| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Shin, Michelle B. Oluoch, Lynda Myra Barnabas, Ruanne V. Baynes, Colin Fridah, Harriet Heitner, Jesse Kerubo, Mary Bernadette Ngure, Kenneth Pinder, Leeya F. Thomas, Katherine K. Mugo, Nelly Rwamba Gimbel, Sarah |
| Abstract | Background An important cervical cancer prevention strategy in low- and middle-income countries (LMICs) has been single-visit screen-and-treat (SV-SAT) approach, using visual inspection with acetic acid (VIA) and ablative treatment with cryotherapy to manage precancerous lesions. While SV-SAT with VIA and cryotherapy have established efficacy, its population level coverage and impact on reducing cervical cancer burden remains low. In Kenya, the estimated cervical cancer screening uptake among women aged 30–49 is 16% and up to 70% of screen-positive women do not receive treatment. Thermal ablation for treatment of precancerous lesions of the cervix is recommended by the World Health Organization and has the potential to overcome logistical challenges associated with cryotherapy and facilitate implementation of SV-SAT approach and increase treatment rates of screen-positive women. In this 5-year prospective, stepped-wedge randomized trial, we plan to implement and evaluate the SV-SAT approach using VIA and thermal ablation in ten reproductive health clinics in central Kenya. Methods The study aims to develop and evaluate implementation strategies to inform the national scale-up of SV-SAT approach with VIA and thermal ablation through three aims: (1) develop locally tailored implementation strategies using multi-level participatory method with key stakeholders (patient, provider, system-level), (2) implement SV-SAT approach with VIA and thermal ablation and evaluate clinical and implementation outcomes, and (3) assess the budget impact of SV-SAT approach with VIA and thermal ablation compared to single-visit, screen-and-treat method using cryotherapy. Discussion Our findings will inform national scale-up of the SV-SAT approach with VIA and thermal ablation. We anticipate that this intervention, along with tailored implementation strategies will enhance the adoption and sustainability of cervical cancer screening and treatment compared to the standard of care using cryotherapy. Trial registration NCT05472311. |
| Related Links | https://implementationscience.biomedcentral.com/counter/pdf/10.1186/s13012-023-01282-3.pdf |
| Ending Page | 11 |
| Page Count | 11 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 17485908 |
| DOI | 10.1186/s13012-023-01282-3 |
| Journal | Implementation Science |
| Issue Number | 1 |
| Volume Number | 18 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2023-06-26 |
| Access Restriction | Open |
| Subject Keyword | Health Services Research Public Health Health Informatics Health Policy Health Administration Health Promotion and Disease Prevention Human papilloma virus Cervical cancer Thermal ablation Single visit Screen-and-treat approach Kenya RE-AIM CFIR ORIC Implementation science |
| Content Type | Text |
| Resource Type | Article |
| Subject | Health Policy Public Health, Environmental and Occupational Health Health Informatics |
| Journal Impact Factor | 8.8/2023 |
| 5-Year Journal Impact Factor | 9.2/2023 |
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