Research Project 2

研究项目2

• 批准号: 10738107
• 负责人: Jennifer Rose Moodley
• 金额: $ 19.46万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 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/10738107
• 关键词: Acceleration; Biological Assay; Budgets; Cancer Control; Cancer Etiology; Cervical; Cervical Cancer Screening; Cessation of life; Clinical Trials; Collaborations; Country; Cytology; DNA; Data; Data Collection; Decision Aid; Decision Making; Detection; Development; Economics; Effectiveness; Eligibility Determination; Equity; Evaluation; Goals; Guidelines; Health care facility; Health system; Healthcare; Heterogeneity; Human Papillomavirus; Incidence; Infrastructure; Intervention; Investments; Knowledge; Lesion; Malignant neoplasm of cervix uteri; Maps; Methods; Modeling; Molecular; Motion; Outcome; Patients; Policy Maker; Prevention strategy; Primary Care; Primary Prevention; Process; Provider; Province; Public Health; Recommendation; Reporting; Research; Research Personnel; Research Project Grants; Resource-limited setting; Review Literature; Safety; Secondary Prevention; Seminal; Site; South Africa; System; Testing; Time; Time and Motion Studies; Translating; Universities; Vaccinated; Visual; Woman; Women' s Health; World Health Organization; aged; cancer health disparity; clinical care; cost; cost effective; cost effectiveness; cost estimate; design; detection assay; economic evaluation; evidence base; girls; health economics; implementation evaluation; implementation science; implementation strategy; incremental cost; innovation; low and middle-income countries; marginalized community; meetings; microcosting; mortality; new technology; point of care; point of care testing; post implementation; primary care setting; scale up; screening; screening guidelines; screening policy; screening program; synergism; theories; tool; treatment duration; uptake

Cervical cancer is the leading cause of cancer-related deaths among women in low and middle-income countries (LMICs) and a key contributor to global disparities in cancer incidence and mortality. The WHO recommends Human Papillomavirus (HPV)-based testing followed by immediate treatment, known as screen-and-treat (SAT). Although endorsed in global and national guidelines, the SAT approach has not yet been widely implemented outside of research settings. New technologies such as the Xpert HPV DNA test, a point-of-care (POC) test which has distinct advantages over competing assays and has been shown to be cost-effective in low-resource settings, is also more expensive. Like many countries, South Africa is grappling with how to operationalize and promote the widespread and equitable uptake of HPV-based screening. Through a 30-year collaboration between investigators at Columbia University and the University of Cape Town, and leveraging Project 1’s development and evaluation of strategies for the implementation and evaluation of Xpert HPV POC-SAT, this Project 2 of the Empilisweni Center for Women’s Health will address the cost and financing of POC-SAT and its tailored implementation strategies. In Aim 1, using a comprehensive tool from the WHO, we will estimate costs of cervical cancer screening pre and post implementation of HPV-based POC-SAT in public primary care settings in Khayelitsha. Outcomes will be cost per woman screened and cost per woman screened and treated. In Aim 2, we will conduct a time-and-motion study to estimate the costs of the scalable, tailored implementation strategy package to support delivery of POC-SAT in two primary care facilities implementing Aim 3 of Project 1. In Aim 3, we will use a fiscal mapping process to identify, select, and pursue innovative financing strategies for HPV- based SAT and its implementation in Western Cape. Cost data collection will be conducted in coordination with the Capacity Building and Stakeholder Engagement Cores to translate knowledge needs and study findings, where applicable. We will further synergize activities by leveraging the routine Administrative and Engagement Core stakeholder meetings and External Advisory Panel to brief stakeholders before and after cost data collection, analysis, and reporting. The findings of this project will be disseminated to local and regional stakeholders in order to aid decision-making regarding investments in cervical cancer screening and advance the widespread use of HPV-based SAT in South Africa.

宫颈癌是中低收入国家女性癌症相关死亡的主要原因 这是全球癌症发病率和死亡率差异的一个关键因素。世界卫生组织建议 以人类乳头瘤病毒(HPV)为基础的检测，然后立即进行治疗，称为筛查和治疗(SAT)。 虽然在全球和国家指导方针中得到认可，但SAT方法尚未得到广泛实施 在研究环境之外。新技术，如Xpert HPV DNA检测、护理点(POC)检测 与竞争对手的检测方法相比，该方法具有明显的优势，并已被证明在低资源条件下具有成本效益 设置，也更昂贵。像许多国家一样，南非正在努力解决如何运作和 促进普遍和公平地采用基于HPV的筛查。通过30年的合作 哥伦比亚大学和开普敦大学的研究人员之间的合作，并利用项目1的S 制定和评估实施和评估Xpert HPV POC-SAT的战略，这 Empiisweni妇女健康中心的项目2将解决POC-SAT及其 量身定做的实施战略。在目标1中，使用世卫组织的综合工具，我们将估算成本 在公共初级保健机构实施基于HPV的POC-SAT前后的宫颈癌筛查 在卡耶利沙。结果将按每名妇女筛查和每名妇女筛查和治疗的费用计算。在AIM 2、我们将进行时间和行动研究，以估计可扩展、量身定制的实施战略的成本 支持在实施项目1目标3的两个初级保健机构提供POC-SAT的一揽子计划。 3、我们将使用财政规划流程来确定、选择和实施针对HPV的创新融资策略- 基于SAT及其在西开普省的实施。成本数据收集将与以下机构协调进行 能力建设和利益攸关方参与核心，以转化知识需求和研究结果， 在适用的情况下。我们将通过利用常规的管理和参与来进一步协同活动 核心利益相关者会议和外部咨询小组，在成本数据之前和之后向利益相关者通报情况 收集、分析和报告。该项目的成果将向当地和地区传播。 利益相关者，以帮助关于宫颈癌筛查和进展投资的决策 基于HPV的SAT在南非的广泛使用。