Rural community health center partnerships to develop and implement process for HPV self-collection and follow-up among women overdue for cervical cancer screening

农村社区卫生中心合作开发和实施 HPV 自我采集流程以及逾期宫颈癌筛查妇女的随访

• 批准号: 10838292
• 负责人: CORNELIA M ULRICH
• 金额: $ 21.5万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-05-09 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10838292
• 关键词: Area; Cancer Patient; Caring; Censuses; Cervical Cancer Screening; Classification; Clinic; Collection; County; Disparity; Ensure; Home; Human Papillomavirus; Idaho; Incidence; Instruction; Interview; Location; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Neighborhood Health Center; Nevada; Patients; Persons; Pilot Projects; Population; Printing; Process; Protocols documentation; Provider; Research; Rural; Rural Community; Services; Structure; Surveys; Survival Rate; Testing; Time; Utah; Woman; care systems; experience; follow-up; frontier; frontier counties; implementation facilitation; outreach; outreach program; patient-level barriers; pilot test; prevention service; programs; rural counties; rural patients

ABSTRACT In 2021, Huntsman Cancer Institute (HCI) formalized our long-standing service to the entire 5-state Mountain West (MW). Three of the five states: Idaho, Nevada, and Utah, all ranked among the top five fastest growing states in the 2020 U.S. Census. At the same time, the area we serve is notable for its vast frontier areas. Of the 169 counties in the Mountain West, 104 are frontier (< 7 people per square mile), covering 74% of the landmass and an additional 54 classify as rural (< 100 people per square mile). Combined, the frontier and rural counties account for 97% of the landmass. Over 10% of the Mountain West population lives in frontier counties and over 40% lives in frontier and rural counties combined. These populations experience disparities due primarily to distance to care. HCI is committed to overcome distance as a disparity by ensuring frontier and rural patients have equal access to excellent care and prevention services, regardless of location. Cervical cancer incidence rates are higher in rural Utah (compared to urban Utah) and 5-year relative survival rates are lower among rural cervical cancer patients than among urban patients. Furthermore, Utah ranks as one of the lowest states in the nation for cervical cancer screening with rural communities demonstrating the lowest rates. This study pilot tests a mail-delivered HPV self-collection program for rural Utah women (N=900). This study aims to develop a rural community health center delivered home-based human papillomavirus (HPV) self- collection outreach program for women overdue for cervical cancer screening and a follow-up program for women with HPV screen-positive results. Specifically, we will launch an HPV self-collection program to women overdue for cervical cancer screening, revise related illustrated video- and print-delivered instructions in English and Spanish on how to complete the test, and develop an effective follow-up approach for HPV screen-positive patients. Through surveys, we will assess barriers for why patients do not return the HPV self- collection kits and why HPV screen-positive women do not receive follow-up care. We will also assess the organizational, provider, and clinic staff level factors at rural community health centers that facilitate the implementation, assessment and follow-up for the pilot HPV self-collection program. These clinic-level assessments will be completed through work-flow analyses, surveys, and semi-structured interviews. Findings from this study will be used to develop a mail-delivered HPV self-collection protocol for rural community health centers that can be adapted and replicated in other rural community health center settings.

摘要 2021年，亨斯迈癌症研究所(HCI)正式确定了我们对整个五州山区的长期服务 西区(MW)。五个州中的三个：爱达荷州、内华达州和犹他州都跻身增长最快的前五名之列 2020年美国人口普查中的州。与此同时，我们服务的地区以其广阔的边境地区而闻名。的 西部山区的169个县中，有104个是边境县(每平方英里7人)，覆盖了74%的 陆地和另外54个归类为农村(&lt；每平方英里100人)。加在一起，边疆和 农村县占国土面积的97%。西部山区超过10%的人口生活在边境地区 边疆县和农村县的人口总和超过40%。这些人群经历了差异 主要是由于距离到照顾。HCI致力于克服距离的差距，确保边境和 农村患者无论身在何处，都有平等机会获得优质的护理和预防服务。宫颈 犹他州农村的癌症发病率更高(与城市相比)，5年相对存活率为 农村宫颈癌患者的死亡率低于城市患者。此外，犹他州是 宫颈癌筛查的州是全国最低的，农村社区的筛查率最低。 这项研究试点测试了犹他州农村妇女(N=900)的邮递HPV自我收集计划。本研究 旨在发展一家农村社区卫生中心，提供以家庭为基础的人乳头瘤病毒(HPV)自我治疗 为逾期进行宫颈癌筛查的妇女开展的收集外展计划和 感染HPV的女性筛查结果呈阳性。具体地说，我们将向女性推出HPV自我收集计划 早该进行宫颈癌筛查，修改相关的图文并茂的视频和打印说明 英语和西班牙语，关于如何完成测试和制定有效的HPV后续方法 筛查呈阳性的患者。通过调查，我们将评估患者为什么不返回HPV自身的障碍 收集试剂盒，以及为什么HPV筛查阳性妇女没有得到后续护理。我们亦会评估 农村社区卫生中心的组织、提供者和诊所工作人员水平的因素 实施、评估和跟进人乳头瘤病毒自我收集试点计划。这些诊所级别 评估将通过工作流程分析、调查和半结构化面试完成。发现 这项研究将用于开发邮寄的HPV自我收集方案，用于农村社区卫生 可在其他农村社区卫生中心环境中改编和复制的中心。