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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.

本申请是针对特别利益通知(NOSI)而提交的为“非-CA-23-025”。在博茨瓦纳，宫颈癌是癌症相关死亡的主要原因。大约有一半的人博茨瓦纳患有宫颈癌的妇女得不到及时的治疗，增加了她们患宫颈癌的风险更高的发病率和死亡率。围绕宫颈癌的耻辱和恐惧是重要的在这种文化背景下的护理障碍，因为癌症及其治疗往往伴随着负面协会，对生殖健康受损的担忧，以及自责。虽然之前的研究探讨了耻辱对中低收入人群宫颈癌筛查的影响在许多国家(LMIC)，人们对癌症污名是如何在诊断后护理和生存的后续阶段。这项拟议的研究建立在其父项目“Thibang Diphatlha”(U01CA275032)，该项目测试自适应策略以关闭博茨瓦纳从宫颈癌诊断到治疗启动的差距。在这项补充研究中，我们建议进行额外的定性评估，以了解宫颈癌是如何耻辱在整个护理级联中在多个层面影响幸存者，以及其他跨部门因素，如艾滋病毒状况，在污名过程中表现出来。通过参与我们还将与不同的利益相关者群体共同制作干预逻辑模型和预测试单个干预组件，以开发高效、节俭的反博茨瓦纳对宫颈癌幸存者的污名干预。拟议的研究将会取得进展我们对浸润性宫颈癌中污名的文化显著经验的理解幸存者，告知有针对性的干预措施的开发、优化和预测试减少耻辱，促进这一高度脆弱的人口在#年的复原和恢复博茨瓦纳和其他LMIC背景下。