Research Project 1

在非洲死于人类乳头瘤病毒(HPV)的人中，尼日利亚人占了相当大的比例。 相关癌2例。然而，他们无法获得基本的癌症预防服务，如证据- 3以人乳头瘤病毒疫苗为主，预防癌症。这在一定程度上是由个别(较低)的障碍造成的 4)、社会(社会支持不足)和结构(难以获得疫苗)。实施 HPV疫苗计划可以通过分散疫苗获得机会来减少这些障碍中的一部分 6人乳头瘤病毒相关癌的发病率和死亡率。我们建议扩大对年轻人友好的HPV疫苗， 7由青年参与行动研究框架、第三期笔会文化模式和 8实施科学综合框架。与以年轻人为被动目标的项目不同 9名获奖者，YPAR认为青年是创造和领导解决影响 10个人。PEN-3文化模式利用当地资源和合作伙伴关系，以股权思维改善 11健康，而CFIR能够评估执行成效的障碍和促进者。这个 12建议的创新工具，以扩大青少年友好型服务和HPV服务的翻译(i-test HPV) 13将利用两种参与性方法，即众包(即公开征集和指定)和学徒制， 14根据国家指导方针，增加9-15岁女孩接种HPV疫苗。我们假设 这两种方法(开放式挑战和学徒制)将增加对HPV疫苗的接受。 在尼日利亚开展了16场运动。使用混合类型II有效性实施设计来同时评估 17临床和实施成果，我们的目标是：1)使用参与性方法(众包 18和学徒)开发新的HPV疫苗活动；2)确定最终是否 19众包活动增加9-15岁女孩的HPV疫苗接种率，并评估 20干预维持，实施后一年。我们将从32个社区招募1120名女孩 21个阶梯楔形随机对照试验，决赛组与常规护理组比较。共有六十四名受训人员 来自每个环境的22名青年研究协调员(每个环境2名)将实施最后的HPV疫苗接种活动。 23主要结果是通过疫苗接种记录确定女孩最初接种HPV剂量疫苗的情况。 24个社区诊所。次要结果包括第二次疫苗接种，核心维持百分比 25个持续受益的计划要素(采用HPV疫苗)和持续的参与能力 26个社区在试验一年后；以及3)使用混合方法来探索多水平的因素 27影响HPV运动的接受。本研究符合RFA-CA-11-019的研究要求 28和美国癌症登月倡议。该项目建立在与尼日利亚研究所牢固关系的基础上 29医学研究(NIMR)实施可持续和可扩展的基于社区的模式，以实现公平 30癌症控制。 31 32 33 34.

1 Nigerians make up a significant proportion of individuals in Africa dying from human papillomavirus-(HPV) 2 associated cancers. However, they do not access essential cancer prevention services such as evidence- 3 based HPV vaccination to prevent cancer. This is partly explained by barriers that are individual (low 4 awareness), social (insufficient social support), and structural (poor access to vaccines). Implementation of 5 HPV vaccine programs can mitigate some of these barriers by decentralizing vaccine access to reduce the 6 incidence and death rate of HPV-associated cancers. We propose to expand youth-friendly HPV vaccines, 7 informed by a youth participatory action research framework (YPAR), the PEN-3 cultural model, and the 8 Consolidated Framework for Implementation Science (CFIR). Unlike projects targeting youth as passive 9 recipients, the YPAR considers youth to be partners in creating and leading solutions to problems that affect 10 them. PEN-3 cultural model leverages local resources and partnerships from an equity mindset to improve 11 health, while CFIR enables an evaluation of the barriers and facilitators of implementation effectiveness. The 12 proposed Innovative Tools to Expand youth-friendly Services and Translation of HPV services (I-TEST HPV) 13 will draw on two participatory methods, crowdsourcing (i.e., open calls and designathons) and apprenticeships, 14 to increase HPV vaccine uptake among girls aged 9-15 years old per national guidelines. We hypothesize that 15 these two approaches (open challenges and apprenticeships) will increase the uptake of HPV vaccine 16 campaigns in Nigeria. Using a hybrid type II effectiveness implementation design to simultaneously assess 17 both clinical and implementation outcomes, our aims are: 1) To use participatory approaches (crowdsourcing 18 and apprenticeships) to develop new HPV vaccine campaigns; 2) To determine whether the final 19 crowdsourced campaign increases HPV vaccination uptake among girls aged 9-15 years, and evaluate 20 intervention sustainment, one-year post implementation. We will recruit 1,120 girls from 32 communities to a 21 stepped-wedge randomized control trial of the finalist campaign versus usual care. A total of sixty-four trained 22 youth research facilitators from each setting (2 per setting) will implement the final HPV vaccination campaign. 23 The primary outcome is the initial HPV dose vaccine uptake among girls ascertained by vaccination records at 24 community clinics. The secondary outcomes include the second vaccine dose, percent sustainment of core 25 program elements with sustained benefits (uptake of HPV vaccines), and sustained capacity at participating 26 communities at one year after the trial; and 3) To use mixed-methods to explore multilevel factors that 27 influence the uptake of the HPV campaigns. This research aligns with the RFA-CA-11-019 request for research 28 and the US Cancer Moonshot Initiative. The project builds on a strong relationship with the Nigerian Institute 29 for Medical Research (NIMR) to implement a sustainable and scalable community-based model for equitable 30 cancer control. 31 32 33 34 .