Using CHWs and HPV Home Tests to Increase Cervical Cancer Screening in Minority Populations
Condition: Cervical Cancer
MeSH terms: Uterine Cervical Neoplasms
Study type: Interventional

Summary: 
      Caribbean immigrants (both Hispanics and Blacks from Haiti) are less likely to be screened
      for cervical cancer than the general population. One promising approach is outreach
      strategies that employ Community Health Workers (CHWs). Yet even in well structured CHW
      programs, many women remain unscreened. In our NCI Community Networks sponsored project, we
      are testing an approach that combines CHWs with self sampling for the human papilloma virus
      (HPV) as a screening strategy among such hard to reach populations.
    

Detailed description: 
      Building on our existing community partnerships, we propose a randomized CBPR study among 600
      women in three underserved communities in Miami-Dade County to determine optimal approaches
      to increase cervical cancer screening among Caribbean and other underserved women. The study
      is a three arm study with 200 women randomized at each site over 3 years. Women in the
      control group would be exposed to NCI approved culturally and linguistically appropriate
      outreach and educational materials on cervical cancer screening. Our two specific aims are 1)
      to determine if as compared to our control group, women randomized to the community health
      worker intervention group consisting one on one health education and facilitation of
      referrals to existing screening programs results in increase proportion of women who are
      screened 2) to determine if as compared to the CHW group, women randomized to a CHW
      intervention with the addition of a home based self-sampling strategy results in an
      additional increase in proportion of women who are screened versus the CHW group without HPV
      sampling. Secondary outcomes include comparisons of a) measures of access to care (health
      insurance, having a usual source of care, and visit to provider in six months) b) cost of
      providing the intervention in order to determine the cost of recruiting an individual woman
      into screening c) among women having abnormal screens, time to follow-up and further testing.
    

Intervention name(s): CHW Outreach and HPV Self-sampling; CHW Outreach
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The intervention strategies will involve three overlapping domains 1)provide health education on cervical cancer screening, 2) motivation to encourage women to have screening 3) provide navigation services to obtain the screening. We envision visits lasting no more than 60 minutes. Women who are randomized to this arm will also include information on the alternative screening method. They will be told that cervical self-sampling is an alternative screening technique for the Pap smear and they will be offered the choice of having the HPV screen done during that home visit or have a Pap Smear at the participating FQHC.; The intervention strategies will involve three overlapping domains 1)provide health education on cervical cancer screening, 2) motivation to encourage women to have screening 3) provide navigation services to obtain the screening. We envision visits lasting no more than 60 minutes.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Screening
Keywords: Screen; cervical, cancer; HPV; women; community health workers; Hispanic/ Latinas; Haitian