||5P01CA229143-02 Interpret this number
||Ohio State University
||Improving Uptake of Cervical Cancer Prevention Services in Appalachia
PROJECT SUMMARY - OVERALL
The goal of this Program Project is to address the burden of cervical cancer incidence and mortality in Appalachia
through the delivery of a clinic-based integrated prevention program that focuses on the major causes of cervical
cancer (tobacco smoking, Human Papillomavirus (HPV) infection, and lack of cervical cancer screening)
designed to target individual, social and community, health system and broader contextual-level barriers related
to the burden of cervical cancer. Building upon our long history of collaborative research and community
partnerships, the Program will test the effectiveness of health system-based interventions focused on tobacco
use, HPV vaccination and cervical cancer screening (Pap test and/or self-testing with follow-up of positive tests),
as part of an integrated clinic-based cervical cancer prevention program. The multi-level interventions (directed
to three levels of influence – clinic, provider and patient) will be offered to eligible female patients and age-eligible
children and young adults in four Appalachian states (Ohio, Kentucky, West Virginia and Virginia). Our research
process is guided by a socio-ecological model based on the Social Determinants of Health, the Proctor Model
for Implementation Science and a Community-Based Participatory Research (CBPR) framework. The aims of
this Program Project are to: 1) Test the effectiveness of an integrated cervical cancer prevention program,
consisting of three established interventions, designed to address three causes of cervical cancer in a region
with one of the highest cervical cancer incidence and mortality rates in the United States; and 2) Evaluate the
impact of the cervical cancer prevention program, including implementation, and acceptability, with attention to
both short- and long-term impact and sustainability at the clinics. Four cores – Intervention and Consortium,
Survey and Data Collection, Biostatistics and Evaluation, and Administrative – will facilitate the smooth and
integrated operation of all projects. Integration and interaction of the projects in this Program is evident in several
ways: 1) all projects focus on one health disparity; 2) participants will be recruited from the same health systems;
3) a core set of measures is being used by all projects; 4) all projects include transdisciplinary teams; 5) all
projects build upon and extend findings from our long history of collaborative research and community
partnerships; 6) all projects focus on multi-level assessment and/or interventions using the Warnecke model as
a framework and utilize the Proctor et al. Implementation Science Framework; 7) all projects involve interaction
with the community in some way, thus enhancing the CBPR nature of the Program; and 8) evaluation will assess
implementation, service and client outcomes at the project and overall Program levels including: cost,
satisfaction, effectiveness, sustainability, and safety, to name a few outcomes. If successful, this Program Project
will provide evidence for a novel and innovative approach to address disparities in underserved communities
with plans for sustainability and dissemination, as well as cost-effectiveness data.
A Multi-level Model to Understand Cervical Cancer Disparities in Appalachia.
, Pennell M.L.
, Ruffin M.T.
, Weghorst C.M.
, Lu B.
, Hade E.M.
, Peng J.
, Bernardo B.M.
, Wewers M.E.
Cancer prevention research (Philadelphia, Pa.), 2020 03; 13(3), p. 223-228.