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

采用技术增强的多层次方法促进艾滋病毒感染妇女的宫颈癌预防

• 批准号: 10740622
• 负责人: Daisy Le
• 金额: $ 17.26万
• 依托单位: GEORGE 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: 2023-09-15 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10740622
• 关键词: AIDS prevention; Acceleration; Active Learning; Address; Adherence; Adoption; Appointments and Schedules; Area; Award; Awareness; Behavior; Cancer Burden; Cancer Control; Cancer Control Research; Caring; Cervical Cancer Screening; Cities; Clinic; Clinical; Cluster randomized trial; Collaborations; Collection; Communities; Complex; Control Groups; Cues; Data; Detection; Early Diagnosis; Education; Educational Intervention; Eligibility Determination; Enhancement Technology; Enrollment; Extramural Activities; Faculty; Funding; Future; Goals; Government; Guidelines; HIV; HIV diagnosis; HPV-High Risk; Health; Health Personnel; Home; Human Papilloma Virus-Related Malignant Neoplasm; Human Papillomavirus; Human Resources; Human papilloma virus infection; Incidence; Infection; Institution; Instruction; Intention; Interdisciplinary Study; Intervention; Intervention Studies; Interview; Intraepithelial Neoplasia; K-Series Research Career Programs; Knowledge; Location; Malignant neoplasm of cervix uteri; Measures; Mentors; Mentorship; Methodology; Methods; Mission; Modality; Outcome; Patient Education; Patient-Centered Care; Patients; Persons; Pre-Post Tests; Preventive screening; Provider; Quasi-experiment; Randomized; Recommendation; Records; Reporting; Research; Research Activity; Research Methodology; Research Personnel; Research Project Grants; Research Support; Research Training; Risk; Sampling; Scientific Advances and Accomplishments; Screening for cancer; Security; Self Efficacy; Speculums; Surveys; System; Technology; Testing; Text Messaging; Training; Training Activity; Transportation; Triage; Visit; Vulnerable Populations; Wait Time; Woman; World Health Organization; acceptability and feasibility; behavioral health; biobehavior; cancer health disparity; cancer prevention; career; cervical cancer prevention; cervicovaginal; comparison control; cost; digital health; electronic medical record system; empowerment; evidence base; follow-up; health care availability; health care delivery; health disparity; health information technology; high risk; implementation science; improved; innovation; mHealth; marginalized population; meetings; participant enrollment; patient-clinician communication; pilot test; preference; primary care provider; primary care setting; primary health service; primary outcome; programs; recruit; remote delivery; screening; screening disparities; secondary outcome; self testing; shared decision making; skills; social; tool; uptake

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.

高风险的发生率和持续时间更长 项目概要/摘要 （WLH）由于更大的原因而承担着不成比例的浸润性宫颈癌（CC）风险 人乳头瘤病毒（HPV）感染。尽管有有效的 确诊艾滋病毒感染者的女性 CC 筛查方法，WLH 中 CC 筛查的采用率较低。 CC 筛查使用率不理想的原因 WLH 之间的关系是复杂且多因素的。同时解决可改变的障碍的多层次干预措施 因此，需要在不同影响水平上进行筛查，以有效减少 WLH 之间的 CC 差异。到 实现世界卫生组织建议的到 2030 年消除 CC 的全球目标，加速进展 复杂的健康问题也可能来自社会创新和技术进步的结合。 这个拟议的 K01 项目的总体目标是进行形成性研究并试点测试提供商级别 我的自我采样以提高 HPV 意识、结果和赋权 (MySHARE+) 的患者级别组件 干涉。 MySHARE+ 旨在利用技术的力量并应用多层次的方法来促进 在未接受/从未接受筛查的 WLH（弱势群体）中采用 CC 筛查（HPV 自我采样；巴氏涂片分类依从性） 人口。具体目标是：1）确定在医疗保健提供者提示中实施的促进因素和障碍 初级保健机构和 2) 进行试点随机对照试验，以检验一项方案的可行性、可接受性和初步疗效 移动健康教育干预可提高 WLH 中的 CC 意识和 HPV 自我采样。这些目标一致 NCI 的使命是推进科学知识，减少癌症的不平等负担，并有目的地解决 他们的研究领域重点是生物行为研究和通过针对多个层面改善健康差距 的影响。研究结果将产生来自提供者和患者的实施可行性和可接受性数据 观点，并告知后续的 R01，该 R01 将测试 MySHARE+ 干预对大型集群的影响 随机试验，可以评估不同成分的独立和重叠效应。 得到导师和顾问的大力支持，他们是特定方法和内容领域的领先专家 为了实现她的长期目标，乐博士提出的 K01 包括一个全面的培训计划，将帮助她获得新的知识 知识和高级技能：1）使用多层次方法的准实验研究和集群随机对照试验，2）数字化 基于健康/技术的干预措施，以促进以患者为中心的护理，以及 3) 实施科学方法和 框架。在 5 年奖励期内，她将参与指导研究、一对一和咨询/团队 会议、教学指导、定向阅读、培训研讨会和科学会议。上述研究及 培训活动无疑将帮助乐博士实现她利用学术- 社区与政府的伙伴关系，以成功执行和维持社区驱动和临床嵌入 由卫生信息技术和远程提供初级卫生保健服务支持的干预研究 加强以患者为中心的护理。 GW 已准备好支持乐博士开展这些研究工作，特别是 由于教师的专业知识、其在城市的位置和声誉以及该机构的高质量研究环境。