Reducing Barriers and Sustaining Utilization of a Cervical Cancer Screening Program in Rural Senegal
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 160
- 试验地点
- 4
- 主要终点
- Change in the number of women screened for the first time, age stratified
研究概览
简要总结
This research project will investigate the determinants of cervical cancer screening uptake and sustained utilization in this region and develop and evaluate a context-specific peer education behavioral intervention to improve uptake. Research supports the effectiveness of peer education in increasing cancer screening rates but, currently, no cervical cancer screening peer education program specific to rural Senegal exists. To inform the participatory development of this program, the investigators will assess barriers and facilitators of screening at multiple levels: individuals (women aged 30 to 59), households (family or principle social unit of at-risk women), and the community (immediate village or neighborhood with common amenities of at-risk women). We hypothesize that a peer education program that adapts to changing contexts over time and is targeted at a multi-level audience will result in early, widespread uptake and sustained use of the VIA cervical cancer screening program. Study findings will inform programmatic planning in Kedougou and the peer education curriculum we develop can serve as a template for maximizing early impact of new cervical cancer screening services implemented in other areas of rural Senegal. Our long-term goal is to inform national-level policy to guide the implementation of cervical cancer screening programs in other rural Senegal regions.
详细描述
The goal of this study is to inform the sustainable implementation of cervical cancer screening services in low-resource areas of Senegal naïve to cancer screening programs by
- investigating the access barriers and determinants of initial uptake and
- developing and adapting a peer education health promotion intervention to diverse and dynamic contexts to achieve sustained utilization.
Framework: Implementation Science is the study of how proven technical solutions are applicable to real world settings. The investigators will study how the implementation of VIA, as a proven intervention, can be optimized and how the screening service can best "fit" into the local context. Established complementary frameworks will guide our study. The investigators will apply
- the Patient-Centered Access Framework to assess the demand-side barriers and facilitators of uptake in aim 1,
- the Integrated Theory of Health Behavior Change to evaluate how a peer education program facilitates self-management behavior of women in aim 2, and
- the Dynamic Sustainability Framework to evaluate the initial uptake and sustained utilization of the health service in aim 3.
The investigators seek to understand the dynamic nature of the influential factors within the local context and the process by which the investigators can facilitate responsive adaptations to the intervention in order to reduce barriers, maximize early uptake, and sustain utilization.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Sequential
- 主要目的
- Screening
- 盲法
- None
入排标准
- 年龄范围
- 30 Years 至 59 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Women. Criteria for inclusion include:
- •female Senegal citizen between the ages of 30 and 59,
- •Resident in Kedougou Region,
- •eligible to seek cervical cancer prevention services at a designated intervention or control health center in the Kedougou Region, Senegal,
- •willing to participate in survey assessments; 5) able to give informed consent.
- •Men. Criteria for inclusion include:
- •male Senegal citizen between the ages of 30 and 59,
- •Resident in Kedougou Region,
- •living in a household with at least one woman eligible to seek cervical cancer prevention services at a designated intervention or control health center in the Kedougou Region, Senegal,
- •willing to participate in survey assessments;
- •able to give informed consent.
排除标准
- •No additional exclusion criteria exist.
结局指标
主要结局
Change in the number of women screened for the first time, age stratified
时间窗: measured at baseline and every 6 months through 35 months.
Number of women who are screened for cervical cancer
次要结局
- Change in the number of women and men recommending the service(measured at baseline and every 6 months through 35 months.)
- Change in the number of households directly receiving intervention(measured at baseline and every 6 months through 35 months.)
- Change in the knowledge of cervical cancer(measured at baseline and every 6 months through 35 months.)
- Change in the number of women being re-screened, age stratified(measured at baseline and every 6 months through 35 months.)
- Change in the number of individuals directly receiving intervention(measured at baseline and every 6 months through 35 months.)
- Change in the number communities directly receiving intervention(measured at baseline and every 6 months through 35 months.)
研究者
Jon Andrew Dykens
Assistant Professor of Family Medicine
University of Illinois at Chicago