Towards Cervical cancer elimination: Implementation and scale-up of a single-visit, screen-and-treat approach with thermal ablation for sustainable cervical cancer prevention services in Kenya

消除宫颈癌：在肯尼亚实施和扩大单次就诊、筛查和治疗的热消融方法，以提供可持续的宫颈癌预防服务

• 批准号: 10843625
• 负责人: Sarah Odell Gimbel
• 金额: $ 12.45万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-21 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10843625
• 关键词: Ablation; Administrative Supplement; Africa South of the Sahara; Award; Caring; Cervical; Client; Clinic; Continuity of Patient Care; Early Diagnosis; Early treatment; Eligibility Determination; Excision; Focus Groups; Future; Goals; Health Personnel; Health Services Accessibility; Health system; Hysterectomy; Interview; Kenya; Lesion; Malignant neoplasm of cervix uteri; Maps; Mentors; Methods; Oncology; Parents; Prevention strategy; Process; Radiation therapy; Research; Sampling; Structure; Surveys; Thermal Ablation Therapy; Visit; Woman; barrier to care; burden of illness; cervical cancer prevention; follow-up; interest; mortality; parent grant; premalignant; prevention service; recruit; referral services; reproductive; response; scale up; treatment strategy; tv watching

ABSTRACT This application is submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA-23- 038 “Administrative Supplements for NCI Global Oncology Mentored Research” and proposes an administrative supplement to our parent award R01CA258590. Background While prevention and treatment strategies exist for cervical cancer, it remains the leading cause of mortality in Sub-Saharan Africa. The timely screening, early diagnosis and treatment of precancerous cervical lesions is key in reducing the disease burden. Current treatment goals have focused on ablative methods but there are women who require different treatment either by excision, hysterectomy, or radiotherapy. We will conduct a mixed methods study on Kenyan women with precancerous cervical lesions who are not amendable to ablative therapy and referred by our study for other treatment- little research is available for this group. Women will be recruited from the parent grant TIBA clinics. We will evaluate this via the following two aims: AIM 1: Evaluate the barriers and facilitators (health system, health care provider and client levels) in the referral and linkage to care for women who screen positive for pre-cancerous lesions and not amenable to ablative therapy. We shall conduct semi-structured surveys, focused group discussions and in-depth interviews to gain information on the barriers and facilitators from the health care providers and clients. AIM 2a: Determine the proportion of women with pre-cancerous cervical lesions and not amenable to ablation therapy who access treatment within a four-month period. All women who are screen-positive and not eligible for ablative therapy will be invited to participate in this study and followed up for a period of four months to determine whether they are treated or not. AIM 2b: Conduct flow mapping of existing referral services for women who screen positive for pre-cancer lesions and not amenable for ablative therapy with a focus on identifying the steps that create barriers to treatment access. A sample of four to five women who screen positive for pre-cancer lesions but who are not amenable to thermal ablation and health care providers will be interviewed to perform flow mapping. Barriers and facilitators to treatment access will be catalogued during the flow mapping process The objective of this study is to understand the bottlenecks in the cervical cancer care continuum following referral and linkage of these women. This will form the basis of future studies that will enhance seamless integration for women with precancerous cervical lesions referred for treatment.

摘要

项目成果

Implementation and scale-up of a single-visit, screen-and-treat approach with thermal ablation for sustainable cervical cancer prevention services: a protocol for a stepped-wedge cluster randomized trial in Kenya.

• DOI: 10.1186/s13012-023-01282-3
• 发表时间: 2023-06-26
• 期刊: IMPLEMENTATION SCIENCE
• 影响因子: 7.2
• 作者: Shin, Michelle B.;Oluoch, Lynda Myra;Barnabas, Ruanne V.;Baynes, Colin;Fridah, Harriet;Heitner, Jesse;Kerubo, Mary Bernadette;Ngure, Kenneth;Pinder, Leeya F.;Thomas, Katherine K.;Mugo, Nelly Rwamba;Gimbel, Sarah
• 通讯作者: Gimbel, Sarah