HPV and Cancer mHealth Prevention Education for HIV Positive Women Pilot Study

应聘者描述(由申请人提供)：应聘者是一名研究助理教授，接受过健康促进、教育和行为方面的学术培训，以及艾滋病毒/艾滋病预防、健康差距和卫生服务研究方面的博士后培训。她还拥有数据管理专业知识和临床免疫学经验。这位候选人已经完成了两项试验性研究，调查了HPV感染和宫颈癌预防知识、信念和艾滋病毒携带者(WLH)女性的筛查行为。候选人正在寻求更多所需的培训，以开发和实施有效的癌症健康(包括移动健康)沟通和社区导航战略，以改善世界卫生组织对癌症筛查、诊断和治疗服务和程序的及时使用。这位候选人的长期目标是为她的独立研究项目获得外部研究资金，该项目专注于在未来5-10年内预防和控制WLH中HPV介导的癌症。晋升副教授(终身教职或研究轨道)是应聘者在未来五年内努力实现的中间目标。将利用正规教学培训和体验式学习机会相结合的方式，获得以下领域的癌症预防和控制研究技能：癌症健康(包括mHealth)沟通、癌症流行病学、HPV介导的癌症生物学、社区导航、高级流行病学研究技能(例如，社会流行病学、n-of-1研究研究设计和多水平建模)。候选人将利用通过拟议职业发展奖获得的癌症预防和控制研究以及健康沟通知识和技能，进行必要的形成性研究，为干预措施的发展提供信息，其中她将审查癌症健康信息在世界卫生组织及其非临床艾滋病毒服务提供者(例如，艾滋病毒/性传播感染风险降低顾问)之间的寻求和共享。非临床艾滋病毒服务提供者将被包括在内，因为除了这些人已经在世界卫生组织中推广安全的性行为之外，他们还能够接触到世界卫生组织的边缘群体，如无家可归的人。这包括收容所和无收容所的无家可归妇女。候选人的导师和共同导师拥有科学专业知识和基于社区的参与性研究经验，这将增加成功完成拟议的具体目标的可能性。候选人将首先考察HPV介导的癌症预防知识、信念和行为，以及癌症健康交流寻求和分享行为(包括使用技术寻找健康信息)(目标1)。这些形成的研究数据将被用于制定(目标2)和随后的试点测试和评估(目标3)HPV介导的癌症预防mHealth教育干预措施，旨在培训已经担任同行领袖和非临床艾滋病毒服务提供者的WLH使用mHealth工具和社区导航战略来传播HPV介导的癌症预防教育。作为社区导航员，这些人将使用癌症健康(包括mHealth)传播和社区导航策略来提高对HPV介导的癌症风险的认识。这将包括促进降低癌症风险的行为，如安全的性行为，以及及时使用建议的癌症筛查、诊断和治疗服务和程序)。将发送召回和提醒消息进行筛查和后续癌症护理预约。用户定义的社会支持消息也将发送给可能遇到癌症护理障碍的妇女。候选人将通过她将在科学会议和年度会议上发表的演讲以及她将制作的同行评议出版物向当地、地区、国家和国际受众传播科学研究成果。与候选人实现研究独立的长期目标最相关的是，在5年期培训结束前，将同行评审出版物的数量从目前的每年大约3份增加到每年4份或更多份，并在5年期培训结束前提交至少一份赠款提案(例如，R01级资助)。拟议的职业发展/培训和研究活动将使应聘者能够实现她的长期职业目标，即成为一名独立的癌症研究人员，拥有利用癌症健康通信、社区导航和mHealth技术的专业知识，以解决在癌症护理连续过程中易受伤害、医疗服务不足的WLH遇到的健康系统故障。持续的指导和团队科学研究合作的机会将促进候选人成功地成为一名独立的癌症研究人员。世界卫生组织和非临床艾滋病毒服务提供者将从瑞安·怀特资助的诊所和艾滋病服务组织中招聘，这些诊所和艾滋病服务组织位于南卡罗来纳州的城乡地理区域，这些组织代表着艾滋病毒/艾滋病、癌症和其他慢性病方面差距的缩影，这些差距给医疗服务不足的少数族裔人口带来了不成比例的负担。解决在癌症护理连续过程中发生的导致错过预防、检测、诊断和治疗HPV介导性癌症的机会的卫生系统故障，将有助于减轻这一高癌症风险、脆弱的WLH群体的癌症发病率和死亡率的负担。拟议的HPV介导的癌症mHealth预防教育干预将在社区环境中进行，并建立在候选人与当地艾滋病服务组织之间现有的学术-社区伙伴关系的基础上。这位候选人有一个支持性的、资源密集型的科学环境来进行她的癌症研究培训。

DESCRIPTION (provided by applicant): The candidate is a research assistant professor with academic training in health promotion, education, and behavior, as well as postdoctoral training in HIV/AIDS prevention, health disparities, and health services research. She also has data management expertise and clinical immunology experience. The candidate has completed two pilot studies that examined HPV infection and cervical cancer prevention knowledge, beliefs and screening behaviors among women living with HIV (WLH). The candidate is seeking additional training needed to develop and implement effective cancer health (including mHealth) communication and community navigation strategies to improve WLH's timely use of cancer screening, diagnostic and treatment services and procedures. The candidate's long-term goal is to obtain extramural research funding for her independent research program focusing on the prevention and control of HPV-mediated cancers among WLH over the next 5-10 years. Promotion to associate professor (tenure- or research-track) is an intermediate goal that the candidate is striving to attain within the next five years. A combination of formal didactic trainig and experiential learning opportunities will be used to acquire cancer prevention and control research skills in the following areas: cancer health (including mHealth) communication, cancer epidemiology, HPV-mediated cancer biology, community navigation, advanced epidemiological research skills (e.g., social epidemiology, n- of-1 research study designs, and, multilevel modeling). The candidate will use the cancer prevention and control research and health communication knowledge and skills acquired through the proposed career development award to conduct formative research needed to inform intervention development in which she will examine cancer health information seeking and sharing among WLH as well as their non-clinical HIV service providers (e.g., HIV/STI risk reduction counselors). Non-clinical HIV service providers will be included because, in addition to the fact that these individuals are already promoting safe sexual practices among WLH, they are also able to reach marginalized groups of WLH such as those who are homeless. This includes sheltered and unsheltered homeless WLH. The candidate's mentors and co-mentors have scientific expertise and community-based participatory research experience that will increase the likelihood of the proposed specific aims being successfully completed. The candidate will first examine HPV-mediated cancer prevention knowledge, beliefs and behaviors, as well as cancer health communication seeking and sharing behaviors (including the use of technology to find health information) (Aim 1). These formative research data will then be used to inform the development (Aim 2) and subsequent pilot testing and evaluation (Aim 3) of an HPV- mediated cancer prevention mHealth education intervention aimed at training WLH who already serve as peer leaders and non-clinical HIV service providers to use mHealth tools and community navigation strategies to disseminate HPV-mediated cancer prevention education. As community navigators, these individuals will use cancer health (including mHealth) communication and community navigation strategies to increase awareness about HPV-mediated cancer risk. This will include promoting cancer risk reducing behaviors such as safe sexual practices and the timely use of recommended cancer screening, diagnostic, and treatment services and procedures). Recall and reminder messages will be sent for screening and follow-up cancer care appointments. User-defined social support messages will also be sent to WLH who may be encountering access to cancer care barriers. The candidate will disseminate the scientific research findings to local, regional, national, and international audiences via presentations that she will give at scientific conferences and annual meetings as well as peer-reviewed publications that she will produce. Most relevant to the candidate's long-term goal of attaining research independence is increasing her number of peer-reviewed publications from her current publication rate of approximately three per year to four or more produced annually by the end of the 5-year training period and the submission of at least one grant proposal (e.g., R01-level funding) by the end of the 5-year training period. The proposed career development/training and research activities will enable the candidate to realize her long-term career goal of becoming an independent cancer researcher with expertise in using cancer health communication, community navigation, and mHealth technologies to address health system failures encountered by vulnerable, medically-underserved WLH along the cancer care continuum. Continued mentoring and opportunities for team science research collaborations will facilitate the candidate's successful progression to being an independent cancer researcher. WLH and non-clinical HIV service providers will be recruited from Ryan White funded clinics and AIDS-service organizations located in urban and rural geographical areas of South Carolina that represent a microcosm of disparities in HIV/AIDS, cancer, and other chronic illness that disproportionately burden medically underserved minority populations. Addressing health system failures that occur along the cancer care continuum that result in missed opportunities to prevent, detect, diagnose and treat HPV-mediated cancers will help to reduce the burden of cancer incidence and mortality among this high cancer risk, vulnerable group of WLH. The proposed HPV-mediated cancer mHealth prevention education intervention will be conducted in a community-based setting and builds upon an existing academic-community partnership between the candidate and a local AIDS-service organization. The candidate has a supportive, resource-intensive scientific environment for her cancer research training.