Mixed-Methods approach to evaluate a mHealth intervention to increase adherence to triage of HPV+ women who have performed self-collection

7.项目摘要/摘要 项目：评估移动健康干预以提高对分诊的依从性的混合方法 HPV+进行过自我收集的女性 宫颈癌是一个严重的公共卫生问题，反映了健康方面的社会和性别不平等。它是 世界上女性癌症死亡的第三大原因，85%以上的病例发生在发展中国家 国家。目前，基于HPV DNA检测的新技术的发展使HPV自身 收集，增加筛查覆盖面。在基于自我收集的策略中，分类成为 预防过程，因为这是确定需要诊断和治疗的HPV阳性妇女的第一种方法 程序。然而，很难获得对分类的高度遵守，这并不令人惊讶，因为 坚持随访和治疗是宫颈癌项目中的一个普遍问题。 这项研究的具体目标是：1.评估创新的多组件移动健康的有效性 与平时相比，干预措施提高了HPV阳性女性患者对分诊的依从性 关心。2.评价执行战略，找出执行《 多组分的移动健康干预。 研究研究设计将遵循有效性-实施混合型I类试验的结构，以及 将采用混合方法。一项包括200名CHW(组)和4000名妇女的整群随机试验将 用于评估多组分移动健康干预措施的有效性，以提高对 HPV检测阳性后120天进行细胞学分流。移动健康干预将包括短信 当检测结果可用时，发送给HPV+女性通知她们，并随后发送短信 提醒。此外，对于那些HPV阳性的妇女，在治疗后60天内没有分类细胞学结果的人 HPV检测结果，CHWS将收到一封电子邮件和短信，以便他们在 家访，以获得具体的咨询和支持。对于执行情况评估，综合评估 将使用执行研究框架(CFIR)指导定性数据收集和分析 关于影响执行的因素。Re-AIM将用于评估覆盖范围、有效性、采用率、 实施和维护干预措施。 该项目的结果将为多成分移动健康干预的有效性提供证据 增加对HPV阳性妇女的分流，但可以调整以提高诊断/治疗的依从性 宫颈癌和其他健康问题。执行情况评估的结果将是 适用于使用或计划在不同环境中整合HPV自我收集的计划 国家。此外，在这项创新性研究中使用CFIR和RE-AIM将作为工作模式， 这是该区域在使用执行科学方面的一项重要进展。

7. Project summary/abstract PROJECT: Mixed-Methods approach to evaluate a mHealth intervention to increase adherence to triage of HPV+ women who have performed self-collection Cervical cancer is a serious public health problem reflecting social and gender inequalities in health. It is the third cause of cancer death among women in the world, with more than 85% of cases occurring in developing countries. Currently, the development of new technologies based on HPV DNA detection allows HPV self- collection, increasing screening coverage. In a self-collection based strategy, triage becomes a key step in the prevention process, as it is the first method to identify HPV+ women who will need diagnostic and treatment procedures. However, high adherence to triage is difficult to obtain, which is not surprising given that adherence to follow-up and treatment is a generalized problem in cervical cancer programs. Specific aims of the study are: 1. To evaluate the effectiveness of an innovative multi-component mHealth intervention to increase adherence to triage among women with HPV+ self-collected tests compared to usual care. 2. To evaluate the implementation strategy and identify barriers and facilitators to implementation of the multi-component mHealth intervention. The research study design will follow the structure of an effectiveness-implementation hybrid type I trial, and will use mix-method approach. A cluster randomized trial including 200 CHWs (clusters) and 4000 women will be used to evaluate the effectiveness of the multi-component mHealth intervention to increase adherence to cytology triage at 120 days after positive HPV testing. The mHealth intervention will include SMS messages sent to HPV+ women to inform them when results are available, and subsequent SMS messages as reminders. In addition, for those HPV+ women who did not had a triage cytology result within 60 days of the HPV test result, CHWs will receive an e-mail and SMS message so they can contact these women during home visits for specific counseling and support. For the implementation evaluation, the Consolidated Framework for Implementation Research (CFIR) will be used to guide qualitative data collection and analysis of factors that influence implementation. RE-AIM will be used to assess the Reach, Effectiveness, Adoption, Implementation and Maintenance of the Intervention. Results of this project will provide evidence on the effectiveness of the multi-component mHealth intervention to increase triage of HPV+ women, but it could be adapted to increase compliance of diagnoses/ treatment of cervical cancer and other health problems. Findings from the implementation evaluation will be highly applicable to programs that use or are planning to incorporate HPV self-collection in different settings and countries. In addition, the use of CFIR and RE-AIM in this innovative study will serve as a model of work, constituting an important advance in the use of Implementation Science in the Region.