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- Klinische proef NCT07624123
Clinic vs Clinic+Community Outreach HPV Self-Collection to Increase Cervical Screening in Women Living With HIV (C-3001B-P-CS7)
Comparison of Clinic-based Versus Clinic-plus Community Outreach-based Strategy Via HPV Self-Collection to Increase Uptake of Cervical Cancer Screening Among Women Living With HIV: a Cluster Randomized Trial (CASCADE-3001-B)
This Clinical Trials Network for Human Immunodeficiency Virus (HIV)-Associated Cervical Cancer Screening and Treatment Optimization (CASCADE)-3001-B trial aims to assess how the introduction of a community-health-worker-facilitated model, in addition to the existing static clinic-only model, influences the rates of cervical cancer screening uptake among women living with HIV (WLWH). This study involves offering human papillomavirus (HPV) self-collection for cervical cancer screening to eligible WLWH.
The 'CASCADE' Network is a clinical trials network aimed at improving cervical cancer screening, management, and pre-cancer treatment for WLWH, in various healthcare settings. The network will conduct implementation trials to improve the triage of HPV-positive WLWH, as well as algorithms to optimize access to and options for effective treatment. Trials will be conducted using a mixed-methods approach aimed at assessing implementation strategies and outcomes and their potential to integrate into existing health systems.
Further understanding of HPV-based community-based strategies to reach WLWH, and the acceptability, feasibility, appropriateness, and cost of these strategies will be valuable for cervical cancer screening programs serving WLWH. Inputs from various 'CASCADE' Clinical Sites (CS) regarding feasible screening outreach options available in their settings for WLWH have guided this study that focuses on evaluating a pragmatic HPV self-collection implementation model to improve access to screening.
While it is clear that HPV self-collection is a highly acceptable and feasible screening option, creating opportunities to conduct self-collection in alternative venues outside the clinic premises, and with the guidance of and facilitation by trusted community healthcare workers (CHWs) is an important implementation strategy that needs to be evaluated and considered for its potential benefit. Studies have not yet evaluated a community-based approach for HPV self-collection kit distribution among WLWH - who may have different characteristics, preferences, and access to screening services than women not living with HIV. Providing WLWH with the option of receiving HPV self-collection kits in their own homes or other community-based settings ('community-based HPV self-collection') is a novel implementation strategy that could improve cervical cancer screening rates among eligible women. Therefore, this novel trial aims to evaluate the feasibility and effectiveness of implementing community-based HPV self-collection among WLWH.
Studie Overzicht
Toestand
Gedetailleerde beschrijving
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Jennifer Smith, PhD
- Telefoonnummer: 919-445-6911
- E-mail: jennifers@unc.edu
Studie Contact Back-up
- Naam: Poonam Rawat, MPH
- Telefoonnummer: 919-445-6911
- E-mail: Poonam.Rawat@unc.edu
Studie Locaties
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Harare, Zimbabwe, 263-772287143
- University of Zimbabwe Clinical Trials Research Centre
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Contact:
- Bothwell T Guzha, MD
- Telefoonnummer: 263-772287143
- E-mail: bothwellguzha@gmail.com
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Hoofdonderzoeker:
- Bothwell T Guzha, MD
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
Accepteert gezonde vrijwilligers
Beschrijving
Clinic Inclusion Criteria
- Clinics selected for inclusion will include those clinics that provide Human Immunodeficiency Virus (HIV) care and distribute antiretroviral therapy (ART) to Women living with Human Immunodeficiency Virus (WLWH.
- These clinics should also have the ability to collect their own data.
- Such clinics could be supported by national programs and bilateral donor-funded initiatives
Inclusion Criteria for Medical Record Abstraction
- Are living with Human Immunodeficiency Virus (HIV)
- Are 25-49 years of age, or as recommended by the Zimbabwe National Screening Guidelines
- Live in the catchment areas of or attend a study-eligible clinic
- Are eligible for Human Papillomavirus (HPV)-based cervicovaginal testing either because:
- They have never undergone cervical cancer screening before, or
- They have never undergone HPV-based testing before and are now due for Visual Inspection with Acetic Acid and Cervicography (VIAC), per national guidelines, or
- They have previously undergone HPV-based testing, and are now due for follow-up HPV-based testing per national guidelines, and /or
- They underwent ablative or excisional treatment for presumed or confirmed cervical dysplasia >1 year ago and have not had any follow-up cervical cancer screening since treatment.
Exclusion Criteria for Medical Record Abstraction
- Have had their cervix removed
- Are pregnant or <6 weeks post-delivery
- Were positive on their most recent cervical cancer screening test and referred for further evaluation or treatment, but did not complete their referral
- Have previously been treated for invasive cervical cancer
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Screening
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: Deelnemers ingeschreven bij Model 1 Klinieken
Vrouwen die leven met het Humaan Immunodeficiëntievirus (WLWH) ingeschreven bij Model 1 Kliniek.
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Model 1 involves only the recommended standard-of-care of cervical cancer screening Human Papillomavirus (HPV) self-collection, if available, or Visual Inspection with Acetic Acid and Cervicography (VIAC), if HPV-based testing is not available) to clients who are due for screening at clinics that distribute Antiretroviral Therapy (ART) to Women living with Human Immunodeficiency Virus (WLWH).
Efforts will be made to ensure availability of HPV kits for Model 1 clinics.
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Experimenteel: Participants enrolled at Model 2 Clinics
Women living with Human Immunodeficiency Virus (WLWH) enrolled at Model 2 Clinics.
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Model 2 will include clinic-based Human Papillomavirus (HPV) self-collection, as well as the implementation strategy of providing community-based distribution for HPV self-collection via Community Health workers (CHWs).
Women living with Human Immunodeficiency Virus (WLWH) who are due and overdue for cervical cancer screening will be identified via line lists and appointment directories.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Cervical cancer monthly screening rates
Tijdsspanne: Up to 1 month
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Monthly cervical cancer screening rates among Women living with Human Immunodeficiency Virus (WLWH) will be compared between two models: (1) standard-of-care screening at static clinics only (Model 1) , and (2) Human Papillomavirus (HPV) self-collection offered at static clinics and through a community-based strategy by community health workers (CHWs)(Model 2). Standard-of-care for Model 1 is defined as HPV self-collection when available or Visual Inspection with Acetic Acid and Cervicography (VIAC) when HPV-based screening is not available. |
Up to 1 month
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Medewerkers en onderzoekers
Medewerkers
Onderzoekers
- Studie directeur: Michael Hudgens, PhD, University of North Carolina, Chapel Hill
- Studie stoel: Jennifer Tang, MD, UNC Lineberger Comprehensive Cancer Center
- Hoofdonderzoeker: Jennifer Smith, PhD, UNC Lineberger Comprehensive Cancer Center
- Studie directeur: Katie Mollan, PhD, University of North Carolina, Chapel Hill
- Studie directeur: Lameck Chinula, MD, University of North Carolina, Chapel Hill
- Studie directeur: Lisa Spees, PhD, University of North Carolina, Chapel Hill
- Studie directeur: Chemtai Mungo, MD MPH, University of North Carolina, Chapel Hill
- Studie directeur: Vikrant Sahasrabuddhe, MBBS, MPH, DrPH, Division of Cancer Prevention (DCP)
- Studie directeur: Sue Siminski, MS, MBA, Frontier Science Foundation
- Studie directeur: Zvavahera M Chirenje, MD, University of California, San Francisco
Publicaties en nuttige links
Studie record data
Bestudeer belangrijke data
Studie start (Geschat)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Door bloed overgedragen infecties
- Urogenitale ziekten
- Genitale ziekten
- Pathologische processen
- Urogenitale neoplasmata
- Neoplasmata per site
- Neoplasmata
- Vrouwelijke urogenitale ziekten
- Vrouwelijke urogenitale ziekten en zwangerschapscomplicaties
- Ziekte attributen
- Ziekten van het immuunsysteem
- Infecties
- RNA-virusinfecties
- Virusziekten
- Baarmoeder Ziekten
- Genitale ziekten, vrouw
- Overdraagbare ziekten
- Seksueel overdraagbare aandoeningen, viraal
- Seksueel overdraagbare aandoeningen
- Lentivirus-infecties
- Retroviridae-infecties
- Immunologische deficiëntie syndromen
- DNA-virusinfecties
- Genitale neoplasmata, vrouwelijk
- Baarmoederhalsaandoeningen
- Baarmoeder Neoplasmata
- Tumorvirusinfecties
- Pathologische aandoeningen, tekenen en symptomen
- HIV-infecties
- Baarmoeder Cervicale Neoplasmata
- Papillomavirus-infecties
Andere studie-ID-nummers
- 25-0894
- U24CA275417 (Subsidie/contract van de Amerikaanse NIH)
- UG1CA275403 (Subsidie/contract van de Amerikaanse NIH)
- UG1CA284918 (Subsidie/contract van de Amerikaanse NIH)
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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