Actions for Collaborative Community Engaged Strategies for HPV (ACCESS HPV)

摘要 宫颈癌是包括尼日利亚在内的许多撒哈拉以南国家发病率和死亡率的主要原因。 扩大9-26岁年轻女孩/妇女的人乳头瘤病毒（HPV）疫苗接种（初级） 预防）和HPV自我收集，用于30-49岁老年妇女的宫颈癌筛查（二级 预防）对于实现世卫组织和尼日利亚减少宫颈癌负担的目标至关重要。的 尼日利亚政府现在建议HPV疫苗接种和自我收集，但接受率很低。因此，在本发明中， 需要有针对具体情况、有针对性和文化上相关的执行战略。我们专注于HPV 由于宫颈癌的巨大负担， 癌尼日利亚的母女关系可以被用来增加HPV疫苗接种率， 年轻女孩和母亲中的HPV自我收集。母亲（或类似的女性照顾者）深刻地 在尼日利亚的文化背景下，影响年轻女孩接种疫苗的决定和偏好。在 同时，母亲在与女儿讨论时可以加强对HPV自我采集的选择。在 在拟议的研究，HPV（ACCESS-HPV）合作社区战略的行动，我们将 使用参与式众包方法，推动母女二人组的HPV预防。 众包公开电话将使我们能够确定当地相关的信息和传播技术， 增加HPV预防的接受率。然后，参与式学习社区将为社区建设能力- 领导选定战略的实施。根据社会学习理论和PEN-3文化模式，我们的 一个多学科研究小组提出了以下具体目标：（1）开发一种新的组合 开展运动，增加年轻女孩（9-26岁）的HPV疫苗接种和母亲（9-26岁）的HPV自我采集 （2）利用众包公开电话和参与式学习社区;（3）确定 在年轻女孩/妇女中进行HPV疫苗接种的最后一次联合运动的有效性 使用阶梯楔形随机对照试验在其母亲中自我收集;（3）估计 众包运动的影响和成本效益。我们的主要成果将是疫苗的吸收 （通过接种疫苗的诊所记录确定）和HPV自我采集（通过 实验室收到的标本）的母亲。尼日利亚医学研究所的大力支持 研究（NIMR）与国家HPV计划一起创建了丰富的研究基础设施，并增加了 成功实施的可能性。我们的多学科研究团队拥有组织 在尼日利亚，执行情况研究侧重于众包和社区参与。本研究将 加强我们对资源有限环境中HPV预防的理解。这项拨款申请直接 响应美国政府、国立卫生研究院、国家卫生研究院和国家卫生研究院的战略优先事项。 癌症研究所和NOT-CA-20-025。

ABSTRACT Cervical cancer is a major cause of morbidity and mortality in many sub-Saharan countries, including Nigeria. Expanding human papillomavirus (HPV) vaccination for young girls/women, ages 9-26 years (primary prevention) and HPV self-collection for cervical cancer screening for older women, ages 30-49 (secondary prevention) are both critical to achieving WHO and Nigerian goals for reducing the cervical cancer burden. The Nigerian government now recommends HPV vaccination and self-collection, yet uptake is poor. As such, context-specific, targeted and culturally relevant implementation strategies are needed. We focus on HPV vaccination among girls and self-collection among women because of the substantial burden of cervical cancer. Mother-daughter relationships in Nigeria can be leveraged to increase HPV vaccination uptake among young girls and HPV self-collection among mothers. Mothers (or similar female caregivers) profoundly influence decisions and preferences about young girls’ vaccine uptake in the Nigerian cultural context. At the same time, maternal choices about HPV self-collection can be reinforced in discussions with their daughters. In the proposed study, Actions for Collaborative Community-Engaged Strategies for HPV (ACCESS-HPV), we will use participatory crowdsourcing methods to drive HPV prevention among mother-daughter dyads. Crowdsourcing open calls will allow us to identify locally relevant messages and dissemination techniques to increase uptake of HPV prevention. Then, participatory learning communities will build capacity for community- led implementation of selected strategies. Informed by social learning theory and the PEN-3 cultural model, our multi-disciplinary research team proposes the following specific aims: (1) to develop a new combined campaign to increase HPV vaccination for young girls (ages 9-26) and HPV self-collection for mothers (ages 30-49) using crowdsourcing open calls and participatory learning communities; (2) to determine the effectiveness of a final combined campaign on uptake of HPV vaccination among young girls/women and HPV self-collection among their mothers using a stepped-wedge randomized controlled trial; (3) to estimate the impact and cost-effectiveness of the crowdsourced campaign. Our primary outcome will be vaccine uptake (ascertained by clinic records of vaccine uptake) among young girls and HPV self-collection (ascertained by laboratory receipt of specimens) among their mothers. The strong support of the Nigerian Institute for Medical Research (NIMR) alongside national HPV programs creates a rich research infrastructure and increases the likelihood of successful implementation. Our multi-disciplinary research team has experience organizing implementation research focused on crowdsourcing and community participation in Nigeria. This study will enhance our understanding of HPV prevention in resource-constrained settings. This grant application directly responds to strategic priorities of the United States government, the National Institutes of Health, the National Cancer Institute, and NOT-CA-20-025.