Thibang Diphatlha: Testing adaptive strategies to close the gap from cervical cancer diagnosis to treatment in Botswana

Thibang Diphatlha：测试适应性策略，以缩小博茨瓦纳从宫颈癌诊断到治疗的差距

基本信息

批准号：
10844698
负责人：
Surbhi Grover
金额：
$ 21.94万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-06 至 2027-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10844698
关键词：
Address Botswana Cancer Etiology Cancer Family Cancer Survivor Caring Cervical Cancer Screening Cessation of life Church Cognitive Communities Development Diagnosis Educational workshop Evaluation Family member Feedback Foundations Fright Gender Grant HIV Health Health Personnel High Prevalence Impairment Individual Infertility Influentials Intervention Interview Knowledge Length Life Link Logic Maintenance Malignant Neoplasms Malignant neoplasm of cervix uteri Mediator Modeling Morbidity - disease rate Newly Diagnosed Nurses Outcome Physicians Pregnant Women Process Recovery Reproductive Health Research Research Design Risk Risk Factors Shapes Survivors Testing Vulnerable Populations Woman Work acceptability and feasibility barrier to care cancer care cancer diagnosis cancer therapy care providers combat comorbidity coping depressive symptoms experience follow-up improved innovation interest low and middle-income countries member mortality motherhood parent project promote resilience psychoeducation psychoeducational resilience response social stigma survivorship uptake

项目摘要

This application is being submitted in response to the Notice of Special Interest (NOSI) identified as “NOT-CA-23-025”. Cervical cancer is the leading cause of cancer-related death in Botswana. About half of the women with cervical cancer in Botswana do not receive timely treatment, increasing their risk of greater morbidity and mortality. Stigma and fear surrounding cervical cancer present significant barriers to care in this cultural context, as cancer and its treatment are often paired with negative associations, concerns over impaired reproductive health, and self-blame. While prior studies have explored the impact of stigma on cervical cancer screening in low- and middle-income countries (LMIC), there is limited knowledge regarding how cancer stigma manifests during the subsequent stages of post-diagnosis care and survivorship. This proposed study builds upon its parent project “Thibang Diphatlha” (U01CA275032), which tests adaptive strategies to close the gap from cervical cancer diagnosis to treatment initiation in Botswana. In this supplemental study, we propose to conduct additional qualitative assessments to understand how cervical cancer stigma impacts survivors at multiple levels throughout the care cascade, and how other intersectional factors, such as HIV status, manifest in the stigma process. Through engagement with different stakeholder groups, we will also co-produce an intervention logic model and pre- test individual intervention components to inform development of an efficient, parsimonious anti- stigma intervention for cervical cancer survivors in Botswana. The proposed research will advance our understanding of culture salient experiences of stigma among invasive cervical cancer survivors, to inform the development, optimization, and pre-testing of a targeted intervention to reduce stigma and facilitate resilience and recovery among this highly vulnerable population in Botswana and other LMIC contexts.

该申请是根据已确定的特殊利益通知（NOSI）提交的为“非CA-23-025”。宫颈癌是博茨瓦纳与癌症相关死亡的主要原因。约一半博茨瓦纳宫颈癌的妇女不接受及时治疗，增加了她们的风险更大的发病率和死亡率。周围宫颈癌的污名和恐惧表现出明显的在这种文化背景下，护理的障碍，因为癌症及其治疗通常与负面配对协会，对生殖健康受损的关注以及自我塑造。在先前的研究中探索了污名对低收入和中等收入中宫颈癌筛查的影响国家（LMIC），关于癌症污名如何表现的知识有限随后的诊断后护理和生存阶段。这项拟议的研究基于其父母项目“ Thibang Diphatlha”（U01CA275032），该项目测试了自适应策略以关闭该策略从宫颈癌诊断到博茨瓦纳的治疗计划的差距。在这项补充研究中，我们建议进行其他定性评估，以了解宫颈癌如何污名会影响整个护理级联的多个级别的浮力表面，以及其他如何诸如HIV状态之类的交叉因素在污名过程中表现出来。通过参与对于不同的利益相关者群体，我们还将共同生产干预逻辑模型和预先制作测试个人干预组件，以告知开发有效的，简约的反 - 博茨瓦纳宫颈癌存活的污名干预。拟议的研究将进步我们对侵入性宫颈癌中污名的文化显着经历的理解幸存者，以告知有针对性干预的发展，优化和预测试在这种高度脆弱的人群中，减少污名并促进韧性和恢复博茨瓦纳和其他LMIC环境。