Self-Testing Options in the era of Primary HPV screening for cervical cancer: the STEP trial

宫颈癌初级 HPV 筛查时代的自我检测选择：STEP 试验

• 批准号: 10468556
• 负责人: DIANA SM BUIST
• 金额: $ 20万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10468556
• 关键词: Adult; Age; Behavior; Cervical; Cervical Cancer Screening; Characteristics; Computerized Medical Record; Ensure; Epidemiologist; Ethnic Origin; Ethnic group; Future; Goals; Gold; Guidelines; Health Professional; Healthcare Systems; Human Papillomavirus; Individual; Intervention; Language; Malignant neoplasm of cervix uteri; Measurement; Measures; Modality; National Health Interview Survey; Patients; Provider; Public Health; Questionnaire Designs; Questionnaires; Race; Recording of previous events; Regimen; Research Personnel; Sampling; Screening for cancer; Surveys; Testing; Time; Time trend; Validity and Reliability; Washington; Woman; base; cancer risk; cognitive interview; electronic data; outreach; patient population; preference; recruit; response; screening; self testing; sociodemographics

Title: Validity and Reliability of Survey Measures for Cervical Cancer Screening in the Redesigned National Health Interview Survey (NHIS) Measuring cervical cancer screening behavior in the U.S. helps public health professionals evaluate progress towards the Healthy People goals and develop and evaluate interventions to increase appropriate screening use. It also helps healthcare systems/providers determine if a cervical screening or surveillance regimen is needed for new patients, which is critical to support outreach and quality metric activities. Comprehensively assessing whether an woman has received appropriate screening requires multiple questions that probe on the type of screening test (Pap alone, primary HPV, co-testing with Pap and HPV), time since and results of their last test (normal, abnormal), and indication (screening or symptomatic). Ideally, similar cancer screening history questions would be used by public health professionals and healthcare systems to facilitate comparable measurement of screening trends over time. While several national surveys ask individuals about cancer screening, there are no standard, validated, national set of questions for cervical cancer screening history. Because past studies have shown lower validity among race/ethnic groups speaking different languages, it is also critically important to evaluate if survey items are understood equivalently across groups and languages. Soon, self-collected primary HPV screening will be added to the set of recommended modalities. In this supplement, we propose conducting cognitive interviews with a purposive sample of diverse screening-eligible adult women (e.g., by race/ethnicity, English/Spanish language preference, screening history) to further refine National Health Interview Survey (NHIS) cancer screening questions that reflect the new recommended guidelines and anticipate the expanded set of modalities. The goal of the cognitive interviews is to ensure women have similar understanding of items and are willing to respond. We will: (1) use existing electronic data from two healthcare systems (Harborview - U Washington, Parkland-UT Southwestern) that serve diverse patient populations to identify screening-eligible individuals whom we can also characterize in terms of cancer risk, socio-demographics, age, and prior screening history; (2) purposefully sample individuals based on known characteristics to maximize efficiency in recruitment; and (3) employ a highly qualified team of epidemiologists, qualitative researchers, and experts in cervical cancer and questionnaire design. After completing the cognitive interviews and refining the questionnaire, a future study will further evaluate validity and reliability by comparing responses to the gold standard (the patient’s electronic medical record) and survey responses over time. Findings will also be shared with healthcare systems to advise on how to best ascertain screening history among new patients.

标题：重新设计的宫颈癌筛查调查指标的有效性和可靠性 国民健康访问调查（NHIS） 测量美国的宫颈癌筛查行为有助于公共卫生专业人员评估进展 实现健康人的目标，并制定和评估干预措施，以增加适当的筛查 使用.它还有助于医疗保健系统/提供者确定宫颈筛查或监测方案是否 新患者需要这一点，这对于支持外展和质量指标活动至关重要。全面 评估一名妇女是否接受了适当的筛查需要多个问题， 筛查试验的类型（单独的Pap、原发性HPV、Pap和HPV联合检测）、自筛查以来的时间和结果 末次检查（正常、异常）和适应症（筛选或有症状）。理想情况下，类似的癌症筛查 历史问题将由公共卫生专业人员和医疗保健系统使用，以促进可比 测量筛查随时间的变化趋势。虽然一些国家的调查询问个人关于癌症的问题， 目前，没有一套标准的、经过验证的、全国性的宫颈癌筛查问题。 因为过去的研究表明，在讲不同语言的种族/民族群体中， 同样至关重要的是，要评估各群体和各语言对调查项目的理解是否相同。 不久，自我收集的初级HPV筛查将被添加到推荐的模式中。在这 补充，我们建议进行认知访谈与有目的的样本不同筛选合格 成年女性（例如，按人种/种族、英语/西班牙语偏好、筛选史）进一步细化 反映新建议的国家健康访谈调查（NHIS）癌症筛查问题 准则，并预期扩大的一套模式。认知访谈的目标是确保 妇女对项目有类似的理解，并愿意作出答复。我们将：（1）使用现有的电子数据 从两个医疗保健系统（港景- U华盛顿，帕克兰-UT西南），服务于不同的 患者人群，以确定符合筛查条件的个体，我们也可以根据癌症来描述这些个体 风险、社会人口统计学、年龄和既往筛查史;（2）根据已知的 特点，以最大限度地提高招聘效率;和（3）雇用一个高素质的流行病学家团队， 质性研究人员和宫颈癌专家以及问卷设计。在完成认知之后， 访谈和完善问卷，未来的研究将进一步评估效度和信度， 将对黄金标准（患者的电子病历）的答复与对 时间研究结果也将与医疗保健系统分享，以建议如何最好地确定筛查史 在新患者中。