Enhanced BReast and cErvical cAncer screening in Kenya THROUGH implementation science research and training (The BREAKTHROUGH Center)

通过实施科学研究和培训，肯尼亚加强了乳腺癌和宫颈癌筛查（突破中心）

• 批准号: 10738131
• 负责人: Mohammed Kumail Ali
• 金额: $ 96.17万
• 依托单位: EMORY 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/10738131
• 关键词: Acceleration; Address; Adoption; Advanced Malignant Neoplasm; Africa; Africa South of the Sahara; Awareness; Behavioral; Biometry; Breast Cancer Detection; Breast Cancer Early Detection; Breast Cancer Treatment; Canada; Cancer Burden; Cancer Control; Caring; Cervical Cancer Screening; Cessation of life; Clinic; Clinical; Communities; Complex; Country; Data; Development; Diagnosis; Disease; Early Diagnosis; Early identification; Early treatment; Economics; Effectiveness; Epidemiology; Equity; Faculty; Family; Future; Gender; Government; Guidelines; HIV; Health; Health Services Accessibility; Health system; Hospitals; Human Papillomavirus; Incidence; Individual; Inequity; Infection; Information Technology; Infrastructure; Institution; International; Intervention; Kenya; Knowledge; Leadership; Life Style; Link; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Maps; Mentors; Mentorship; Methods; Morbidity - disease rate; Obesity; Oncology; Patients; Pattern; Personal Satisfaction; Policies; Policy Maker; Preventive screening; Primary Care; Process; Provider; Recommendation; Research; Research Personnel; Research Project Grants; Resources; Rest; Scientist; Screening for cancer; Smoking; Students; System; Talents; Technology; Testing; Time; Training; Translations; Universities; Variant; Washington; Woman; Women' s Health; Work; advanced disease; base; cancer diagnosis; cancer type; care coordination; career; community engagement; cost; design; disability; effectiveness testing; effectiveness trial; evidence base; experience; feasibility testing; implementation research; implementation science; implementation strategy; improved; knowledge translation; low and middle-income countries; mHealth; malignant breast neoplasm; mortality; next generation; patient oriented; premalignant; prevent; programs; screening; social; tumor progression; uptake; user-friendly

CENTER OVERALL: PROGRAM SUMMARY / ABSTRACT While considerable evidence is available for screening and early treatment of breast and cervical cancers, huge gaps remain in equitable and sustainable translation of this knowledge into practice and policy, especially in sub-Saharan Africa. In Kenya, gaps in screening and linkage to treatment result in late-stage presentation of breast and cervical cancers, profound preventable morbidity and mortality, and disproportionate hindrance to women’s development. To close these gaps, the Enhanced BReast and cErvical cAncer screening in Kenya THROUGH implementation science research and training (BREAKTHROUGH) Center coalesces trans- disciplinary expertise at Kenyatta National Hospital (KNH), Emory University, University of Washington, and Queen’s University. BREAKTHROUGH will include an Administrative and Engagement Core that engages community, clinical, and government stakeholders and scientific partners, and seamlessly coordinates [Overall Aim 1] our interrelated Research Capacity Building Core and two Research Projects. Our multi-institutional, collaborative partners bring considerable breadth and depth of implementation science and oncology expertise, a substantial research base, matched resource commitments (>$125,000 in contributions), international gravitas, and >10 years of working together. To grow implementation science in women’s cancer control and conduct impactful research, BREAKTHROUGH has a training framework that engages investigators across the career spectrum (faculty, fellows, students) to sustainably strengthen capacity by supporting trainees to become mentors [Overall Aim 2]. We provide didactic training; engagement in Research Projects; and access to stakeholders, technologies, networking, and enrichment activities. BREAKTHROUGH’s projects will map and co-design (with stakeholders) strategies that overcome barriers to women’s cancer control. We then test feasibility, implementation, effectiveness, and sustainment of context-specific, theoretically-informed strategies for overcoming complex barriers to adoption and integration of breast and cervical cancer screening and referral linkages in primary care [center theme; Overall Aim 3]. We also utilize these projects as training platforms to strengthen local capacity and research administration for implementation science at KNH. Project 1 is entitled “accelerating aDoption of pAtient-centereD cervicAl cancer screening and treatment LINKage in Kenya” (DADA LINK) and Project 2 is entitled “a Multi-level strATegy for InTegrating Information technologY and mobile health to strengthen linkAges to breast caNcer screeninG and early detection among women Utilizing primary care in Kenya (MATITI YANGU). The Center, Cores, and Projects will produce actionable, mixed methods, user-friendly evidence and bidirectionally engage with key stakeholders as advisors and disseminators, maximizing reach, uptake, and sustainability. BREAKTHROUGH is well-integrated across Cores and Projects and embodies an ethos of promoting equity in our institutions, research, and our impacts.

总体中心：计划摘要/摘要 虽然有相当多的证据可以用于乳腺癌和宫颈癌的筛查和早期治疗， 在公平和可持续地将这一知识转化为实践和政策方面仍然存在巨大差距，特别是 在撒哈拉以南非洲。在肯尼亚，筛查和与治疗的联系方面的差距导致晚期 乳腺癌和宫颈癌，严重的可预防的发病率和死亡率，以及对 妇女发展。为了缩小这些差距，肯尼亚加强了乳腺癌和宫颈癌筛查 通过实施科学研究和培训(突破)中心将跨 肯雅塔国家医院(KNH)、埃默里大学、华盛顿大学和 皇后大学。突破将包括管理和接洽核心， 社区、临床和政府利益相关者和科学合作伙伴，并无缝协调[总体 目的1]我们相关的研究能力建设核心和两个研究项目。我们的多机构， 合作伙伴带来了实施科学和肿瘤学专业知识的相当大的广度和深度， 雄厚的研究基础，匹配的资源承诺(捐款12.5万美元)，国际 庄严，和&gt；10年的合作。在妇女癌症控制和预防中发展实施科学 进行有影响力的研究，突破性有一个培训框架，让全世界的调查人员参与进来 职业范围(教师、研究员、学生)，通过支持受训人员可持续地增强能力 成为导师[总体目标2]。我们提供教学培训；参与研究项目；以及访问 对利益相关者、技术、网络和丰富活动。突破性的项目将绘制地图 以及(与利益相关者)共同设计克服女性癌症控制障碍的战略。然后我们测试 针对具体情况、从理论上了解情况的战略的可行性、实施、有效性和维持 克服采用和整合乳腺癌和宫颈癌筛查和整合的复杂障碍 初级保健中的转诊联系[中心主题；总体目标3]。我们还利用这些项目作为培训 加强KNH实施科学的地方能力和研究管理的平台。项目 1题为《加快采用以患者为中心的宫颈癌筛查和治疗联动机制》 肯尼亚“(达达链接)和项目2题为”整合信息技术的多层次战略“ 和流动保健，以加强与乳腺癌筛查和妇女早期发现的联系 在肯尼亚利用初级保健(MATITI Yangu)。该中心、核心和项目将产生可操作的、 混合方法、用户友好的证据并作为顾问和关键利益相关者双向接触 传播者，最大限度地扩大影响、吸收和可持续性。突破性进展与 核心和项目，体现了在我们的机构、研究和影响中促进公平的精神。