Rapid implementation mapping to identify implementation determinants and strategies for cervical cancer control in Nigeria.
Rapid implementation mapping to identify implementation determinants and strategies for cervical cancer control in Nigeria.
复制标题
DOI：
10.3389/fpubh.2023.1228434
复制
发表时间：
2023
影响因子：
5.2
通讯作者：
Aarons, Gregory A.
中科院分区：
文献类型：
--
作者：
Itanyi, Ijeoma Uchenna;Viglione, Clare;Rositch, Anne F.;Olawepo, John Olajide;Olakunde, Babayemi Oluwaseun;Ikpeazu, Akudo;Nwokwu, Uche;Lasebikan, Nwamaka;Ezeanolue, Echezona Edozie;Aarons, Gregory A.
关键词：
宫颈癌对尼日利亚妇女，特别是感染艾滋病毒的妇女构成巨大负担。然而，尼日利亚宫颈癌筛查和治疗的提供和接受程度有限。了解实施决定因素对于将此类循证干预措施有效转化为实践至关重要，特别是在资源匮乏的环境中。 COVID-19 大流行需要在线协作，这使得实施映射在某些方面具有挑战性，同时提供了简化的机会。在本研究中，我们描述了使用虚拟在线方法进行实施映射（步骤 1-3），以确定实施决定因素、机制和策略，以在尼日利亚现有的艾滋病毒基础设施中实施循证宫颈癌筛查和治疗。本研究采用混合方法研究设计，采用虚拟修改名义组技术 (NGT) 流程，与实施映射步骤 1-3 保持一致。十一名利益相关者（六名计划工作人员和五名医疗保健提供者和管理员）参与了虚拟 NGT 流程，该流程分两个阶段进行。第一阶段利用在线调查，第二阶段利用 NGT 和实施映射流程。探索、准备、实施和维持（EPIS）框架用于引发围绕外部背景（即国家和地区）、现有艾滋病毒基础设施的内部组织背景、与双向影响相关的桥接因素以及要实施的健康创新（在本例中为宫颈癌筛查和治疗）的决定因素和战略的讨论。在 NGT 期间，该小组对实施障碍进行了排名，并使用 Mentimeter 对实施策略进行了投票。将宫颈癌筛查和治疗纳入现有综合艾滋病毒规划的十八个决定因素与人力资源能力、获得宫颈癌服务的机会、后勤管理、诊所和客户相关因素有关。排名前三位的决定因素包括人力资源能力差距、获得宫颈癌服务的机会较少以及由于缺乏对疾病和服务的认识而导致对服务的需求不足。确定了一套六项核心实施战略和两项强化实施战略。快速实施映射是一种可行且可接受的方法，用于识别和阐明中低收入国家复杂医疗保健干预措施的实施决定因素、机制和策略。
Cervical cancer constitutes a huge burden among women in Nigeria, particularly HIV-infected women. However, the provision and uptake of cervical cancer screening and treatment is limited in Nigeria. Understanding implementation determinants is essential for the effective translation of such evidence-based interventions into practice, particularly in low-resource settings. COVID-19 pandemic necessitated online collaboration making implementation mapping challenging in some ways, while providing streamlining opportunities. In this study, we describe the use of a virtual online approach for implementation mapping (steps 1–3) to identify implementation determinants, mechanisms, and strategies to implement evidence-based cervical cancer screening and treatment in existing HIV infrastructure in Nigeria. This study used a mixed methods study design with a virtual modified nominal group technique (NGT) process aligning with Implementation Mapping steps 1–3. Eleven stakeholders (six program staff and five healthcare providers and administrators) participated in a virtual NGT process which occurred in two phases. The first phase utilized online surveys, and the second phase utilized an NGT and implementation mapping process. The Exploration, Preparation, Implementation and Sustainment (EPIS) framework was used to elicit discussion around determinants and strategies from the outer context (i.e., country and regions), inner organizational context of existing HIV infrastructure, bridging factors that relate to bi-directional influences, and the health innovation to be implemented (in this case cervical cancer screening and treatment). During the NGT, the group ranked implementation barriers and voted on implementation strategies using Mentimeter. Eighteen determinants to integrating cervical cancer screening and treatment into existing comprehensive HIV programs were related to human resources capacity, access to cervical cancer services, logistics management, clinic, and client-related factors. The top 3 determinants included gaps in human resources capacity, poor access to cervical cancer services, and lack of demand for services resulting from lack of awareness about the disease and servicesA set of six core implementation strategies and two enhanced implementation strategies were identified. Rapid Implementation Mapping is a feasible and acceptable approach for identifying and articulating implementation determinants, mechanisms, and strategies for complex healthcare interventions in LMICs.
登录
查看更多内容
影响因子：
4.5
作者：
John-Akinola YO;Oluwasanu MM;Oladepo O
通讯作者：
Oladepo O
DOI：
10.1186/s13012-015-0242-0
发表时间：
2015-04-21
期刊：
Implementation science : IS
影响因子：
--
作者：
Nilsen P
通讯作者：
Nilsen P
影响因子：
3.5
作者：
Becan, Jennifer E;Bartkowski, John P;Aarons, Gregory A
通讯作者：
Aarons, Gregory A
DOI：
10.1007/s11414-012-9291-1
发表时间：
2012-10-01
影响因子：
1.9
作者：
Green, Amy E.;Fettes, Danielle L.;Aarons, Gregory A.
通讯作者：
Aarons, Gregory A.
影响因子：
7.4
作者：
Gbadamosi SO;Eze C;Olawepo JO;Iwelunmor J;Sarpong DF;Ogidi AG;Patel D;Oko JO;Onoka C;Ezeanolue EE
通讯作者：
Ezeanolue EE