The CHESS (Community, Home-based Education, Screening Services) Strategy to increase cervical cancer control access for HIV positive women in Nigeria

CHESS（社区、家庭教育、筛查服务）战略旨在增加尼日利亚艾滋病毒阳性妇女获得宫颈癌控制的机会

• 批准号: 10541349
• 负责人: Olutosin Awolude
• 金额: $ 59.29万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10541349
• 关键词: AIDS related cancer; AIDS/HIV problem; Adherence; Administrator; Adoption; Aftercare; Age; Anti-Retroviral Agents; Attitude; Belief; Cancer Control; Cancer Intervention; Caring; Cervical; Cervical Cancer Screening; Characteristics; Clinic; Clinical; Communities; Consensus; Consolidated Framework for Implementation Research; Data; Decision Making; Diagnostic Reagent Kits; Disadvantaged; Education; Effectiveness; Ensure; Evaluation; Female; Focus Groups; HIV; HIV Seronegativity; HIV Seropositivity; HPV-High Risk; Health Status; High Prevalence; Highly Active Antiretroviral Therapy; Home; Human Papillomavirus; Human papilloma virus infection; Impact evaluation; Incidence; Individual; Infrastructure; Intervention; Interview; Lesion; Maintenance; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Measures; Mentors; Methodology; Methods; Modeling; Monitor; Mothers; Nigeria; Nigerian; Participant; Persons; Pharmaceutical Preparations; Phase; Prevention; Prevention program; Primary Health Care; Process; Professional counselor; Published Comment; Reach Effectiveness Adoption Implementation and Maintenance; Records; Recurrence; Resources; Risk; Rural Community; Sampling; Shapes; Structure; Support Groups; System; Training; Vertical Disease Transmission; Viral; Viral Load result; Woman; base; cancer risk; evidence base; experience; follow-up; health service use; home test; implementation evaluation; implementation fidelity; implementation framework; implementation process; innovation; insight; low and middle-income countries; male; mortality; outreach; peer; peer support; post implementation; premalignant; process evaluation; program costs; programs; routine practice; scale up; screening; screening program; screening services; social stigma; symposium; systematic review; treatment program

Abstract Despite the increased risk of cervical cancer (CC) for women living with HIV (WLWH), access to CC screening in Nigeria is limited. Access to screening, prevention programs, and highly active antiretroviral therapy has contributed to dramatic declines in the incidence of many AIDS-associated malignancies but have not lowered CC risk in WLWH. Therefore, we seek to leverage the existing HIV treatment infrastructure in Nigeria to integrate home-based CC (HCC) screening for WLWH and evaluate the implementation and sustainability of this model. We will weave HCC activities into the successful, long-standing MoMent (MOther MENTor) peer- based HIV support program and evaluate the implementation of this adapted program for adoption, integration, sustainability, and potential for national scale-up. The Consolidated Framework for Implementation Research (CFIR) and Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) conceptual frameworks will guide our implementation and impact evaluation. In this project, we will pursue three specific aims: 1) use a stakeholder deliberation conference methodology to adapt the successful MoMent program to promote home-based HPV CC screening and follow-up treatment for women who are HIV positive; 2) implement the MoMent HIV+HCC screening program and assess program reach, effectiveness, adoption, and fidelity; and 3) conduct post-implementation process evaluation of barriers and enablers to program maintenance and sustainability. Stakeholder input from WLWH, peer counselors, clinical managers, and federal/state policymakers will shape the adapted program and promote its successful implementation in a sample of 1,500 WLWH. We will be among the first to apply recent systematic review findings that the “characteristics of systems” construct of CFIR is particularly relevant in low/middle income countries. We ensure scalability by focusing on national and state policymaker perspectives in the pre-implementation, implementation, and maintenance phases of the adapted program. In this project, we will advance CC control for WLWH in Nigeria and generate data that can inform effective adaptation and implementation of evidence- based cancer control strategies for people living with HIV in low/middle income countries worldwide.

摘要