bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Feasibility Study of a Behavioral Intervention to Increase Uptake of Human Papillomavirus (HPV) Vaccination in Envigado, Colombia
Authors: Sanchez Veronica Cordoba , Lemos Mariantonia , Gorin Sherri Sheinfeld 
Published: July 2024

PURPOSE The estimated HPV vaccination coverage in Colombia is approximately 39%, falling short of the 90% goal set by the Global Strategy for Cervical Cancer Elimination proposed by the WHO for 2030. The aim of this study was to evaluate the feasibility of a behavioral intervention named Super Protegidas, to increase HPV vaccination of girls aged 9 to 14 years. Following the recommendations of the ORBIT model for behavioral interventions development, the problem was conceptualized, an intervention was designed with stakeholders, and the results of the feasibility phase are presented here. METHODS The protocol, based on the COM-B model, focuses on dyads of girls and caregivers. For the girls, a playful pedagogical workshop was conducted in two schools, addressing primary prevention of cervical cancer through HPV vaccination. For parents, the protocol includes a letter, a series of multimedia messages with text, a video on cervical cancer prevention, and a reminder message the day before vaccination. After conducting this intervention, a feasibility study was carried out through semi-structured telephone interviews with participating caregivers. This aimed to assess acceptability, retention, comprehension, effort required to participate, and suggestions for improvement. RESULTS Fifteen dyads of girls and their caregivers participated, with an 80% sample retention completing both the intervention and the telephonic interview. Of these, 69.2% did not watch the videos, 83.3% read the letter with their daughter, 100% were pleased with the intervention, the clarity of the messages, and the delivery method. Regarding areas for improvement, 41.6% suggested avoiding videos due to the time required to watch them and recommended sending messages in the early hours of the night as this increases the likelihood of reading them. CONCLUSION The intervention was well-received by participants and deemed feasible by researchers. Adjustments are needed to enable participants to access information in a more timely manner.
Awkwardness As a Social Anxiety: Perceived Barriers to Gynecologic Screening Among Black Women
Authors: Sesay Nadia A. 
Published: July 2024

PURPOSE Routine gynecologic screening detects cervical cancer symptoms. Black women are 75% more likely to die from cervical cancer than White women, suggesting disparities in screening adherence. Under the Paper Gown, a campaign by the Centers for Disease Control and Prevention, seeks to encourage screening behaviors among Black women. The campaign portrays awkwardness as the Black woman protagonist's impediment to gynecologic screening. There is limited research examining how social anxiety acts as a barrier among Black women to undergo gynecologic screening. Instead, socioeconomic determinants and perceived racism are oft investigated as factors to Black women's gynecologic screening hesitancy. This study conceptualized awkwardness as social anxiety defined by Diagnostic and Statistical Manual of Mental Disorders. Thus, this study aims to challenge the archetypes of barriers to positive health behaviors presented in cancer prevention research. The study has two main goals: (a) to gain insight into Black women's perceived barriers to gynecologic screening and (b) to examine whether a health campaign's portrayal of awkwardness reflects real-life gynecology experiences as reported by the participants. METHODS A cross-sectional survey of Black women (N = 20) was conducted to examine gynecology appointment frequency and the role of social anxiety before and during the appointment. Semi-structured interviews (n = 10) guided by the Health Belief Model further explored how social anxiety acts as a hinderance to gynecologic screening. RESULTS One-way ANOVA tests revealed that participants' anxiety leading to their appointment did not lead them to skip their appointment. Phronetic iterative analysis of interview transcript analysis produced eight themes: Barriers to scheduling, Gynecology knowledge gaps, Awkwardness valence, Vagina talk, Cues to action, Realism of campaign, Physician dialogue, and Black women physicians' innate understanding (race and gender concordance). Participants reported discordance between the campaign's portrayal and their real-life gynecology experiences. CONCLUSION Despite participants' willingness to attend gynecologic screening appointments, there exists knowledge deficits regarding the recommended frequency. This may potentially exacerbate disparities in cervical cancer mortality. Additionally, health campaigns should consider the implications and consequences of ill-representative portrayals of Black women's health experiences. Future studies should explore the multidimensionality of Black women's experiences concerning gynecology and prevention screening.
Genomic and Immunophenotypic Characteristics of Conjunctival Squamous Cell Carcinoma in a Sub-Saharan African Cohort Suggest a Role for Immune Checkpoint Inhibitors in Locally Advanced or Metastatic Patients
Authors: Esmaeli Bita , Gleber-Netto Frederico , Sagiv Oded , Pickering Curtis , Gross Neil , Ning Jing , Yeshi Melisachew , Mitku Yonas , Nagarajan Priyadharsini 
Published: July 2024

PURPOSE Conjunctival squamous cell carcinoma (conjSCC) is more prevalent and aggressive in sub-Saharan African countries compared with North America. The genomic and immunophenotypic characteristics of conjSCC is largely unknown. The long-term goal of this project is to evaluate the possible role of immune checkpoint inhibitor (ICI) therapy for this cancer in Sub-Saharan and developing nations. METHODS We compared histologic features and mutational profiles using whole exome sequencing, high-risk human papillomavirus (HPV) status, PD-L1 expression, and tumor-infiltrating lymphocytes in conjSCC tumors of patients from Ethiopia (ETH, n=25) and USA (MDA, n=29). Genomic alterations were compared with SCCs from other anatomic sites using data from The Cancer Genome Atlas. A few patients from the MDA cohort with locally advanced and/or metastatic conjSCC were treated empirically with ICI and treatment outcomes were analyzed. RESULTS Solar elastosis was seen in 78% of ETH and 10% of MDA samples. Thicker tumors had higher density of CD8+ and CD3+ cells. HPV status was similar between the cohorts (ETH: 21%, MDA: 28%). The mean tumor mutation burden (TMB) was significantly higher in conjSCC (3.01/Mb, log10) and cutaneous SCC compared other SCC subtypes. ETH samples had higher TMB compared to MDA cohort (3.34 vs 2.73). Mutations in genes associated with ultraviolet light (UV) signature were most frequently encountered (SBS7b: 74% and SBS7a: 72%), with higher prevalence in ETH cohort, while SBS2 and SBS13 signatures were more common among MDA HPV+ conjSCCs. ICI therapy led to significant and dramatic clinical response in several patients with locally advanced conjSCC; these patients will be highlighted in the presentation. CONCLUSION Our findings suggest that UV exposure may play a role in conjSCC, with a higher prevalence in sub-Saharan Africa and that this cancer is associated with a high TMB. Of translational significance is the high TMB in conjSCC supports a possible role for ICI in the management of locally advanced or metastatic patients, particularly in sub-Saharan Africa, where this cancer is endemic and leads to significant morbidity and mortality. Future clinical trials should be designed using ICI in locally advanced and /or metastatic conjSCC patients in sub-Saharan Africa.
Health System Strengthening Strategies for Improved Cancer Control in Sub-Saharan Africa: A Case of the International Cancer Institute's Blueprint for Innovative Healthcare Access Program in Western Uganda
Authors: Kitur Gloria , Kwizera Christopher , Olodi Dennis , Chite Fredrick 
Published: July 2024

PURPOSE Globally, cancer is the second leading cause of mortality and morbidity with Sub-Saharan Africa bearing the greatest brunt due to the double burden of communicable and non-communicable diseases (NCDs) thus further constraining the already weakened health system. The goal of the Blueprint program is to improve access to screening, diagnostics, treatment and patient support services for breast, cervical and prostate cancers while integrating with other NCD care through a health systems strengthening approach by collaborating with communities, districts health care services and Uganda's ministry of health and its partners. METHODS International Cancer Institute (ICI) partnered with Uganda Non-Communicable Diseases Alliance and Uganda Cancer Society to implement two projects on strengthening community awareness and screening for diabetes and hypertension integrating breast, cervical and prostate cancer; and improving public awareness on cancer by building advocacy capacity for cancer control in Uganda's Bushenyi, Mbarara and Sheema Districts. The program targets were to screen 36,000 clients for the 5 NCDs; train 70 healthcare providers (HCPs) and 160 community health workers (CHWs); reach 150,000 community members with cancer messages and to build the capacity of 10 facilities in NCD care. RESULTS Between January and December 2023, at total of 1,675 women were screened for cervical cancer;1,926 for breast cancer; 608 men for prostate cancer; 7,406 people for diabetes and 11,477 for hypertension; 587,172 community members were reached with cancer messages through community dialogue meetings and radio spot messages; 80 HHPs, 30 media personnel and 40 CHWs were trained; and a baseline survey was conducted on 10 facilities and 25 HCPs through which, support for basic NCD screening equipment and supplies was provided and 2 supportive supervision visit conducted. Nine abstracts were also presented in local and international conferences. CONCLUSION Implementation of cancer control programs in Sub-Saharan Africa calls for collaborative partnerships between local and international or governmental and non-governmental organizations with the aim of strengthening the existing public health system. Comprehensive interventions that include cancer awareness, research, advocacy, training, screening and linkage to care provide access to resource sharing opportunities and creation of sustainable cancer control programs.
If I Have the Courage…I Prefer to See a Doctor: A Qualitative Exploration of Ethiopian Women’s Hesitancy to Screen for Cervical Cancer Using HPV Self-Sampling
Authors: Rahman Nimra , Boey Emma , Tubassum Rushna , Tisha Tasnim , Halkiyo Atota B. , Hussein Asiya Jaylan , Dedefo Abdulkerim , Bekele Etsegenet , Pierz Amanda J. , Deressa Biniyam Tefera , Madhivanan Purnima , Lott Breanne E. 
Published: July 2024

PURPOSE In Ethiopia, cervical cancer screening uptake remains low (14%), despite efforts to increase access to preventive services. While Ethiopia’s national screening program currently uses a “screen-and-treat” approach with visual inspection with acetic acid (VIA), human papillomavirus (HPV) self-sampling may be a screening option available in the future, which has been found to be a safe and easy approach for sample collection in many global contexts. Some concerns exist among age-eligible women for HPV self-sampling, therefore understanding the nuanced perceptions towards HPV self-sampling from an Ethiopian perspective is important. This qualitative study explores perceived pros and cons to cervical cancer screening with HPV self-sampling so that this approach can be tailored to the cultural and social context of Ethiopia to increase screening uptake. METHODS In 2022, four focus groups were conducted with 50 Ethiopian women to discuss their perceptions towards cervical cancer and cervical cancer screening methods. Participants were shown educational videos on VIA and HPV self-sampling. They were prompted to compare the two screening modalities and discuss why they liked or disliked each. Audio recordings were translated and transcribed, transcripts were coded with Dedoose software, and content analysis was conducted to identify major themes contributing to hesitancy to screen using HPV self-sampling. RESULTS A lack of awareness, coupled with a lack of confidence in collecting their own specimen, influenced many women to have notable negative views of the HPV self-sampling process. Many women thought the self-sampling would be “difficult,” as it “might hurt sensitive places.” A participant shared: “I might not use the device properly. If I have the courage and the desire, I prefer to see a doctor.” Interestingly, participants often stated that they would be more willing to try HPV self-sampling if they had increased understanding, education, and “awareness” of cervical cancer and the procedure. CONCLUSION To promote cancer screening services in underserved communities such as in Ethiopia, it is imperative to understand the major factors that influence screening. Focus groups revealed reasons that women may be hesitant to screen for cervical cancer using HPV self-sampling. Education and screening interventions should address these concerns and self-described knowledge gaps to empower patients to make informed decisions about screening.
Impacting the Cervical Cancer Burden in India: Collective Efforts and Strategies to Train Health Care Providers on HPV Vaccination and Cervical Cancer Screening
Authors: Hayward Ashleigh , Anand Meenu , Biswas Sutapa , Gupta Mridu , Kumar Priya Ganesh , Kurkure Purna , Foley Shaylen 
Published: July 2024

PURPOSE Cervical cancer is the second leading cause of cancer deaths among women in India. More than 77,000 women die each year due to cervical cancer, accounting for 23% of all cervical cancer deaths globally. The Global HPV Cancer Free program of the American Cancer Society (ACS) envisions a world free of HPV cancers, starting with cervical cancer. METHODS To increase uptake of cervical cancer prevention services in India, ACS has partnered with civil society organizations (CSOs) with a mission to prevent cancers to catalyze engagement of trusted health care providers through implementation of two programs at the national and district level. A key component is training health care providers at multiple levels to increase knowledge, confidence, beliefs and intent around HPV vaccination and cervical screening. At the national level, the Federation of Obstetric and Gynecological Societies of India (FOGSI) and the Indian Academy of Pediatrics (IAP), with support from Cancer Foundation of India (CFI) and ACS, are convening and training 20,000+ pediatricians and obstetrician-gynecologists via a train-the-trainer model. The training refreshes physicians on HPV vaccination facts and shares evidence-based messaging and communication strategies. At the district level, Cancer Awareness, Prevention, and Early Detection (CAPED), in collaboration with selected districts across three states, is training community health workers (CHWs) and primary health center (PHC) nurses to facilitate and mobilize community uptake of cervical cancer prevention services, starting with screening. RESULTS CAPED's 2022 pilot successfully trained 213 CHWs and 61 nurses covering 73 villages, who mobilized 5,653 women for cervical screenings. Implementation of both programs will wrap up in 2024, and data from the program evaluation will be explored to assess the impact on cervical cancer prevention. CONCLUSION As one of the leading causes of cancer deaths, cervical cancer is a significant burden in India. Health care providers are the most trusted source of health information for the community. A strong recommendation can increase the demand and uptake of cervical cancer prevention services across communities. This poster and/or presentation will describe the two programs in more detail along with successes, challenges, lessons learned, and impact.
Is the Compassion of Anesthesiologists Associated With Postoperative Pain and Patient Experience? A Prospective Cohort Study
Authors: Mitrev Ludmil V. , Chin Gabrielle R. , Roberts Brian W. , van Helmond Noud , Trivedi Keyur C. , Libraro Nicholas J. , Rana Dhaval D. , Dibato John E. , Trzeciak Stephen , Solina Alann R. , Greeson Jeffrey M. 
Published: July 2024

BACKGROUND:
Patient perception of physician compassion may be associated with improved health outcomes, yet it is unclear whether it is associated with postoperative pain reduction or improved patient experience metrics in same-day surgery patients. We hypothesized that higher anesthesiologist compassion during the preanesthesia interview, rated by patients, is associated with lower postoperative pain via the anxiety pathway in same-day surgery patients. We also performed exploratory correlation analysis to assess whether compassion was associated with less opioid consumption and improved patient experience in same-day surgery patients.

METHODS:
We conducted a single-center, prospective, observational cohort study in American Society of Anesthesiologists (ASA) physical status I to III patients scheduled to undergo same-day surgery with anesthesia. Compassion was scored using a validated 5-item tool. State anxiety (SA) and trait anxiety (TA) were measured using the State-Trait Anxiety Inventory. Pain scores were obtained using a 0 to 10 Likert scale. Daily opioid use was recorded. Patient experience was assessed using the Consumer Assessment of Healthcare Providers and Systems Outpatient and Ambulatory Surgery Survey (OAS CAHPS) and the Surgical Care CAHPS. Mediation analysis was used to assess the association between compassion and pain scores via the anxiety pathway. Spearman correlation was performed to test for association between the compassion score and the secondary outcomes.

RESULTS:
A total of 147 subjects completed the study with a median age of 50 years and 81% female. Fifty percent underwent breast surgery, 35% abdominal surgery, and the rest underwent gynecological and urological surgeries. The median (Q1–Q3) postoperative pain scores on postoperative days 0 and 3 days later were 4 (1.5–6) and 3 (1–5), respectively.
Mediation analysis results showed a same-day anxiety-mediated effect (95% confidence interval [CI]) of compassion on pain of −0.08 (−0.13 to −0.02), attributing to 9% of the total effect. On postoperative day 0, an increase in compassion was associated with a significant average drop in pain of between 0.02 and 0.13. In addition, higher compassion was correlated with better patient experience metrics (ρ= −0.53 [95% CI, −0.64 to −0.39]).

CONCLUSIONS:
The study results suggest that an anxiety-mediated pathway exists through which compassionate care may help improve the patient’s perception of postoperative pain on the day of surgery (before discharge from the hospital). Higher compassion was also associated with better patient experience metrics.
Gaps in cancer care in a multi-ethnic population in Sarawak, Borneo: A central referral centre study
Authors: Lim Melissa Siaw Han , Voon Pei Jye , Ali Adibah , Mohamad Fitri Suraya , Jong Lin Lin , Chew Lee Ping , Bujang Mohamad Adam , Augustin Yolanda , Cheng Yuong Kang 
Published: July 2024

Background
The state of Sarawak on the island of Borneo in East Malaysia, in working towards developing and strengthening cancer services through a holistic patient-centred approach, must focus on the comprehensive needs of cancer patients by taking into account the psycho-social, cultural and spiritual aspects of Sarawak’s multi-ethnic, multi-cultural population.

Methods
A 42-item survey questionnaire was developed and validated with a total of 443 patients. The perceived importance of information provided and level of patient satisfaction were assessed with a 5-point Likert scale in 10 domains (Diagnosis, Surgery, Radiotherapy, Systemic therapy, Clinical trials, Pain management, Treatment monitoring, Psychosocial support, Sexual care and fertility issues, and Financial support). A Spearman’s rank correlation test was applied to determine the correlation between response in both item and domain categories for perceived importance and satisfaction.

Results
Overall, patients were more satisfied with information related to cancer diagnosis, treatment and surgery but less satisfied with information pertaining to sexual aspects of care and family planning, psycho-social support and financial support. The majority of patients were satisfied with the level of treatment-related information received but preferred the information to be delivered in more easily comprehendible formats. Sexual aspects of care and family planning, psychosocial support and treatment monitoring post-discharge were perceived as important but seldom addressed by health care professionals due to lack of professional counsellors, social workers and clinical nurse specialists. Many patients face financial toxicity following a cancer diagnosis, particularly when diagnosed with advanced cancer requiring complex multi-modality treatment.

Conclusion
Cancer patients in Sarawak have various unmet information needs. Written information and educational videos in local indigenous languages may be more suitable for Sarawak’s multi-ethnic population. Sexual aspects of care and family planning are challenging but essential topics to discuss, in particular due to the high prevalence of breast and cervical cancer amongst young women of reproductive age in Sarawak. Financial assessment and information on support services offered by government and non-government organisations should be provided to eligible patients. A holistic needs assessment of each patient at time of diagnosis and support through their cancer journey requires a multi-disciplinary team of medical, nursing and allied health professionals including clinical nurse specialists, pharmacists, counsellors, physiotherapists, occupational therapists, speech and language therapists, dieticians and social workers.