Strategia comunitaria, educativa domiciliare e di servizi di screening per aumentare l’accesso al controllo del cancro cervicale per le donne sieropositive in Nigeria
Strategia comunitaria, educativa domiciliare e di servizi di screening (CHESS) per aumentare l’accesso al controllo del cancro cervicale per le donne sieropositive in Nigeria
The goal of this observational study is to focus on adapting and implementing a program to promote HPV and cervical cancer (CC) screening and follow-up treatment for HIV-positive women, with three specific aims:
- Adaptation: Use stakeholder deliberation to tailor the successful MoMent program for this population.
- Implementation and Assessment: Deploy the adapted MoMent program and evaluate its reach, effectiveness, adoption, and fidelity.
- Evaluation: Conduct a post-implementation process evaluation to identify barriers and facilitators to the program's maintenance and sustainability.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
Despite the increased risk of cervical cancer (CC) among women living with HIV (WLWH), access to CC screening in Nigeria remains limited. While advances in prevention programs and antiretroviral therapy have reduced other AIDS-associated malignancies, CC risk in WLWH persists. This study aims to leverage Nigeria's existing HIV treatment infrastructure to integrate home-based CC (HCC) screening for WLWH.
The approach involves adapting the MoMent (MOther MENTor) peer-based HIV support program to include HCC screening and evaluating its implementation and sustainability using the Consolidated Framework for Implementation Research (CFIR) and RE-AIM frameworks. The study has three key aims:
- Adapting the MoMent program to promote home-based HPV screening and follow-up treatment through stakeholder deliberation.
- Implementing and assessing the program's reach, effectiveness, adoption, and fidelity with a sample of 1,500 WLWH.
- Conducting a post-implementation evaluation to identify barriers and enablers for program maintenance and scalability.
Stakeholder input, including perspectives from WLWH, peer counselors, clinical managers, and policymakers, will guide the program's design and execution. By integrating stakeholder insights and addressing systemic challenges, the study aims to advance CC control in Nigeria and provide a scalable model for implementing cancer control strategies for people living with HIV in low- and middle-income countries globally.
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Contatti e Sedi
Luoghi di studio
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Abuja, Nigeria
- APIN Health Initiatives
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Ibadan, Nigeria
- University of Ibadan
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Lagos, Nigeria
- Nigeria Institute of Medical Research (NIMR
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Metodo di campionamento
Popolazione di studio
Aim 1: The stakeholder deliberation conferences will include stakeholders from the following groups:
- State and National Policymakers
- Organizational-clinical managers
- Mentor mothers
- Women living with HIV (WLWH) Since this is a socio-behavioral component, pregnant individuals may partake. All individuals who take part in this portion of the study will be above 18 and capable of providing informed consent.
Aim 2: This study will only include WLWH aged 25-50. Pregnant individuals will not be included due to the potential for treatment of precancerous lesions. All individuals who partake in the study will be older than 18 and capable of providing informed consent.
Descrizione
Inclusion Criteria:
- Patients must be able to perform vaginal self-collection as well as give informed consent
Exclusion Criteria:
- Male gender
- Age <25 or >50
- Unknown or negative HIV status
- Pregnancy
- Hysterectomy
- Inability to give informed consent Inability/refusal to perform vaginal self-collection
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Modelli osservazionali: COHORT
- Prospettive temporali: PROSPECTIVE
Numero di gruppi/coorti
Coorti e interventi
Gruppo / CoorteGruppo / Coorte |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
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Women living with HIV
During the screening process:
WLWH testing positive for HrHPV 16/18/45 via self-collection will be notified by a Mentor Mother, who, along with Nigerian clinical staff, will assist in scheduling VIA. Treatment follows the standard of care protocol. |
The MOther MENTor (MoMent) program in Nigeria pairs trained treatment-experienced Women living with HIV (WLWH), known as Mentor Mothers (MMs), with new mothers who are newly diagnosed with HIV to improve access to and retention in HIV care
Altri nomi:
A cervical cancer screening tool. |
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Program Reach
Lasso di tempo: Baseline, Month 6, Month 18
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Reach evaluated through the provision of home test kits to eligible women, returned samples, number of WLWH positive for high-risk HPV (hrHPV) treated, persistence or reoccurrence of hrHPV or cervical precancerous lesions post-treatment, and correlation of these results with CD4 and HIV viral load. |
Baseline, Month 6, Month 18
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Effectiveness of the Program
Lasso di tempo: Baseline, Month 6, Month 18
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Effectiveness evaluated through the provision of home test kits to eligible women, returned samples, number of WLWH positive for high-risk HPV (hrHPV) treated, persistence or recurrence of hrHPV or cervical precancerous lesions post-treatment, and correlation of these results with CD4 and HIV viral load. |
Baseline, Month 6, Month 18
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Adoption of the program
Lasso di tempo: Baseline, Month 6, Month 18
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Adoption will be measured through the proportions of MMs who complete training and WLWH who return self-collected (SC) samples |
Baseline, Month 6, Month 18
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Fidelity of the program
Lasso di tempo: Baseline, Month 6, Month 18
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Will be measured by peer leaders' monitoring of practices, as well as measuring system barriers and added MoMent program costs per completed home screening |
Baseline, Month 6, Month 18
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Collaboratori e investigatori
Sponsor
Sponsor
Collaboratori
Collaboratori
Investigatori
Investigatori
- Investigatore principale: Lisa Flowers, MD, MPH, Emory University
Pubblicazioni e link utili
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
- Malattie urogenitali
- Malattie genitali
- Neoplasie urogenitali
- Neoplasie per sede
- Neoplasie
- Malattie urogenitali femminili
- Malattie urogenitali femminili e complicanze della gravidanza
- Malattie uterine
- Malattie genitali, femmina
- Neoplasie genitali, femmina
- Malattie della cervice uterina
- Neoplasie uterine
- Neoplasie cervicali uterine
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- STUDY00004817
- U01CA275113 (Sovvenzione/contratto NIH degli Stati Uniti)
Piano per i dati dei singoli partecipanti (IPD)
Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?
Descrizione del piano IPD
Data shared:
De-identified sociodemographic data (e.g., race/ethnicity, age). Health behavior and health care utilization data from medical records. Cervical pathology results, HPV testing data, laboratory tests (e.g., CD4 and viral load), prescribed HIV medications, and adherence data.
Qualitative data from in-depth interviews and focus group discussions, coded and anonymized.
Periodo di condivisione IPD
Start Date: After primary analyses have been completed and results are published (expected within 12 months of study completion).
End Date: Indefinitely, contingent on adherence to data-sharing agreements
Criteri di accesso alla condivisione IPD
Researchers will submit a Data Analysis Request Form, detailing their proposed analysis, purpose, and data needed.
Data access will be granted following review and approval. Approved users will sign a Data Use and Confidentiality Agreement. Anonymized data will be shared securely via a designated data repository or encrypted file transfer.
Researchers must commit to using the data for specified purposes, implementing secure data storage, and destroying or returning the data after analyses are completed.
Tipo di informazioni di supporto alla condivisione IPD
- STUDIO_PROTOCOLLO
- LINFA
- ICF
- CODICE_ANALITICO
Informazioni su farmaci e dispositivi, documenti di studio
Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti
Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
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