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Patient- and Practice-Centered Assessment of Self-Collection

以患者和实践为中心的自取评估

基本信息

批准号：
8729296
负责人：
Andrew Louis Sussman
金额：
$ 29.77万
依托单位：
UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR
依托单位国家：
美国
项目类别：
财政年份：
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/8729296
关键词：
Address American Indians Appalachian Region Caring Cervical Cervical Cancer Screening Clinic Clinical Clinical Sensitivity Collection Communities Community Practice Complex Continuity of Patient Care Counseling Country Cytology DNA Decision Making Development Disease Documentation Effectiveness Evaluation Failure Hispanics Home environment Human Papillomavirus Income Intervention Intervention Trial Interview Life Link Malignant Neoplasms Malignant neoplasm of cervix uteri Methods Mexico Mississippi New Mexico Outcome Outcome Measure Patient Care Patients Performance Phase Population Poverty Prevention program Primary Health Care Process Provider Resources Sample Size Sampling Self Assessment Specimen Test Result Testing Translational Research Underserved Population Woman Work aged base cancer care cervical cancer prevention cervicovaginal design experience innovation medically underserved novel strategies patient population primary care setting programs screening translational study willingness

项目摘要

Failures to screen women for cervical cancer are well documented. The current U.S. screening program fails to reach small pockets of populations living mainly in low-resource, medically underserved regions as part of a complex of diseases linked to poverty and/or racial disparities. These populations have cen/ical cancer rates that are similar to middle-income countries and contribute approximately 60% of the cervical cancer cases that occur annually in the U.S. it is reasonable to suggest that the current cervical cancer prevention program has reached its limits and innovative strategies are needed to overcome these barriers and further reduce the burden in underserved populations. HPV DNA testing offers a promising strategy to enhance cervical screening coverage and address both patient and primary care provider challenges along the care process. HPV DNA testing is highly sensitive (90-95%) for identifying women with cervical precancer and cancer when using a clinician-collected specimen, and 20-50% more sensitive than routine cytology programs. Thus, self-collection combined with HPV DNA testing can potentially be used to extend access to women who are not reached by current Pap-based programs. However, there are only limited, small studies of self-collection in the U.S. and more work is needed to determine whether self-collection is acceptable to diverse patient populations as well as potential barriers toward integration of this approach into primary care settings. This mixed method study is designed to: 1. fully describe the current cervical cancer screening and treatment care continuum, and to assess the translational potential of a promising new approach - self-collection - by conducting a three-phase sequential mixed-method translational study (Phase la): 2. involve American Indian and Hispanic women in the co-development of a culturally-appropriate approach to self-collection (Phase lb): 3. integrate practice assessment and patient findings (Aims 1 and 2) in an intervention to assess the feasibility and comparability of self-collection methods for HPV testing and routine cervical cytology with HPV co-testing in four purposefully selected primary care clinical settings: (Phase 2)

没有对妇女进行宫颈癌筛查是有充分记录的。目前美国的筛查项目