The CHESS (Community, Home-based Education, Screening Services) Strategy to increase cervical cancer control access for HIV positive women in Nigeria

CHESS（社区、家庭教育、筛查服务）战略旨在增加尼日利亚艾滋病毒阳性妇女获得宫颈癌控制的机会

• 批准号: 10693963
• 负责人: Olutosin Awolude
• 金额: $ 56.14万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10693963
• 关键词: AIDS related cancer; Adherence; Administrator; Adoption; Aftercare; Age; Anti-Retroviral Agents; Attitude; Belief; Cancer Control; Cancer Intervention; Caring; Cervical; Cervical Cancer Screening; Characteristics; Clinic; Clinical; Communities; Consensus; Consolidated Framework for Implementation Research; Data; Decision Making; Diagnostic Reagent Kits; Disadvantaged; Education; Effectiveness; Eligibility Determination; Ensure; Evaluation; Female; Focus Groups; HIV; HIV Seronegativity; HIV Seropositivity; HIV/AIDS; HPV-High Risk; Health Status; High Prevalence; Highly Active Antiretroviral Therapy; Home; Human Papillomavirus; Human papilloma virus infection; Impact evaluation; Incidence; Individual; Infrastructure; Intervention; Interview; Lesion; Maintenance; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Measures; Mentors; Methodology; Methods; Modeling; Monitor; Mothers; Nigeria; Nigerian; Participant; Persons; Pharmaceutical Preparations; Phase; Policy Maker; Prevention; Prevention program; Process; Professional counselor; Published Comment; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Records; Recurrence; Resources; Risk; Rural Community; Sampling; Shapes; Structure; Support Groups; System; Training; Vertical Disease Transmission; Viral; Viral Load result; Woman; cancer risk; evidence base; experience; follow-up; health service use; home test; implementation evaluation; implementation fidelity; implementation framework; implementation process; innovation; insight; low and middle-income countries; male; mortality; outreach; peer; peer support; post implementation; premalignant; primary health center; process evaluation; program costs; programs; routine practice; scale up; screening; screening program; screening services; social stigma; symposium; systematic review; treatment program

Abstract Despite the increased risk of cervical cancer (CC) for women living with HIV (WLWH), access to CC screening in Nigeria is limited. Access to screening, prevention programs, and highly active antiretroviral therapy has contributed to dramatic declines in the incidence of many AIDS-associated malignancies but have not lowered CC risk in WLWH. Therefore, we seek to leverage the existing HIV treatment infrastructure in Nigeria to integrate home-based CC (HCC) screening for WLWH and evaluate the implementation and sustainability of this model. We will weave HCC activities into the successful, long-standing MoMent (MOther MENTor) peer- based HIV support program and evaluate the implementation of this adapted program for adoption, integration, sustainability, and potential for national scale-up. The Consolidated Framework for Implementation Research (CFIR) and Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) conceptual frameworks will guide our implementation and impact evaluation. In this project, we will pursue three specific aims: 1) use a stakeholder deliberation conference methodology to adapt the successful MoMent program to promote home-based HPV CC screening and follow-up treatment for women who are HIV positive; 2) implement the MoMent HIV+HCC screening program and assess program reach, effectiveness, adoption, and fidelity; and 3) conduct post-implementation process evaluation of barriers and enablers to program maintenance and sustainability. Stakeholder input from WLWH, peer counselors, clinical managers, and federal/state policymakers will shape the adapted program and promote its successful implementation in a sample of 1,500 WLWH. We will be among the first to apply recent systematic review findings that the “characteristics of systems” construct of CFIR is particularly relevant in low/middle income countries. We ensure scalability by focusing on national and state policymaker perspectives in the pre-implementation, implementation, and maintenance phases of the adapted program. In this project, we will advance CC control for WLWH in Nigeria and generate data that can inform effective adaptation and implementation of evidence- based cancer control strategies for people living with HIV in low/middle income countries worldwide.

摘要 尽管感染艾滋病毒的妇女患宫颈癌的风险增加， 在尼日利亚是有限的。获得筛查、预防计划和高效抗逆转录病毒治疗， 导致许多艾滋病相关恶性肿瘤的发病率急剧下降，但并未降低 WLWH中的CC风险。因此，我们寻求利用尼日利亚现有的艾滋病毒治疗基础设施， 整合以家庭为基础的CC（HCC）筛查WLWH，并评估 该模型我们将把HCC活动编织成成功的、长期存在的MoMent（MOther MENTor）同行， 基于艾滋病毒的支持计划，并评估这一适应计划的实施情况，以供采用，整合， 可持续性和国家扩大规模的潜力。实施研究综合框架 （CFIR）和覆盖、有效性、采用、实施和维护（RE-AIM）概念 框架将指导我们的执行和影响评估。在这个项目中，我们将追求三个具体的 目标：1）使用利益相关者审议会议方法，以适应成功的MoMent计划， 推广以家庭为基础的HPV CC筛查和对艾滋病毒阳性妇女的后续治疗; 2） 实施MoMent HIV+HCC筛查计划，并评估计划的覆盖范围、有效性、采用率， 忠诚度;以及3）对计划的障碍和推动因素进行实施后流程评估 维护和可持续性。来自WLWH、同伴顾问、临床经理和 联邦/州的政策制定者将制定经过调整的计划，并促进其在一个 1，500 WLWH的样品。我们将率先应用最近的系统评价结果， CFIR的“系统特征”结构在低收入/中等收入国家尤其相关。我们 通过在实施前关注国家和州决策者的观点，确保可扩展性， 调整后的程序的实施和维护阶段。在本项目中，我们将推进CC控制 为尼日利亚的WLWH提供数据，并生成数据，为有效适应和实施证据提供信息- 为全世界低/中等收入国家的艾滋病毒感染者制定基于癌症控制战略的方案。