Research Project 1

研究项目1

• 批准号: 10738442
• 负责人: Juliet Iwelunmor
• 金额: $ 25.55万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-19 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10738442
• 关键词: 15 year old; Address; Affect; Africa; Area; Awareness; Behavior; Cancer Control; Characteristics; Charge; Climate; Clinical; Communities; Community Participation; Consolidated Framework for Implementation Research; Country; Data; Death Rate; Decentralization; Development; Dose; Effectiveness; Elements; Eligibility Determination; Equity; Evaluation; Evidence based intervention; Friends; Geography; Guidelines; HIV; Health; Health Services; Human Papilloma Virus Vaccination; Human Papilloma Virus Vaccine; Human Papilloma Virus-Related Malignant Neoplasm; Human Papillomavirus; Hybrids; Improve Access; Incidence; Individual; Intervention; Leadership; Malignant Neoplasms; Medical Research; Mentorship; Methods; Modeling; Nigeria; Nigerian; Policies; Private Sector; Randomized, Controlled Trials; Records; Research; Research Project Grants; Resources; Risk; Sampling; Services; Social support; Testing; Time; Training; Translations; Vaccination; Vaccines; Youth; aged; apprenticeship; cancer prevention; community based participatory research; community clinic; community setting; cost; crowdsourcing; effectiveness/implementation design; evidence base; experimental study; girls; implementation facilitators; implementation outcomes; implementation process; implementation science; implementation strategy; implementation/effectiveness; improved; innovation; policy recommendation; post implementation; preference; prevent; prevention service; primary outcome; programs; recruit; scale up; secondary outcome; self testing; skills; social; supportive environment; tool; treatment as usual; uptake; vaccine acceptance; vaccine access

1 Nigerians make up a significant proportion of individuals in Africa dying from human papillomavirus-(HPV) 2 associated cancers. However, they do not access essential cancer prevention services such as evidence- 3 based HPV vaccination to prevent cancer. This is partly explained by barriers that are individual (low 4 awareness), social (insufficient social support), and structural (poor access to vaccines). Implementation of 5 HPV vaccine programs can mitigate some of these barriers by decentralizing vaccine access to reduce the 6 incidence and death rate of HPV-associated cancers. We propose to expand youth-friendly HPV vaccines, 7 informed by a youth participatory action research framework (YPAR), the PEN-3 cultural model, and the 8 Consolidated Framework for Implementation Science (CFIR). Unlike projects targeting youth as passive 9 recipients, the YPAR considers youth to be partners in creating and leading solutions to problems that affect 10 them. PEN-3 cultural model leverages local resources and partnerships from an equity mindset to improve 11 health, while CFIR enables an evaluation of the barriers and facilitators of implementation effectiveness. The 12 proposed Innovative Tools to Expand youth-friendly Services and Translation of HPV services (I-TEST HPV) 13 will draw on two participatory methods, crowdsourcing (i.e., open calls and designathons) and apprenticeships, 14 to increase HPV vaccine uptake among girls aged 9-15 years old per national guidelines. We hypothesize that 15 these two approaches (open challenges and apprenticeships) will increase the uptake of HPV vaccine 16 campaigns in Nigeria. Using a hybrid type II effectiveness implementation design to simultaneously assess 17 both clinical and implementation outcomes, our aims are: 1) To use participatory approaches (crowdsourcing 18 and apprenticeships) to develop new HPV vaccine campaigns; 2) To determine whether the final 19 crowdsourced campaign increases HPV vaccination uptake among girls aged 9-15 years, and evaluate 20 intervention sustainment, one-year post implementation. We will recruit 1,120 girls from 32 communities to a 21 stepped-wedge randomized control trial of the finalist campaign versus usual care. A total of sixty-four trained 22 youth research facilitators from each setting (2 per setting) will implement the final HPV vaccination campaign. 23 The primary outcome is the initial HPV dose vaccine uptake among girls ascertained by vaccination records at 24 community clinics. The secondary outcomes include the second vaccine dose, percent sustainment of core 25 program elements with sustained benefits (uptake of HPV vaccines), and sustained capacity at participating 26 communities at one year after the trial; and 3) To use mixed-methods to explore multilevel factors that 27 influence the uptake of the HPV campaigns. This research aligns with the RFA-CA-11-019 request for research 28 and the US Cancer Moonshot Initiative. The project builds on a strong relationship with the Nigerian Institute 29 for Medical Research (NIMR) to implement a sustainable and scalable community-based model for equitable 30 cancer control. 31 32 33 34 .

1非洲人占非洲死于人乳头瘤病毒（HPV）的人的很大比例 2相关癌症然而，他们无法获得基本的癌症预防服务，如证据- 3、接种HPV疫苗预防癌症。这在一定程度上是由于个人（低） 4、社会（社会支持不足）和结构性（难以获得疫苗）。执行 5 HPV疫苗计划可以通过分散疫苗接种以减少接种， 6 HPV相关癌症的发病率和死亡率。我们建议扩大对年轻人友好的HPV疫苗， 7.青年参与行动研究框架（YPAR）、PEN-3文化模式和 8执行科学综合框架。与针对青年的被动项目不同， 9个获奖者，YPAR认为青年是创造和领导解决影响问题的伙伴， 10他们。PEN-3文化模式从公平的心态出发，利用当地资源和伙伴关系， 11健康，而CFIR能够评估执行有效性的障碍和促进因素。的 12个拟议的创新工具，以扩大对青年友好的服务和翻译的HPV服务（I-TEST HPV） 13将利用两种参与性方法，众包（即，公开电话和设计马拉松）和学徒制， 14.根据国家指南，增加9-15岁女孩的HPV疫苗接种。我们假设 15这两种方法（公开挑战和学徒制）将增加HPV疫苗的使用 在尼日利亚的16个运动。使用混合型第二类有效性实施设计同时评估 17临床和实施结果，我们的目标是：1）使用参与式方法（众包 18和学徒）开发新的HPV疫苗运动; 2）确定最终是否 19众包运动增加了9-15岁女孩的HPV疫苗接种率，并评估 20次干预维持，实施后一年。我们将从32个社区招募1,120名女孩， 21项阶梯楔形随机对照试验，比较决赛运动与常规护理。共有64人接受了培训 来自每个环境的22名青年研究促进者（每个环境2名）将实施最终的HPV疫苗接种活动。 23.主要结果是通过接种记录确定的女孩中HPV疫苗的初始剂量摄取， 24个社区诊所次要结局包括第二次疫苗接种率、核心免疫维持率 25个具有持续效益的项目要素（HPV疫苗的接种），以及参与的持续能力 3）采用混合方法探讨多水平因素， 27影响HPV运动的吸收。本研究符合RFA-CA-11-019研究要求 28和美国癌症登月计划。该项目建立在与尼日利亚研究所的牢固关系之上 29医学研究（NIMR）实施可持续和可扩展的基于社区的公平模式， 30癌症控制。 31 32 33 三十四