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

摘要 在包括尼日利亚在内的许多撒哈拉以南国家，宫颈癌是发病率和死亡率的主要原因。 为9-26岁(初级)的年轻女孩/妇女扩大人类乳头瘤病毒(HPV)疫苗接种 预防)和HPV自我收集用于30-49岁(次级)老年妇女的宫颈癌筛查 预防)对于实现世卫组织和尼日利亚降低宫颈癌负担的目标都至关重要。这个 尼日利亚政府现在建议接种HPV疫苗和自我收集，但接受率很低。因此， 需要针对具体情况、有针对性和与文化相关的执行战略。我们专注于HPV 由于宫颈疾病的沉重负担，女孩接种疫苗和妇女自我收集 癌症。尼日利亚的母女关系可以用来提高人群中的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) 在尼日利亚文化背景下影响年轻女孩接种疫苗的决定和偏好。在 与此同时，在与女儿的讨论中，母亲对HPV自我收集的选择可以得到加强。在……里面 拟议的研究，针对HPV的社区协作参与战略(Access-HPV)，我们将 使用参与性众包方法在母女二人组中推动HPV预防。 众包开放呼叫将使我们能够识别与当地相关的消息和传播技术，以 增加对人乳头瘤病毒的预防。然后，参与式学习社区将建设社区能力- 牵头实施选定的战略。受社会学习理论和PEN-3文化模式的启发，我们的 多学科研究团队提出了以下具体目标：(1)开发新的联合 为年轻女孩(9-26岁)增加HPV疫苗接种和为母亲(年龄)增加HPV自我收集的运动 30-49)使用众包开放呼叫和参与式学习社区；(2)确定 关于在年轻女孩/妇女和HPV中接种HPV疫苗的最终联合运动的有效性 采用阶梯楔形随机对照试验对其母亲进行自我收集；(3)估计 众包活动的影响和成本效益。我们的主要成果将是疫苗的普及 (通过接种疫苗的临床记录确定)和HPV自我收集(通过 实验室收到的标本)。尼日利亚医学研究所的大力支持 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具有组织经验 实施研究的重点是尼日利亚的众包和社区参与。这项研究将 提高我们对在资源有限的情况下预防HPV的理解。这项拨款申请直接 响应美国政府、国家卫生研究院、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.