A Technology-enhanced and Multilevel Approach to Promote Cervical Cancer Prevention Among Women Living with HIV

高风险的发生率和持续时间 项目总结/摘要 (WLH)宫颈癌（CC）的发病率高， 人乳头瘤病毒（HPV）感染。尽管有效的 确诊感染艾滋病毒的妇女 CC筛选方法，WLH中存在低CC筛选摄取。次优CC筛查摄取的原因 WLH之间的关系是复杂的和多因素的。多层次干预措施，同时解决可改变的障碍， 因此，需要在不同影响水平上进行筛查，以有效减少WLH中的CC差异。到 实现世界卫生组织建议的到2030年消除CC的全球目标， 复杂的健康问题也可能来自社会创新和技术进步的结合。 本拟议K 01项目的总体目标是进行形成性研究和试点测试， 我的自我采样HPV意识，结果和授权（MySHARE+）的患者水平组件 干预MySHARE+旨在利用技术的力量，并采用多层次的方法来促进 在筛查不足/从未筛查过的WLH中采用CC筛查（HPV自我采样;坚持巴氏分诊）， 人口具体目标是：1）确定促进者和障碍，以实施医疗保健提供者提示， 初级保健环境和2）进行试点随机对照试验，以检查可行性，可接受性和初步疗效， 移动健康教育干预，以促进WLH中的CC意识和HPV自我采样。这些目标是一致的 NCI的使命是推进科学知识，以减少癌症的不平等负担， 他们的研究领域侧重于生物行为研究和通过针对多个层面改善健康差距 的影响。研究结果将生成来自提供者和患者的实施可行性和可接受性数据 透视图，并告知后续的R 01，该R 01将测试MySHARE+干预在大型集群中的影响 随机试验，可以评估不同成分的独立和重叠效应。 得到了导师和顾问的大力支持，他们是方法和具体内容领域的领先专家 对于她的长期目标，Le博士提出的K 01包括一个全面的培训计划，将帮助她获得新的 知识和先进的技能：1）准实验研究和集群RCT使用多层次的方法，2）数字 基于健康/技术的干预措施，以促进以患者为中心的护理，以及3）实施科学方法和 框架。在5年的奖励期内，她将参加指导研究，一对一和咨询/团队 会议、教学指导、指导性阅读、培训研讨会和科学会议。上述研究和 培训活动无疑将帮助乐博士实现她的整体学术生涯目标，利用学术- 社区-政府伙伴关系，以成功执行和维持社区驱动和临床嵌入式 由卫生信息技术和远程提供初级卫生保健服务支持的干预研究 加强以病人为中心的护理。GW准备好支持Le博士从事这些研究工作，特别是 由于教师的专业知识，其在城市中的位置和声誉，以及该机构的高质量研究环境。

incidence and longer persistence of high-risk PROJECT SUMMARY/ABSTRACT (WLH) bear a disproportionate risk of invasive cervical cancer (CC) due to greater human papillomavirus (HPV) infection. Despite the availability of effective Women living with diagnosed HIV CC screening methods, there is low CC screening uptake among WLH. Reasons for suboptimal CC screening uptake among WLH are complex and multifactorial. Multilevel interventions that simultaneously address modifiable barriers to screening at different levels of influences are therefore needed to effectively reduce CC disparities among WLH. To achieve the World Health Organization’s recommended global target to eliminate CC by 2030, accelerated progress in complex health problems may also likely come from the integration of social innovations and technological advances. The overall objective of this proposed K01 project is to conduct formative research and pilot test the provider-level and patient-level components of the My Self-Sampling for HPV Awareness, Results, and Empowerment (MySHARE+) intervention. MySHARE+ aims to harness the power of technology and apply a multilevel approach to promote the adoption of CC screening (HPV self-sampling; Pap triage adherence) among under/never-screened WLH, a vulnerable population. The specific aims are to: 1) identify facilitators and barriers to implementing a healthcare provider prompt in a primary care setting and 2) conduct a pilot RCT to examine the feasibility, acceptability, and preliminary efficacy of a mHealth educational intervention in promoting CC awareness and HPV self-sampling among WLH. These aims align with the NCI’s mission to advance scientific knowledge to reduce the unequal burden of cancer and purposely addresses their areas of research emphasis in biobehavioral research and in improving health disparities by targeting multiple levels of influences. Study findings will generate implementation feasibility and acceptability data from the provider and patient perspectives, and inform a subsequent R01 that will test the impact of the MySHARE+ intervention in a large cluster randomized trial where the independent and overlapping effects of the different components can be evaluated. Strongly supported by mentors and advisors who are leading experts in the methodological and content areas specific to her long-term goals, Dr. Le’s proposed K01 includes a comprehensive training plan that will help her acquire new knowledge and advanced skills in: 1) quasi-experimental studies and cluster-RCTs using multilevel approaches, 2) digital health/technology-based interventions to promote patient-centered care, and 3) implementation science methodologies and frameworks. Over the 5-year award period, she will participate in mentored research, one-on-one and advisory/team meetings, didactic instruction, directed readings, training seminars, and scientific meetings. The aforesaid research and training activities will undoubtedly help Dr. Le achieve her overall academic career objective of leveraging academic- community-government partnerships to successfully execute and sustain community-driven and clinically-embedded intervention research supported by health information technology and the remote delivery of primary health care services to enhance patient-centered care. GW is well poised to support Dr. Le in undertaking these research endeavors, especially due to the expertise on faculty, its location and reputation in the city, and the institution’s high quality research setting.