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

项目总结/摘要 宫颈癌是拉丁美洲妇女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，以确保后续行动/治疗，这是一个主要的 筛选有效性的障碍。人乳头瘤病毒（HPV）检测已成为主要策略， 减轻疾病负担。然而，HPV阳性可能对患者的健康产生重要的负面影响。 测试妇女的心理健康。此外，对许多拉丁美洲妇女来说， 健康提供者对HPV的认识往往令人困惑;妇女难以理解HPV检测结果 和后续步骤。HPV检测的社会心理影响，以及缺乏关于HPV检测的信息， 跟踪过程不仅可能降低妇女的生活质量，还可能减少她们继续跟踪的机会。 该项目的具体目标如下： AIM 1.为了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， HPV检测的心理社会影响，并增加对随访的保留。(R21阶段） AIM 2.评估以应用程式为本的 干预，并确定执行的障碍和促进因素。(R33阶段） 我们将开展一项基于应用程序的干预措施的试点实施研究， 通过关于HPV的循证信息，减少HPV的心理社会影响， 保持跟进。基于应用程序的干预将包括一个提供信息和支持的应用程序 在筛查咨询期间，由受过培训的卫生服务提供者提供给接受HPV检测的妇女。我们 将联合收割机与行为模型和实施科学相结合，以用户为中心的设计方法 测试和评估PHC中心基于应用程序的干预实施策略的框架 阿根廷的我们将使用混合方法描述性设计，包括定量女性研究和 a在保健提供者一级进行的定量-定性研究。根据普罗克特的分类法，在妇女研究中， 我们会评估实施策略的可接受性，适切性及采纳情况。测量 初步成效结果我们将在2005年的不同时刻进行三次定量调查， 筛选/随访过程，我们将分析常规临床记录中的数据。在健康研究中 提供者，我们将进行半结构化访谈，分析CFIR选择的结构。 这项研究将提供有关基于应用程序的干预措施的实施策略的证据， 准备在随机对照试验中评估其有效性。它将构成一个坚实而健全的 实施科学如何用于产生严格的循证信息的例子， 实施移动健康干预措施以控制癌症。

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.