Implementing and Evaluating the Cancer Tracking System (CATSystem): A Systems Level Intervention to Improve Cervical Cancer Screening, Treatment Referral and Follow up in Kenya
Overview
- Phase
- Not Applicable
- Intervention
- Cancer Tracking System (CATSystem)
- Conditions
- Cervical Cancer
- Sponsor
- University of Kansas Medical Center
- Enrollment
- 6600
- Locations
- 10
- Primary Endpoint
- Guideline adherent treatment for a positive screen
- Status
- Active, not recruiting
- Last Updated
- last month
Overview
Brief Summary
Cervical cancer contributes to significant preventable mortality in Kenya where less than 20% of women are screened. The Cancer Tracking System (CATSystem) is a web-based, algorithm generated tool to promote guideline adherent cervical cancer screening and retention through treatment. The goal of this project is to rigorously evaluate the efficacy, implementation, and cost-effectiveness of the CATSystem to improve rates of screening, treatment, referral, and follow-up care in a matched, cluster randomized controlled trial in 10 Kenyan government hospitals (5 intervention, 5 standard of care).
Detailed Description
To help address system level barriers to cervical cancer screening, treatment, and follow-up in Kenya, investigators worked with end-users (providers and patients) to develop the Cancer Tracking System (CATSystem), a web-based, algorithm generated tool to promote guideline adherent cervical cancer screening and retention through treatment. The goal of this project is to rigorously evaluate the efficacy, implementation, and cost-effectiveness of the CATSystem to improve rates of screening, treatment, referral, and follow-up care in a matched, cluster randomized controlled trial in 10 Kenyan government hospitals (5 intervention, 5 standard of care). Specific aims (SA) of the study are to (1) Implement and evaluate the efficacy of CATSystem to improve guideline adherent cervical cancer screening, treatment, referral and follow up, (2) Assess feasibility and acceptability of implementation of CATSystem in government run facilities using a human centered design approach, and (3) Calculate the costs and cost-effectiveness of the CATSystem to increase quality adjusted life years gained. Cervical cancer deaths can be prevented with early detection and treatment. This study will evaluate the public health impact of the CATSystem in improving cervical cancer screening, treatment, referral, follow-up, and the feasibility of scale up to other low resource settings.
Investigators
Eligibility Criteria
Inclusion Criteria
- •women above 16 years of age
- •access to a cell phone,
- •presenting for cervical cancer screening at a study hospital.
Exclusion Criteria
- •greater than 20 weeks gestation,
- •incarcerated patients,
- •women who study staff feel are unable to provide written informed consent due to impaired capacity.
Arms & Interventions
CATSystem Intervention
Participants enrolled at intervention sites will receive CATSytem-supported cervical cancer screening and treatment services. Interventions received will include: text messages to patients and algorithm-driven alerts to providers when guideline-adherent cervical cancer screening and treatment services are required including: initial and follow up cervical cancer screening, on site treatment, and referral tracking.
Intervention: Cancer Tracking System (CATSystem)
Standard of care
Participants enrolled at control sites will receive standard of care PMTCT services, with no CATSystem tracking or follow up
Outcomes
Primary Outcomes
Guideline adherent treatment for a positive screen
Time Frame: 0-12 months [from screening result to treatment completion]
Provide guideline adherent treatment and rescreening for the range of possible positive screen results: cervicitis, precancerous lesions (mild, moderate, severe), invasive cervical cancer. Participants who receive the guideline adherent treatment for their positive screen result will be coded as 1 or "yes". Participants who do not receive the guideline adherent treatment for their positive screen will be coded as 0 or "no".
Secondary Outcomes
- Cervical cancer screening(0-24 months)