Developing and evaluating a mobile application-based intervention to support HPV-tested women and increase their retention to follow-up: a mixed-methods implementation study

开发和评估基于移动应用程序的干预措施，以支持接受 HPV 检测的女性并提高她们的随访率：一项混合方法实施研究

• 批准号: 10740962
• 负责人: Silvina Arrossi
• 金额: $ 24.65万
• 依托单位: CENTER FOR THE STUDY OF STATE / SOCIETY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-22 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10740962
• 关键词: Adoption; Anxiety; Argentina; Behavioral; Behavioral Model; Cancer Control; Cancer Etiology; Cancer Intervention; Cessation of life; Clinical; Cognitive; Communication; Confusion; Consolidated Framework for Implementation Research; Consultations; Counseling; Country; Data; Development; Diagnosis; Disease; Distress; Effectiveness; Evaluation; Face; Family; Fright; Health; Health Personnel; Health Resources; Health system; Human Papilloma Virus-Related Malignant Neoplasm; Human Papillomavirus; Human Resources; Intervention; Interview; Knowledge; Latin America; Latin American; Lesion; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Measures; Methods; Modeling; Outcome; Patients; Perception; Personal Communication; Phase; Prevention; Primary Health Care; Process; Proctor framework; Provider; Quality of life; Randomized, Controlled Trials; Recommendation; Records; Regulation; Reporting; Sexually Transmitted Diseases; Shame; Solid; Structure; Surveys; Test Result; Testing; Time; Training; Vulnerable Populations; Woman; Work; burden of illness; cancer prevention; cervical cancer prevention; cost; design; effectiveness outcome; evidence base; follow-up; health training; implementation evaluation; implementation facilitators; implementation fidelity; implementation framework; implementation outcomes; implementation research; implementation science; implementation strategy; implementation study; improved; individual patient; innovation; mHealth; mobile application; mortality; premalignant; primary health center; psychosocial; screening; screening program; social vulnerability; sound; standard of care; theories; tool; usability; user centered design

PROJECT SUMMARY/ABSTRACT Cervical cancer (CC) is one of the leading causes of cancer death among women from Latin America. In the Region, screening programs face important problems to assure follow-up/treatment, which is a major obstacle for screening effectiveness. Human papillomavirus (HPV) testing has become the main strategy to reduce the burden of the disease. However, HPV positivity can have an important negative impact on the psychosocial health of tested women. In addition, for many Latin-American women, information provided by health providers about HPV is often confusing; women have difficulties in understanding HPV-test results and steps to follow. Both HPV’s psychosocial impact of HPV-testing, and lack of information regarding the follow-up process might not only diminish women's quality of life but also reduce their retention to follow up. The specific aims of this project are the following: AIM 1. To develop and test usability of an app to increase women knowledge about HPV/ CC/FU, reduce the psycho-social impact of HPV-testing and increase retention to follow-up. (R21 phase) AIM 2. To evaluate the implementation strategy and preliminary effectiveness outcomes of the app-based intervention and identify barriers and facilitators to the implementation. (R33 Phase) We will carry out a pilot implementation study of an app-based intervention aimed at providing HPV-tested with evidence-based information about HPV, reducing the psycho-social impact of HPV and increasing retention to follow-up. The app-based intervention will consist of an app to provide information and support to HPV-tested women, offered to women by trained health providers during the screening consultation.We will combine a user-centered design approach with behavioral models and Implementation Science frameworks to test, and evaluate the implementation strategy of the app-based intervention in PHC centers in Argentina. We will use a mixed methods descriptive design, composed of a quantitative Women study and a Quantitative -qualitative Study at Health provider level. Following Proctor´s taxonomy, in the Women Study we will evaluate acceptability, appropriateness, and adoption of the implementation strategy. To measure preliminary effectiveness outcomes we will carry out three quantitative surveys at different moments of the screening/follow-up process and we will analyze data from routine clinical records. In the Study of Health providers, we will carry out semi-structured interviews to analyze CFIR selected constructs. This study will provide evidence about the implementation strategy of an app-based intervention that will be ready for evaluation of its effectiveness in a randomized controlled trial. It will constitute a solid and sound example of how Implementation Science can be used to produce rigorous evidence-based information about implementation of mHealth interventions for cancer control.

项目摘要/摘要 宫颈癌（CC）是拉丁美洲女性癌症死亡的主要原因之一。在 地区，筛查计划面临着重要的问题，以确保随访/治疗，这是一个主要的问题 筛选有效性的障碍。人类乳头瘤病毒（HPV）测试已成为 减少疾病的燃烧。但是，HPV积极性可能对 测试妇女的社会心理健康。此外，对于许多拉丁美洲妇女，提供的信息 关于HPV的卫生提供者通常会令人困惑。女性很难理解HPV检验结果 和遵循的步骤。 HPV对HPV测试的社会心理影响以及缺乏有关 后续过程不仅会降低妇女的生活质量，而且还可以减少其跟进的保留。 该项目的具体目的是： 目的1。开发和测试应用程序的可用性，以增加女性对HPV/ cc/ fu的了解，请减少 HPV测试的心理社会影响并增加对后续行动的保留。 （R21阶段） 目标2。评估基于应用程序的实施策略和初步效果结果 干预并确定实施的障碍和促进者。 （R33阶段） 我们将对旨在提供HPV测试的基于应用的干预措施进行试点实施研究 借助有关HPV的循证信息，减少HPV的心理社会影响并增加 保留跟进。基于应用的干预措施将由一个应用程序组成，以提供信息和支持 在筛查咨询期间训练有素的卫生提供者向女性提供的HPV测试妇女。 将以用户为中心的设计方法与行为模型和实施科学结合 测试和评估基于应用程序干预措施的实施策略的框架 在阿根廷。我们将使用由定量妇女研究组成的描述性设计的混合方法 在健康提供者层面进行的定量质量研究。遵循Proctor的分类法，在妇女研究中 我们将评估实施策略的可接受性，适当性和采用。测量 初步有效性结果我们将在不同时刻的不同时刻进行三项定量调查 筛选/随访过程，我们将分析常规临床记录的数据。在健康研究中 提供者，我们将进行半结构化访谈，以分析CFIR选定的结构。 这项研究将提供有关基于应用程序干预的实施策略的证据 准备在随机对照试验中评估其有效性。它将构成坚实而稳固的声音 如何使用实施科学来生成有关严格循证信息的示例 实施MHealth干预措施以控制癌症。