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

UNC Lineberger Comprehensive Cancer Center348 enrolled

Overview

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.

Study Type

OBSERVATIONAL

Enrollment

348

Conditions

Cervical Cancer

Interventions

Semi-structured focus group discussions - WomenOTHER

Semi-structured focus group discussions to explore women's experiences with cervical cancer screening and treatment.

semi-structured focus groups discussions - MenOTHER

Semi-structured focus group discussions to explore partner dynamics related to women's ability to access cancer screening.

In-depth key stakeholders interviewsOTHER

In-depth interviews to contextualise findings from women and men focus group discussions.

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

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

Locations (1)

Clinical HIV Research Unit Temba Lethu Wing Helen Joseph Hospital

Westdene, Johannesburg, South Africa

Outcomes

Primary Outcomes

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.

Time frame: Single visit

Secondary Outcomes

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.

Time frame: Single visit

Phase 3: Acceptability and feasibility of multi-level package of interventions addressing barriers to cancer screening.

Acceptability and feasibility will be measured through development and user pre-testing workshops.

Time frame: Single visit

Data from ClinicalTrials.gov

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