A hybrid implementation-effectiveness trial of game changers for cervical cancer prevention in uganda

Active Project Grant Awarded Last action

Award ID
R01CA282284
Recipient
Awarding agency
Obligated
$4,116,878

Award facts

Assistance listing
93.393 Cancer Cause and Prevention Research
Completion date 64% complete
Place of performance
Santa Monica, CA 90401, USA

Award details come from USAspending.gov.

Description

As the agency reported it.

Abstract
Cervical cancer (CC) is the leading cause of cancer-related deaths among women in uganda, which has one of the world's highest incidence rates. Evidence-based visual inspection with acetic acid (via) CC screening is free or low cost, yet ~ 5% of ugandan women have ever screened for CC, and ~80% have advanced cancer when initiating care. Drawing on theories of network diffusion and social influence, and known patient-level, non-structural barriers and facilitators of CC screening, we developed the peer-led, 7-session group intervention game changers for cervical cancer prevention (GC-CCP), a patient-level implementation strategy to increase CC screening. GC-CCP empowers women who have recently screened for CC to encourage screening among women in their social networks by disseminating CC knowledge, dispelling myths, and reducing CC stigma. An R21-funded pilot randomized controlled trial (RCT) revealed dramatic effects of increased CC screening among previously unscreened social network members (i.e., alters). These results, and our multidisciplinary team's strong track record of successful collaboration, positions this application to make a strong impact on CC prevention and control in uganda, which could be generalizable to other low to middle income country settings. We propose a hybrid type 1 RCT of GC-CCP to assess its effectiveness for increasing uptake of evidence-based via screening, and implementation and sustainability. The study design is guided by the exploration, preparation, implementation and sustainment (epis) implementation science framework. Exploration: this phase consisted of the completed pilot and study site selection (two public, two private, one each in an urban and rural location). Preparation: in year 1, we will identify and remediate clinic- and provider-level barriers to ensure good access to and delivery of CC screening services. Implementation: at each site, 40 women screened for CC will enroll in the RCT as index participants (n=160 index) and be randomized to the intervention or wait-list control. Each index will recruit up to three (1ST degree) alters (n~440 alters) at baseline who have not screened for CC; these index and alter participants will be followed up at months 6 and 12. At month 6, these alters will each recruit up to two (2ND degree) alters (n ~800 alters) for a phone interview. Sustainment: after enrolled index participants receive the intervention, each clinic will continue to implement GC-CCP (with clients not enrolled in the RCT) for an additional 2.5 years, with training and supervision tasks transferred to clinic staff. Using the RE-aim framework, we will evaluate engagement in GC-CCP and CC advocacy (reach), alter CC screening (effectiveness), adoption into usual care, implementation outcomes (acceptability, fidelity, feasibility, cost), and maintenance. Innovative, sustainable implementation strategies such as GC-CCP are critical to increase demand for CC screening.

Transactions

Action Obligated Date
Amendment $16,399
Amendment $16,795
Amendment $129,842
Amendment $656,908
Amendment $16,796
Amendment $16,075
Amendment $162,822
Amendment $596,526
Amendment $572,759
Amendment $0
Amendment $0
Amendment $637,524
Original award $637,524
Show all 13

Subawards

Subrecipient Amount Awarded
Makerere University School Of Public Health A Hybrid Implementation-Effectiveness Trial of Game Changers for Cervical Cancer Prevention in Uganda $162,822
Trustees Of Indiana University $102,406
African Palliative Care Association $74,261
Subrecipient not on record $317,795
Rays Of Hope Hospice Jinja $78,041

Quick answers

Who received award R01CA282284?

R01CA282284 was awarded to The Rand Corporation by National Cancer Institute (National Institutes of Health) on August 8, 2023.

How much is award R01CA282284 worth?

$4,116,878 has been obligated on R01CA282284.

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