A Technology-enhanced and Multilevel Approach to Promote Cervical Cancer Prevention Among Women Living with HIV

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incidence and longer persistence of high-risk PROJECT SUMMARY/ABSTRACT (WLH) bear a disproportionate risk of invasive cervical cancer (CC) due to greater human papillomavirus (HPV) infection. Despite the availability of effective Women living with diagnosed HIV CC screening methods, there is low CC screening uptake among WLH. Reasons for suboptimal CC screening uptake among WLH are complex and multifactorial. Multilevel interventions that simultaneously address modifiable barriers to screening at different levels of influences are therefore needed to effectively reduce CC disparities among WLH. To achieve the World Health Organization’s recommended global target to eliminate CC by 2030, accelerated progress in complex health problems may also likely come from the integration of social innovations and technological advances. The overall objective of this proposed K01 project is to conduct formative research and pilot test the provider-level and patient-level components of the My Self-Sampling for HPV Awareness, Results, and Empowerment (MySHARE+) intervention. MySHARE+ aims to harness the power of technology and apply a multilevel approach to promote the adoption of CC screening (HPV self-sampling; Pap triage adherence) among under/never-screened WLH, a vulnerable population. The specific aims are to: 1) identify facilitators and barriers to implementing a healthcare provider prompt in a primary care setting and 2) conduct a pilot RCT to examine the feasibility, acceptability, and preliminary efficacy of a mHealth educational intervention in promoting CC awareness and HPV self-sampling among WLH. These aims align with the NCI’s mission to advance scientific knowledge to reduce the unequal burden of cancer and purposely addresses their areas of research emphasis in biobehavioral research and in improving health disparities by targeting multiple levels of influences. Study findings will generate implementation feasibility and acceptability data from the provider and patient perspectives, and inform a subsequent R01 that will test the impact of the MySHARE+ intervention in a large cluster randomized trial where the independent and overlapping effects of the different components can be evaluated. Strongly supported by mentors and advisors who are leading experts in the methodological and content areas specific to her long-term goals, Dr. Le’s proposed K01 includes a comprehensive training plan that will help her acquire new knowledge and advanced skills in: 1) quasi-experimental studies and cluster-RCTs using multilevel approaches, 2) digital health/technology-based interventions to promote patient-centered care, and 3) implementation science methodologies and frameworks. Over the 5-year award period, she will participate in mentored research, one-on-one and advisory/team meetings, didactic instruction, directed readings, training seminars, and scientific meetings. The aforesaid research and training activities will undoubtedly help Dr. Le achieve her overall academic career objective of leveraging academic- community-government partnerships to successfully execute and sustain community-driven and clinically-embedded intervention research supported by health information technology and the remote delivery of primary health care services to enhance patient-centered care. GW is well poised to support Dr. Le in undertaking these research endeavors, especially due to the expertise on faculty, its location and reputation in the city, and the institution’s high quality research setting.