HPV and Cancer mHealth Prevention Education for HIV Positive Women Pilot Study

简介（由申请人提供）：研究助理教授，在健康促进、教育和行为方面受过学术训练，并在艾滋病预防、健康差异和卫生服务研究方面受过博士后训练。她还拥有数据管理专业知识和临床免疫学经验。该候选人已经完成了两项试点研究，检查了感染艾滋病毒的妇女（WLH）的HPV感染和宫颈癌预防知识、信念和筛查行为。该候选人正在寻求制定和实施有效的癌症健康（包括移动健康）沟通和社区导航战略所需的额外培训，以改善WLH及时使用癌症筛查、诊断和治疗服务和程序。候选人的长期目标是在未来5-10年内为她的独立研究项目获得校外研究资金，重点是在WLH中预防和控制hpv介导的癌症。晋升为副教授（终身职位或研究职位）是候选人在未来五年内努力实现的中间目标。正式教学培训和体验式学习机会的结合将用于获得以下领域的癌症预防和控制研究技能：癌症健康（包括移动健康）通信，癌症流行病学，hpv介导的癌症生物学，社区导航，高级流行病学研究技能（例如，社会流行病学，n- of-1研究设计和多层次建模）。该候选人将利用通过拟议的职业发展奖励获得的癌症预防和控制研究以及健康传播知识和技能，进行必要的形成性研究，为干预措施的发展提供信息，其中她将检查妇女医院及其非临床艾滋病毒服务提供者（例如艾滋病毒/性传播感染风险降低顾问）之间的癌症健康信息寻求和共享。非临床艾滋病毒服务提供者将被包括在内，因为除了这些人已经在促进妇女的安全性行为之外，他们还能够接触到妇女的边缘化群体，如无家可归者。这包括受庇护和未受庇护的无家可归者。候选人的导师和共同导师具有科学专业知识和以社区为基础的参与性研究经验，这将增加成功完成所提议的具体目标的可能性。候选人将首先研究hpv介导的癌症预防知识，信念和行为，以及癌症健康沟通寻求和分享行为（包括使用技术查找健康信息）（目标1）。然后，这些形成性研究数据将用于HPV介导的癌症预防移动健康教育干预的开发（目标2）和随后的试点测试和评估（目标3），旨在培训已经作为同行领导者和非临床HIV服务提供者的WLH使用移动健康工具和社区导航策略传播HPV介导的癌症预防教育。作为社区导航员，这些人将使用癌症健康（包括移动健康）沟通和社区导航策略来提高对hpv介导的癌症风险的认识。这将包括促进降低癌症风险的行为（如安全性行为和及时使用推荐的癌症筛查、诊断和治疗服务和程序）。筛查和后续癌症护理预约将发送召回和提醒信息。用户定义的社会支持信息也将发送给可能遇到癌症治疗障碍的WLH。候选人将通过在科学会议和年度会议上的演讲以及她将制作的同行评审出版物向当地、区域、国家和国际受众传播科学研究成果。与候选人获得研究独立的长期目标最相关的是，在5年培训期结束前，将其同行评审出版物的数量从目前的每年约3篇增加到每年4篇或更多，并在5年培训期结束前提交至少一份资助提案（例如，r01级资助）。拟议的职业发展/培训和研究活动将使候选人实现她的长期职业目标，即成为一名独立的癌症研究人员，具有使用癌症健康沟通，社区导航和移动健康技术的专业知识，以解决癌症护理连续体中脆弱，医疗服务不足的WLH遇到的卫生系统故障。持续的指导和团队科学研究合作的机会将促进候选人成功发展成为一名独立的癌症研究人员。WLH和非临床艾滋病毒服务提供者将从瑞安·怀特资助的诊所和艾滋病服务组织中招募，这些诊所和艾滋病服务组织位于南卡罗来纳州的城市和农村地理区域，代表了艾滋病毒/艾滋病、癌症和其他慢性疾病的一个缩影，这些疾病对医疗服务不足的少数群体造成了不成比例的负担。解决在癌症护理连续体中发生的卫生系统故障，这些故障导致错过了预防、发现、诊断和治疗人乳头瘤病毒介导的癌症的机会，将有助于减轻这一高癌症风险、易受伤害的WLH群体的癌症发病率和死亡率负担。拟议的hpv介导的癌症移动健康预防教育干预将在社区环境中进行，并建立在候选人与当地艾滋病服务组织之间现有的学术社区伙伴关系的基础上。候选人有一个支持性的，资源密集型的科学环境，为她的癌症研究培训。

DESCRIPTION (provided by applicant): The candidate is a research assistant professor with academic training in health promotion, education, and behavior, as well as postdoctoral training in HIV/AIDS prevention, health disparities, and health services research. She also has data management expertise and clinical immunology experience. The candidate has completed two pilot studies that examined HPV infection and cervical cancer prevention knowledge, beliefs and screening behaviors among women living with HIV (WLH). The candidate is seeking additional training needed to develop and implement effective cancer health (including mHealth) communication and community navigation strategies to improve WLH's timely use of cancer screening, diagnostic and treatment services and procedures. The candidate's long-term goal is to obtain extramural research funding for her independent research program focusing on the prevention and control of HPV-mediated cancers among WLH over the next 5-10 years. Promotion to associate professor (tenure- or research-track) is an intermediate goal that the candidate is striving to attain within the next five years. A combination of formal didactic trainig and experiential learning opportunities will be used to acquire cancer prevention and control research skills in the following areas: cancer health (including mHealth) communication, cancer epidemiology, HPV-mediated cancer biology, community navigation, advanced epidemiological research skills (e.g., social epidemiology, n- of-1 research study designs, and, multilevel modeling). The candidate will use the cancer prevention and control research and health communication knowledge and skills acquired through the proposed career development award to conduct formative research needed to inform intervention development in which she will examine cancer health information seeking and sharing among WLH as well as their non-clinical HIV service providers (e.g., HIV/STI risk reduction counselors). Non-clinical HIV service providers will be included because, in addition to the fact that these individuals are already promoting safe sexual practices among WLH, they are also able to reach marginalized groups of WLH such as those who are homeless. This includes sheltered and unsheltered homeless WLH. The candidate's mentors and co-mentors have scientific expertise and community-based participatory research experience that will increase the likelihood of the proposed specific aims being successfully completed. The candidate will first examine HPV-mediated cancer prevention knowledge, beliefs and behaviors, as well as cancer health communication seeking and sharing behaviors (including the use of technology to find health information) (Aim 1). These formative research data will then be used to inform the development (Aim 2) and subsequent pilot testing and evaluation (Aim 3) of an HPV- mediated cancer prevention mHealth education intervention aimed at training WLH who already serve as peer leaders and non-clinical HIV service providers to use mHealth tools and community navigation strategies to disseminate HPV-mediated cancer prevention education. As community navigators, these individuals will use cancer health (including mHealth) communication and community navigation strategies to increase awareness about HPV-mediated cancer risk. This will include promoting cancer risk reducing behaviors such as safe sexual practices and the timely use of recommended cancer screening, diagnostic, and treatment services and procedures). Recall and reminder messages will be sent for screening and follow-up cancer care appointments. User-defined social support messages will also be sent to WLH who may be encountering access to cancer care barriers. The candidate will disseminate the scientific research findings to local, regional, national, and international audiences via presentations that she will give at scientific conferences and annual meetings as well as peer-reviewed publications that she will produce. Most relevant to the candidate's long-term goal of attaining research independence is increasing her number of peer-reviewed publications from her current publication rate of approximately three per year to four or more produced annually by the end of the 5-year training period and the submission of at least one grant proposal (e.g., R01-level funding) by the end of the 5-year training period. The proposed career development/training and research activities will enable the candidate to realize her long-term career goal of becoming an independent cancer researcher with expertise in using cancer health communication, community navigation, and mHealth technologies to address health system failures encountered by vulnerable, medically-underserved WLH along the cancer care continuum. Continued mentoring and opportunities for team science research collaborations will facilitate the candidate's successful progression to being an independent cancer researcher. WLH and non-clinical HIV service providers will be recruited from Ryan White funded clinics and AIDS-service organizations located in urban and rural geographical areas of South Carolina that represent a microcosm of disparities in HIV/AIDS, cancer, and other chronic illness that disproportionately burden medically underserved minority populations. Addressing health system failures that occur along the cancer care continuum that result in missed opportunities to prevent, detect, diagnose and treat HPV-mediated cancers will help to reduce the burden of cancer incidence and mortality among this high cancer risk, vulnerable group of WLH. The proposed HPV-mediated cancer mHealth prevention education intervention will be conducted in a community-based setting and builds upon an existing academic-community partnership between the candidate and a local AIDS-service organization. The candidate has a supportive, resource-intensive scientific environment for her cancer research training.