Pilot Program

试点计划

• 批准号: 8548610
• 负责人: SONJIA KENYA
• 金额: $ 2.4万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8548610
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Area; Awareness; Behavior; Caring; Cervical; Cervical Cancer Screening; Clinic; Clinical Trials; Collaborations; Communities; Community Health; Community Health Centers; Control Groups; County; Detection; Development; Disease; Education; Educational Curriculum; Educational Intervention; Enrollment; Ethnic group; Florida; Focus Groups; HIV; HIV Infections; HIV Seropositivity; Haiti; Health; Home visitation; House Call; Human Papillomavirus; Immigrant; Individual; Infection; Intervention; Intervention Studies; Kenya; Knowledge; Lead; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Mentors; Methods; Neighborhoods; Oncogenic; Oropharyngeal; Outcome; Outcome Measure; Participant; Persons; Phase; Pilot Projects; Population; Prevention; Preventive screening; Protocols documentation; Randomized Controlled Trials; Recruitment Activity; Research; Research Methodology; Research Project Grants; Resources; Risk; Screening procedure; Series; Services; Site; Target Populations; Testing; Vision; Vulnerable Populations; Woman; antiretroviral therapy; base; cancer health disparity; cancer risk; community based participatory research; experience; improved; intervention effect; member; metropolitan; prevent; primary outcome; programs; standard of care

Pilot Research Project HPV AWARENESS PREVENTS POSITIVE INFECTIONS (HAPPI): A COMMUNITY HEALTH WORKER INTERVENTION TO IMPROVE HPV AND CERVICAL CANCER SCREENING AMONG HIV POSITIVE WOMEN IN LITTLE HAITI Pilot Project Leader: Dr. Sonjia Kenya Mentor: Dr. Erin Kobetz Project Summary: Women infected with HIV, including those who are adherent to antiretroviral therapy (ART), experience an increased risk of infection with oncogenic Human Papillomavirus (HPV). the principal cause of cervical cancer(1-4) Studies in the U.S. and abroad have found that HIV positive women were at least twice as likely to have HPV.(5,6) Accordingly, it is estimated that cervical cancer risk forthis population sub-group is 68% greater than among women who are not HIV positive.(1,7) During 2000-2004, between 13 to 60% of HIV positive women in the U.S. had cervical cytological abnormalities, which can lead to invasive cervical cancer. (8) In South Florida, Black women are at greatest risk for HIV as well as developing and dying from cervical cancer. (9,10) This disparity is most prominent among Haitian Immigrant women, who represent the largest growing Black ethnic group within the Miami metropolitan area. However, to our knowledge, previous intervention efforts have not explicitly targeted this vulnerable population sub-group. Our proposed research aims to fill this gap. As part of an ongoing community-based participatory research (CBPR) initiative in Little Haiti, the predominately Haitian neighborhood in Miami, we plan to develop and implement a Community Health Worker (CHW) intervention tailored to address the unmet, unique needs of HIV positive, Haitian women. The CBPR initiative, known as Patne en Aksyon currently supports a number of studies to address the excess burden of cervical cancer among Haitian women in Little Haiti and elsewhere in the Miami metropolitan area. Consistent with the tenets of CBPR, all such efforts involve meaningful collaboration between academic and community partners. Key stakeholders from the Haitian community, active in Patne en Akyson's Community Advisory Board (CAB), typically define the scope and focus of research, as well as, the specifics of study implementation. For the proposed research, community partners both encouraged the focus on HIV positive women and selected Community Health Workers (CHWs) as the method of intervention. The intent of our proposed intervention is to improve knowledge about HPV and cervical cancer for HIV positive Haitian women. Using community-based participatory research (CBPR) methods, we will collaborate with the target population to create a culturally-sensitive HPV and cervical cancer educational curriculum, including information about accessible screening, and participating in clinical trials focused on AIDS Malignancies. The effects ofthe educational intervention on potential changes in knowledge, screening behaviors, and clinical trial participation will serve as the primary outcome measures. The intervention will be developed and implemented in two phases. For both phases, we will recruit Black women receiving care for HIV infection at one of the SUCCESS CNP community sites, the Miami Beach Community Health Center at the Center for Haitian Studies Clinic (MBCHC/CHS) located in Littie Haiti. Miami. In Phase One, we will identify HIV positive, Haitian women to participate in focus groups aimed to develop a culturally-relevant HPV/Cervical Cancer curriculum that will be used in Phase Two ofthe proposed study. Following development ofthe curriculum, we will implement a randomized controlled trial to test intervention effects (Phase Two). Forty HIV positive women that did not participate in developing the intervention curriculum will be recruited and assigned to an experimental group that receives the CHW intervention or a control group that will continue to receive standard of care (e.g., traditional clinic based education). Over six months, a CHW will conduct a series of in-person home-visits to 20 intervention participants to deliver the education curriculum. Baseline and post-study assessments will measureknowledge, screening behaviors, and clinical trial participation. Upon completion of the protocol and poststudy assessments, participants in the control condition will be offered the CHW intervention. Between group differences will be assessed at 6 months.

先导研究项目 HPV意识预防阳性感染(HAPPI)： 改善小海地HIV阳性妇女HPV和宫颈癌筛查的社区卫生工作者干预 试点项目负责人：桑加博士，肯尼亚 导师：艾琳·科贝茨博士 项目总结： 感染艾滋病毒的妇女，包括那些坚持抗逆转录病毒疗法(ART)的妇女，感染致癌性人乳头瘤病毒(HPV)的风险增加。宫颈癌的主要原因(1-4)美国和国外的研究发现，艾滋病毒阳性的妇女感染HPV的可能性至少是后者的两倍。(5，6)因此，估计这一人群患宫颈癌的风险比不感染艾滋病毒的妇女高68%。(1，7)2000-2004年间，美国13%至60%的艾滋病毒阳性妇女患有宫颈细胞学异常，这可能导致浸润性宫颈癌。(8)在南佛罗里达州，黑人妇女感染艾滋病毒的风险最大，患宫颈癌和死于宫颈癌的风险也最大。(9，10) 这一差距在海地移民妇女中最为突出，她们是迈阿密大都市地区不断增长的最大黑人族裔群体。然而，据我们所知，以前的干预努力并没有明确针对这一弱势群体。我们提出的研究旨在填补这一空白。 作为在迈阿密以海地人为主的小海地正在进行的基于社区的参与性研究(CBPR)倡议的一部分，我们计划开发和实施社区卫生工作者(CHW)干预措施，以满足艾滋病毒阳性的海地妇女未得到满足的独特需求。被称为Patne en Aksyon的CBPR倡议目前支持一些研究，以解决小海地和迈阿密大都市区其他地区海地妇女宫颈癌负担过重的问题。与CBPR的原则一致，所有这些努力都涉及到学术和社区合作伙伴之间有意义的合作。来自海地社区的主要利益攸关方活跃在Patne en Akyson的社区咨询委员会(CAB)，他们通常定义研究的范围和重点，以及研究实施的细节。在拟议的研究中，社区合作伙伴既鼓励将重点放在艾滋病毒阳性妇女身上，也鼓励选择社区卫生工作者作为干预方法。我们提议的干预措施的目的是提高海地艾滋病毒阳性妇女对HPV和宫颈癌的了解。 利用以社区为基础的参与性研究(CBPR)方法，我们将与目标人群合作，创建对文化敏感的HPV和宫颈癌教育课程，包括有关无障碍筛查的信息，并参与专注于艾滋病恶性肿瘤的临床试验。教育干预对知识、筛查行为和临床试验参与的潜在变化的影响将作为主要结果指标。干预措施将分两个阶段制定和实施。在这两个阶段，我们将招募接受艾滋病毒感染护理的黑人妇女，在Success CNP社区站点之一，位于海地利蒂的海地研究中心诊所(MBCHC/CHS)的迈阿密海滩社区卫生中心。迈阿密。在第一阶段，我们将确定艾滋病毒阳性的海地妇女参加重点小组，目的是制定与文化相关的HPV/宫颈癌课程，该课程将用于拟议研究的第二阶段。 随着课程的发展，我们将实施一项随机对照试验来测试干预效果(第二阶段)。40名未参与制定干预课程的艾滋病毒阳性妇女将被招募，并被分配到接受CHW干预的试验组或将继续接受标准护理(例如，以传统诊所为基础的教育)的对照组。在六个月的时间里，社区卫生服务中心将对20名干预参与者进行一系列面对面的家访，以讲授教育课程。基线和研究后评估将衡量知识、筛查行为和临床试验参与情况。在完成方案和研究后评估后，在控制条件下的参与者将被提供CHW干预。组间差异将在6个月后进行评估。