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| ID | Type | Description | Link |
|---|---|---|---|
| R21TW011715-01 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| Fogarty International Center of the National Institute of Health | NIH |
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The primary aim of the study explore drivers of cervical cancer screening and barriers contributing to low screening coverage among women in South Africa. Secondary aims are determining preferences for cervical cancer prevention services using a discrete choice experiment and developing a multi-level package of interventions that will address barriers to cervical cancer screening and improve engagement in care among women.
Cervical cancer is a leading cause of cancer death among South African women. Despite a comprehensive national cancer control policy, cervical screening coverage is low and attrition during on-ward referrals for diagnostic confirmation and treatment remains common.
This study uses a sequential mixed-methods design:
Phase 1) A qualitative exploratory phase using focus groups and in-depth interviews with women, men, other stakeholders will inform our design and interpretation of quantitative findings from a multi-cohort DCE.
Phase 2) Women will be recruited to participate in the DCE and determine their preferences for cancer screening services.
Phase 3) Design Thinking to co-create an intervention package for cervical cancer screening and enhanced linkage between screening, diagnosis, and treatment will be created.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Phase 1: 24 Women - FGDs | Focus groups enrolling HIV-positive, previously screened for cervical cancer; HIV-positive, not previously screened for cervical cancer; HIV-negative, previously screened for cervical cancer; HIV-negative, not previously screened for cervical cancer. |
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| Phase 1: 16 Men - FGDs | Focus groups enrolling male partners referred by women previously screened or treated for cervical cancer and by women not previously screened for cervical cancer. |
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| Phase 1: 12 Key Stakeholders - IDIs | Stakeholder interviewers with women's groups, women's health providers, laboratory personnel, NGOs, and public health organizations. |
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| Phase 2: 300 women - DCE | Discrete Choice Experiment enrolling women 18 years of age and older. |
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| Phase 3: 36 Women, women's health providers, and policy makers | Stakeholder groups comprising individuals 18 years and older who participated in Phase 1 will be eligible. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Semi-structured focus group discussions - Women | Other | Semi-structured focus group discussions to explore women's experiences with cervical cancer screening and treatment. |
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| Measure | Description | Time Frame |
|---|---|---|
| Phase 1: Barriers to cancer screening and engagement | Barriers and enablers will be explored through focus groups and in-depth interviews with women, men, and other stakeholders. | Single visit |
| Measure | Description | Time Frame |
|---|---|---|
| Phase 2: Woman preferences for cancer screening services | Preferences for cancer screening will be determined through the relative importance of the attribute according on how it is scored in the Discrete Choice Experiment. | Single visit |
| Phase 3: Acceptability and feasibility of multi-level package of interventions addressing barriers to cancer screening. |
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Inclusion Criteria
Focus Groups with HIV-positive Women
Focus Groups with HIV-negative Women
Focus Groups with Men
In-depth Interviews with Key Stakeholders
Exclusion Criteria:
Focus Groups with HIV-positive Women
Focus Groups with HIV-negative Women
Focus Groups with Men
In-depth Interviews with Key Stakeholders
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Participants for the study will be recruited from both urban and peri-urban settings in Johannesburg, South Africa. The population consists of women who have previously undergone screening/treatment for cervical cancer and those who have not; male partners of these women; and key stakeholders within public health systems.
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| Name | Affiliation | Role |
|---|---|---|
| Carla Chibwesha, MD, MSc | Department of Obstetrics and Gynecology University of North Carolina at Chapel Hill | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Clinical HIV Research Unit Temba Lethu Wing Helen Joseph Hospital | Westdene | Johannesburg | 2092 | South Africa |
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| Label | URL |
|---|---|
| University of North Carolina Lineberger Comprehensive Cancer Center Clinical Trials | View source |
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Deidentified individual data will however be shared widely. We will make research datasets available to South African investigators who request access and meaningfully involve in-country investigators in all our activities, including the production of research manuscripts and presentations at scientific meetings. All data sharing will abide by rules and/or policies defined by the sponsor, relevant IRBs, U.S. local, state, and federal laws and regulations, as well as South African laws and regulations. Data sharing mechanisms will ensure that the rights and privacy of individuals participating in NIH sponsored research will be protected at all times.
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| semi-structured focus groups discussions - Men | Other | Semi-structured focus group discussions to explore partner dynamics related to women's ability to access cancer screening. |
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| In-depth key stakeholders interviews | Other | In-depth interviews to contextualise findings from women and men focus group discussions. |
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| Discrete Choice Experiment - Women | Other | Discrete Choice Experiment to determine preferences to different cancer screening models. |
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| Development and User Pre-testing Workshops | Other | Development and User Pre-testing Workshops to explore acceptability and feasibility of proposed interventions designed using findings from Phases 1 &2. |
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Acceptability and feasibility will be measured through development and user pre-testing workshops. |
| Single visit |
| ID | Term |
|---|---|
| D002583 | Uterine Cervical Neoplasms |
| ID | Term |
|---|---|
| D014594 | Uterine Neoplasms |
| D005833 | Genital Neoplasms, Female |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D002577 | Uterine Cervical Diseases |
| D014591 | Uterine Diseases |
| D005831 | Genital Diseases, Female |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D000091662 | Genital Diseases |
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| ID | Term |
|---|---|
| D048788 | Growth and Development |
| ID | Term |
|---|---|
| D010829 | Physiological Phenomena |
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