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

描述(申请人提供)：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，但这种干预措施的发展受到以下认识差距的限制：(1)对宫颈癌和HPV的文化信仰；(2)针对特定优先人群的有效干预方案，例如土著克丘亚族妇女。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，对克丘亚族妇女的妇科健康产生积极影响，以最大限度地增加筛查机会。该应用程序的总体目标是进行快速评估、响应和评估(RARE)--一种快速的人种学评估方法--评估一项大规模的宫颈癌筛查计划，并使用形成的结果来设计和试点简短的社会营销干预措施。社会营销干预的目的将是 在为期3年的筛查倡议的第三年期间增加筛查接受率。这项拟议研究的基本原理是，当筛查机会既方便又低成本时，使用社会营销策略的干预措施将有效地增加盖丘亚族人的宫颈癌筛查。这两个具体目标是：(1)使用REARE评估影响秘鲁库斯科地区奎丘亚族妇女接受宫颈癌筛查的社会、行为和文化因素；(2)开发和试行一项社会营销干预措施，以增加秘鲁库斯科地区奎丘亚族妇女的宫颈癌筛查接受率和适当的后续护理。拟议的项目具有创新性，因为它将使用REARE对筛查倡议进行实施评估，并为简短的社会营销干预措施的设计和试点提供信息。预计拟议研究的贡献将是制定一项宣传战略，该战略将包括相册和电台广告，并辅之以利用社会网络分析的“口碑”传播。 公共卫生相关性：更好地了解当地克丘亚族妇女对宫颈癌筛查的知识、风险认知和文化态度，将有助于制定更有效的社会营销努力，并影响疾病负担最重的群体中的宫颈癌差距，从而改善公共健康。这项拟议的研究将在系统的人种学研究的基础上，开发和试点一种文化上适当的社会营销干预措施，以增加秘鲁库斯科地区盖丘亚族妇女的宫颈癌筛查，并与一个为期三年的大型宫颈癌筛查计划合作。

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.