Cancer Center Support Grant

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PROJECT SUMMARY This 21-026”. low- stigma cancer cancer cervical cancer and Institute measure cervical Yale the this explanatory sexual facilitators in sexual randomly explore community members individual, stigma reduce at application is being submitted in response to the Notice of Special Interest (NOSI) identified as "NOT-CA- Cervical cancer is the most common cancer among women in the world, disproportionately affecting and middle-income ountries, where 85% of cervical cancer cases occur. Cancer stigma and sexual may be obstacles to successful cancer prevention, screening and treatment programs, undermining the care continuum, particularly with ervical cancer screening and treatment. The link between cervical and the human papilloma virus, a common sexually transmitted infection (STI), has further stigmatized cancer. I t is, therefore, necessary to understand the impact of cancer and sexual stigma on cervical screening and treatment uptake to develop interventions to educe stigma and strengthen screening treatment. The Yale Center for Methods in I mplementation and Prevention Science, in collaboration with f or Implementation Science and Health and Kathmandu University in Nepal, is conducting a study t o acceptability, feasibility, cost, and sustainability of, as well as to explore f acilitators and barriers to, cancer screening and treatment in central Nepal, supported by the parent grant to this supplement, Cancer Center's (YCC) P30 CA016359, “Yale Comprehensive Cancer Center Support Grant”, for which principal investigator of t his supplement application serves as Assistant Director, Global Oncology With research well underway to serve as a platform for the current study, we propose to implement an mixed-method approach to assess the i nfluence of cervical cancer stigma, and other intersecting stigmas on cervica l cancer screening uptake and partner disclosure, and explore the drivers and of such stigma. the cancer stigma scale and STI stigma and shame scale for use Nepal further, examine the prospective association of cancer and stigma with the uptake and disclosure to male partners of cervical cancer screening among 424 selected women of 30 to 60 years residing in the Dhulikhel municipality in central Nepal. Aim 2 will the drivers, facilitators and manifestations of cervical cancer stigma at individual, family, and level using qualitative in-depth interviews among purposively selected women (n=8), family (n=8) and community leaders (n=8) guided by the Health Stigma and Discrimination Framework at family, health provider and community level, aiming to identify promising components of a future reduction intervention. The study will provide insights into key factors for future programmatic efforts to stigma and improve access to cervical cancer screening and treatment in low resource settings, while, the same time, further strengthening the parent grant's Global Oncology Program. c c r . Aim 1 will validate using confirmatory factor analysis; and