Implementation Evaluation of a Cervical Cancer Screening Initiative in Cusco, Per

描述（由申请人提供）：子宫颈癌仍然是全球女性中第二常见的癌症。在秘鲁，粗略估计筛查覆盖率在合格人口的7-43%之间。需要有效的社区干预措施来解决秘鲁安第斯地区的筛查覆盖率问题，但由于我们对以下方面的理解存在差距，此类干预措施的发展受到限制：(1)对宫颈癌和HPV的文化信仰；(2)针对特定优先人群（如土著克丘亚妇女）的有效干预方案。该项目意义重大，因为它将通过实施一项执行良好的、参与性的实施评估和社会营销干预试点研究，最大限度地扩大筛查机会，对克丘亚妇女的妇科健康产生积极影响。本申请的总体目标是进行快速评估、反应和评估（RARE）——一种快速人种学评估方法——来评估一项大型宫颈癌筛查计划，并利用形成性发现来设计和试点一项简短的社会营销干预措施。社会营销干预将旨在

DESCRIPTION (provided by applicant): Cervical cancer continues to be the second most common cancer among women worldwide. In Peru, rough estimates place screening coverage between 7-43% of the eligible population. Effective community-based interventions are needed to address screening coverage in the Andean region of Peru, but the development of such interventions are limited by gaps in our understanding of: (1) cultural beliefs toward cervical cancer and HPV; and (2) effective intervention programs targeting specific priority populations, such as indigenous Quechua women. This project is significant because it will positively impact gynecological health among Quechua women through the implementation of a well-executed, participatory, implementation evaluation and social marketing intervention pilot study to maximize screening opportunities. The overall goal of this application is to conduct Rapid Assessment, Response, and Evaluation (RARE) - a rapid ethnographic assessment approach - to evaluate a large cervical cancer screening initiative and use the formative findings to design and pilot a brief social marketing intervention. The social marketing intervention will be aimed to increase screening uptake during the third year of the 3-year screening initiative. The rationale that underlies the proposed research is that interventions using a social marketing strategy will be effective for increasing cervical cancer screening in Quechua populations when such screening opportunities are both convenient and low cost. The two specific aims are to: (1) evaluate the social, behavioral and cultural factors that impact cervical cancer screening uptake among Quechua women from the Cusco, Peru region using RARE; and (2) develop and pilot a social marketing intervention to increase cervical cancer screening uptake and appropriate follow-up care targeted to Quechua women in the Cusco, Peru region. The proposed project is innovative because it will use RARE to conduct an implementation evaluation of the screening initiative and inform the design and piloting of a brief social marketing intervention. The contribution of the proposed research is expected to be the development of a promotional strategy which will consist of photonovella booklets and radio advertisements, and be supplemented by 'word of mouth' communications using social network analysis. PUBLIC HEALTH RELEVANCE: A better understanding of knowledge, risk perceptions, and cultural attitudes among indigenous Quechua women toward cervical cancer screening will assist in developing more effective social marketing efforts and impacting cervical cancer disparities in groups suffering the greatest burden of the disease, thereby improving public health. The proposed study will develop and pilot a culturally appropriate social marketing intervention based on systematic ethnographic research to increase cervical cancer screening among Quechua women in the Cusco region of Peru in partnership with a large, three-year cervical cancer screening initiative program.