扩散，这预示着在整个网络和更大的社区传播知识和筛选激活。
Cervical cancer (CC) rates are high in Uganda, yet CC screening rates are very low. Our peer advocacy group intervention, Game Changers for Cervical Cancer Prevention (GC-CCP), was shown to increase CC screening uptake among social network members. In this secondary analysis, we examined mediators and moderators of this effect to better understand how and for whom the intervention was most successful in promoting CC screening. We conducted a pilot randomized controlled trial of GC-CCP in Namayingo district, Eastern Uganda between September 2021 and April 2022. Forty adult women who had screened for CC in the past year (index participants) enrolled at baseline: 20 were randomized to receive the 7-session intervention to empower women to engage in CC prevention advocacy, and 20 were assigned to the waitlist control; from these index participants, 103 unscreened social network members (alters) also enrolled. All participants were assessed at baseline and month 6 follow-up. Change in cognitive and behavioral CC-related constructs from baseline to month 6 were examined as mediators, using multivariate linear regression analysis. Index and alter demographics and index CC treatment status were examined as moderators. Increased alter engagement in CC prevention advocacy fully mediated the intervention effect on alter uptake of CC screening, and was associated with an increased likelihood of alter CC screening. CC treatment status of the index participant was the sole moderator of the intervention effect, as those in the intervention group who had screened positive and received treatment for pre-cancerous lesions were more likely to have alters who got screened for CC by month 6. The effect of GC-CCP on alter CC screening is greater when the alter reports increased engagement in her own advocacy for CC prevention with others. The intervention effects on increased engagement in CC prevention advocacy among both index and alter participants suggest a diffusion of advocacy, which bodes well for dissemination of knowledge and screening activation throughout a network and the larger community.
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影响因子：
3.7
作者：
Desta M;Getaneh T;Yeserah B;Worku Y;Eshete T;Birhanu MY;Kassa GM;Adane F;Yeshitila YG
通讯作者：
Yeshitila YG
影响因子：
2.5
作者：
Mbachu, Chinyere;Dim, Cyril;Ezeoke, Uche
通讯作者：
Ezeoke, Uche
影响因子：
3.8
作者：
Marlow LA;Wardle J
通讯作者：
Wardle J
影响因子：
3.3
作者：
Moses, Erin;Pedersen, Heather N.;Ogilvie, Gina S.
通讯作者：
Ogilvie, Gina S.
影响因子：
3
作者：
FESTINGER, L
通讯作者：
FESTINGER, L