Finding Barriers and Designing Solutions to Promote Women s Cancer Screening in South Africa (FIND)

UNC Lineberger Comprehensive Cancer Center

Status: Completed

Conditions: Cervical Cancer

Treatments: Other: Development and User Pre-testing Workshops; Other: semi-structured focus groups discussions - Men; Other: In-depth key stakeholders interviews; Other: Discrete Choice Experiment - Women; Other: Semi-structured focus group discussions - Women

Study type: Observational

Funder types: Other; NIH

Identifiers

NCT05414097

R21TW011715-01 (U.S. NIH Grant/Contract)

IGHID12101

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 348 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria

Focus Groups with HIV-positive Women

1. HIV-positive
2. Women 18 years and older
3. Participants should be willing and able to provide written informed consent

Focus Groups with HIV-negative Women

1. HIV-negative
2. Women 18 years and older
3. Participants should be willing and able to provide written informed consent

Focus Groups with Men

1. Male partners who are 18 years and older
2. Participants should be willing and able to provide written informed consent

In-depth Interviews with Key Stakeholders

1. Healthcare providers working within the public health system and other key stakeholders
2. Individuals 18 years and older
3. Participants should be willing and able to provide written informed consent

Exclusion Criteria:

Focus Groups with HIV-positive Women

1. Women younger than 18 years
2. Unwilling or unable to provide written informed consent

Focus Groups with HIV-negative Women

1. Women younger than 18 years
2. Unwilling or unable to provide written informed consent

Focus Groups with Men

1. Male partners younger than 18 years
2. Participants unwilling or unable to provide written informed consent

In-depth Interviews with Key Stakeholders

1. Providers who do not work in the public health system
2. Individuals younger than 18 years
3. Participants unwilling or unable to provide written informed consent

Trial design

348 participants in 5 patient groups

Phase 1: 24 Women - FGDs

Description:

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.

Treatment:

Other: Semi-structured focus group discussions - Women

Phase 1: 16 Men - FGDs

Description:

Focus groups enrolling male partners referred by women previously screened or treated for cervical cancer and by women not previously screened for cervical cancer.

Treatment:

Other: semi-structured focus groups discussions - Men

Phase 1: 12 Key Stakeholders - IDIs

Description:

Stakeholder interviewers with women's groups, women's health providers, laboratory personnel, NGOs, and public health organizations.

Treatment:

Other: In-depth key stakeholders interviews

Phase 2: 300 women - DCE

Description:

Discrete Choice Experiment enrolling women 18 years of age and older.

Treatment:

Other: Discrete Choice Experiment - Women

Phase 3: 36 Women, women's health providers, and policy makers

Description:

Stakeholder groups comprising individuals 18 years and older who participated in Phase 1 will be eligible.

Treatment:

Other: Development and User Pre-testing Workshops