Implementation Strategies Addressing Caribbean Stigma to Improve the Woman-to- Woman Cervical Cancer Prevention Intervention

项目总结 本申请是对特别利益通知(NOSI)的回应，该通知被标识为“非CA-CA- 23-036“。拟议研究的总体目标是在我们的加勒比污名研究方案的基础上再接再厉 与癌症预防相关。我们的初步研究表明，在加勒比海地区，耻辱阻碍了预防性护理 包括宫颈癌筛查和HPV疫苗接种。作为回应，为了解决癌症的耻辱， 在加勒比背景下，我们将采用执行科学方法来改善有证据的妇女 妇女干预(W2W)，以减少耻辱和加强癌症预防。植根于实施 科学，我们将以不同利益相关者的视角为指导，以及我们最近的初步结果 以人群为基础的加勒比污名调查(CCSS，N=2233)，以加强第二次世界大战干预，包括 将减少耻辱的内容纳入课程。我们将利用我们庞大的非洲加勒比癌症联盟 (AC3)社区合作伙伴，包括Lay Health Advisors和临床医生，以告知和指导改进 使用实施科学方法加强W2W的课程和减少W2W的策略 癌症耻辱，并增加宫颈癌筛查和HPV疫苗接种。为了实现这一目标，我们 提出以下具体目标：目标1：根据我们的加勒比癌症和耻辱研究调查(N= 2233)和定性结果，使用基于证据的过程(EBP)修改策略来改进 目前的W2W干预带有减少耻辱的课程。目标2：参与多方利益攸关方的观点 利用社区卫生工作者焦点小组和临床医生访谈进一步细化改进的目标1 W2W 干预。我们将纳入文化污名的考虑和减少领域和衍生的内容 来自临床医生和社区卫生工作者；解决HPV疫苗接种的改进，并增强 创建增强型W2W_END末梢宫颈癌干预的实施战略。 多部门利益相关者将确保W2W_End耻辱-End宫颈癌干预的文化 一致性，以减少癌症污名，作为宫颈癌筛查和HPV疫苗接种的障碍。这 实施科学研究将率先提供新的和必要的利益攸关方成果，为联合 创建(社区倡导者、临床医生和研究人员)减少污名的课程和交流 最佳提供者和患者激活策略，以增加宫颈癌筛查和HPV的摄取率 接种疫苗。因此，我们的研究结果将改善W2W干预的证据，创造 W2W_End Stamma-End宫颈癌消除耻辱作为宫颈癌筛查和 HPV疫苗接种，为不久的将来加勒比海干预传播。

PROJECT SUMMARY This application is being submitted in response to the Notice of Special Interest (NOSI) identified as “NOT-CA- 23-036”. The overall objective of the proposed study is to build upon our program of Caribbean stigma research relevant to cancer prevention. Our preliminary study shows that in the Caribbean, stigma bars preventive care including cervical cancer screening and HPV vaccination. In response, to address cancer stigma for the Caribbean contexts, we will employ implementation science approaches to improve the evidenced Woman to Woman intervention (W2W) to reduce stigma and increase cancer prevention. Rooted in implementation science, we will be guided by diverse stakeholder perspectives, and the preliminary results of our recent population-based Caribbean stigma survey (CCSS, N=2233) to enhance the W2W intervention by including a stigma reduction component to the curriculum. We will leverage our vast African Caribbean Cancer Consortium (AC3) of community partners including Lay Health Advisors and clinicians to inform and guide the improvements to W2W using implementation science approaches to enhance the curriculum and strategies of W2W to reduce cancer stigma, and increase cervical cancer screening and HPV vaccination. To accomplish this objective, we propose the following specific aims: Aim 1: Informed by our Caribbean Cancer and Stigma Study survey (N= 2233) and qualitative results, using the Evidenced Based Process (EBP) modification strategies to improve the current W2W intervention with a stigma reduction curriculum. Aim 2: Engage multi-stakeholder perspectives using community health workers focus groups and clinician interviews to further refine the improved Aim 1 W2W intervention. We will incorporate cultural stigma consideration and reduction domain and content derived from the clinician and community health workers; address HPV vaccination improvements, and enhance implementation strategy to create the enhanced W2W_End Stigma-End Cervical Cancer intervention. Multi-sectoral stakeholders will ensure W2W_End Stigma-End Cervical Cancer intervention’s cultural congruence to reduce cancer stigma as a barrier to cervical cancer screening and HPV vaccination. This implementation science research will be the first to provide novel and requisite stakeholder results to inform co- created (community advocate, clinician, and researcher) stigma reduction curriculum and communication strategies for optimal provider and patient activation for increased uptake of cervical cancer screening and HPV vaccination. Therefore, our study findings will improve the evidenced W2W intervention creating the W2W_End Stigma-End Cervical Cancer to eliminate stigma as a barrier to cervical cancer screening and HPV vaccination, for near future Caribbean intervention dissemination.