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New Mexico HPV Outcomes, Practice Effectiveness and Surveillance (NM-HOPES)

新墨西哥州 HPV 结果、实践有效性和监测 (NM-HOPES)

基本信息

批准号：
8884548
负责人：
Cosette Marie Wheeler
金额：
$ 100.32万
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：
2011
资助国家：
美国
起止时间：
2011-09-23 至 2018-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8884548
关键词：
Address Advisory Committees American Indians Attitude Belief Caring Cervical Cervical Cancer Screening Clinical Collaborations Communities Data Decision Making Diagnosis Diagnostic tests Disease Documentation Effectiveness Emerging Technologies Environment Epidemiology Evaluation Failure Funding Future Guidelines Health Health Resources Hispanics Home environment Human Papilloma Virus Vaccine Human Papillomavirus Infection Instruction Interdisciplinary Study Intervention Knowledge Leadership Licensure Link Malignant neoplasm of cervix uteri Maps Measures Medical Records Methods Molecular Biology Molecular Epidemiology Monitor New Mexico Outcome Pathology Patients Performance Population Prevention Preventive Primary Health Care Process Provider Public Health Public Health Informatics Recommendation Recording of previous events Registries Reporting Research Research Project Grants Resources Risk Rural Sampling Science Scientist Services Site Solutions System Testing The Sun Therapeutic Effect Transcend Treatment Failure Update Vaccinated Vaccine Design Vagina Vulva Woman Work base care delivery cervical cancer prevention cervicovaginal clinical practice community based participatory research community based practice comparative comparative effectiveness compare effectiveness cost cost effectiveness design follow-up high risk improved innovation interdisciplinary approach multidisciplinary novel patient oriented population based prevent programs screening tool tumor registry

项目摘要

DESCRIPTION (provided by applicant): Approximately 15 HPV types cause virtually all cervical cancers; however, the current HPV vaccines cover only 2 HPV types causing ~70% of invasive cervical cancer and have no therapeutic effect on established infections that place women at risk. Thus, all women will need some kind of routine cervical screening for the foreseeable future. Importantly, the majority of women alive today have not been vaccinated and therefore are at risk for cervical cancer. The US Preventive Services Task Force recommendations on cervical cancer screening have not been updated for nearly a decade and performance measures for cervical cancer screening focus on population coverage rather than on follow-up among women with positive screening and diagnostic tests. Toward improving US cervical cancer prevention, we propose multi-tiered assessments at the statewide, systems, provider and patient levels including targeted medical record review of failures in the screening process; geospatial mapping of population-based screening, diagnosis and treatment; and application of community-based participatory approaches (CBPR) in clinical settings to identify barriers and facilitators across the processes of care including those that may enable novel patient-centered screening options. The cornerstone of our coordinated, multidisciplinary program is the New Mexico HPV Pap Registry which transcends limitations of organizational monitoring by mandating statewide surveillance of all cervical cancer screening, diagnosis and treatment. New Mexico is home to a high proportion of ethnically diverse (i.e., American Indian and Hispanic), rural, impoverished, medically disenfranchised and health-disparate populations at high-risk for cervical cancer. The specific aims of this application are to 1) Establish the New Mexico HPV Outcomes, Practice Effectiveness and Surveillance (NM-HOPES) PROSPR Research Center; 2) Establish a sustainable Screening Process Documentation Unit providing data on patients during their course of cervical cancer screening care; and 3) Integrate and fund 3 research projects with the overarching aim of informing practice and targeted interventions supported by comparative effectiveness evaluations of real-world cervical cancer screening practice and outcomes versus guidelines and innovations.

描述（由申请人提供）：大约 15 种 HPV 类型几乎导致所有宫颈癌；然而，目前的 HPV 疫苗仅涵盖 2 种 HPV 类型，导致约 70% 的浸润性宫颈癌，并且对使女性处于危险之中的既定感染没有治疗作用。因此，在可预见的将来，所有女性都需要进行某种常规宫颈筛查。重要的是，当今大多数女性尚未接种疫苗，因此面临患宫颈癌的风险。美国预防服务工作组关于宫颈癌筛查的建议近十年来一直没有更新，宫颈癌筛查的绩效衡量指标侧重于人群覆盖率，而不是对筛查和诊断测试呈阳性的女性进行随访。为了改善美国宫颈癌的预防，我们建议在全州范围、系统、提供者和患者层面进行多层次评估，包括对筛查过程中失败的有针对性的医疗记录进行审查；基于人群的筛查、诊断和治疗的地理空间测绘；以及在临床环境中应用基于社区的参与方法（CBPR），以确定整个护理过程中的障碍和促进因素，包括那些可能实现以患者为中心的新型筛查方案的方法。我们协调的多学科计划的基石是新墨西哥州 HPV 巴氏涂片登记，它通过强制全州范围内对所有宫颈癌筛查、诊断和治疗进行监测，超越了组织监测的局限性。新墨西哥州拥有大量不同种族（即美洲印第安人和西班牙裔）、农村、贫困、医疗权利被剥夺和健康状况差异的高风险宫颈癌人群。该应用程序的具体目标是 1) 建立新墨西哥州 HPV 结果、实践有效性和监测 (NM-HOPES) PROSPR 研究中心； 2) 建立可持续的筛查过程记录部门，提供患者在宫颈癌筛查护理过程中的数据； 3) 整合并资助 3 个研究项目，其总体目标是为实践和有针对性的干预措施提供信息，并通过对现实世界宫颈癌筛查实践和结果与指南和创新的比较有效性评估来支持。