Barriers to the uptake of cervical cancer services and attitudes towards adopting new interventions in Peru

Vasudevan, Lavanya; Stinnett, Sandra S.; Mizelle, Cecelia; Melgar, Katherine; Makarushka, Christina; Pieters, Michelle M; Sánchez, Luís Enrique; Jerónimo, José; Huchko, Megan J.; Proeschold‐Bell, Rae Jean

doi:10.1016/j.pmedr.2020.101212

Cited by 10 publications

(20 citation statements)

References 20 publications

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“…La falta de conocimiento es el factor que prevalece (18,19,20,21,24) , al igual que el factor miedo y vergüenza. (18,20,21,23,24) Otro factor relevante es la falta de tiempo.…”

Section: Resultsunclassified

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Knowledge and factors associated with cervical cancer

Cajamarca

Cevallos

Gaona

et al. 2022

Salud, Ciencia y Tecnología

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Introducción: el cáncer de cérvix presenta mayores tasas de prevalencia y mortalidad en países en vías de desarrollo, a pesar de la implementación de estrategias preventivas como la vacuna contra el HPV y la detección temprana de lesiones precancerosas aún sigue existiendo una falta de adherencia. Métodos: se realizó un estudio no experimental narrativo, de revisión bibliográfica. Los resultados se obtuvieron de PubMed, ScienciaDirect y Scielo en idiomas inglés y español. Resultados: se obtuvo 13 estudios en los que se encontró que el conocimiento sobre el cáncer de cuello uterino es muy variable, en país de escasos recursos se presenta un bajo conocimiento y países donde el conocimiento es mayor en cambio existe una falta de conocimiento sobre la detección temprana o la prevención. Una estabilidad económica y educativa superior se asocia con un mayor conocimiento y mayor probabilidad de realizarse pruebas de detección temprana. Los factores que se encontraron en la mayoría de artículos son factores socioculturales como miedo, vergüenza y la falta de tiempo. Conclusiones: existen varias limitaciones para la detección temprana de cáncer de cuello uterino a pesar de que los sistemas de salud implementen campañas por lo que se debería reforzar las políticas de salud de países en vías de desarrollo por sus altas tasas de mortalidad.

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“…La falta de conocimiento es el factor que prevalece (18,19,20,21,24) , al igual que el factor miedo y vergüenza. (18,20,21,23,24) Otro factor relevante es la falta de tiempo.…”

Section: Resultsunclassified

“…La falta de conocimiento es el factor que prevalece (18,19,20,21,24) , al igual que el factor miedo y vergüenza. (18,20,21,23,24) Otro factor relevante es la falta de tiempo. (18,20,21,24) Una situación sexual-reproductiva no afectada, (23) no necesitar pruebas de detección (59) y considerarse saludable (20) son también factores.…”

Section: Resultsunclassified

Knowledge and factors associated with cervical cancer

Cajamarca

Cevallos

Gaona

et al. 2022

Salud, Ciencia y Tecnología

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“…The survey included open-ended questions on the barriers to and facilitators of women receiving screening and treatment for cervical cancer, as well as the 15-item Evidence-based Practice Attitude Scale (EBPAS) examining attitudes toward the treatments, interventions, and systems related to cervical cancer [28]. The detailed methods and results of this survey have been reported previously [29].…”

Section: Quantitative Datamentioning

confidence: 99%

“…We previously reported these findings on the EBPAS as well as other survey domains related to provider perceptions of patient-side barriers to screening and follow-up that are not included in this paper. Further details on the statistical methodology are described there [29].…”

Section: Quantitative Data Analysismentioning

confidence: 99%

“…We found a receptive political environment within which La Liga was well situated to navigate local and national partnerships (outer setting). In addition, our survey data among La Liga staff showed a high willingness to accept new technologies related to cervical cancer (characteristics of individuals) [29]. However, overall, we chose to focus on barriers to implementation as these were critical to address before moving forward with the implementation of the mIVAA system.…”

Section: Facilitators Of Implementationmentioning

confidence: 99%

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Using the Consolidated Framework for Implementation Research to Inform the Design of the Mobile Inspección Visual con Ácido Acético System: Mixed Methods Case Study

Reid¹,

Proeschold‐Bell²,

Makarushka³

et al. 2022

JMIR Form Res

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Background There is growing evidence supporting the use of mobile health (mHealth) interventions in low- and middle-income countries to address resource limitations in the delivery of health information and services to vulnerable populations. In parallel, there is an increasing emphasis on the use of implementation science tools and frameworks for the early identification of implementation barriers and to improve the acceptability, appropriateness, and adoption of mHealth interventions in resource-limited settings. However, there are limited examples of the application of implementation science tools and frameworks to the formative phase of mHealth design for resource-limited settings despite the potential benefits of this work for enhancing subsequent implementation, scale-up, and sustainability. Objective We presented a case study on the use of an implementation science framework in mHealth design. In particular, we illustrated the usability of the Consolidated Framework for Implementation Research (CFIR) for organizing and interpreting formative research findings during the design of the mobile Inspección Visual con Ácido Acético (mIVAA) system in Lima, Peru. Methods We collected formative data from prospective users of the mIVAA intervention using multiple research methodologies, including structured observations, surveys, group and individual interviews, and discussions with local stakeholders at the partnering organization in Peru. These activities enabled the documentation of clinical workflows, perceived barriers to and facilitators of mIVAA, overarching barriers to cervical cancer screening in community-based settings, and related local policies and guidelines in health care. Using a convergent mixed methods analytic approach and the CFIR as an organizing framework, we mapped formative research findings to identify key implementation barriers and inform iterations of the mIVAA system design. Results In the setting of our case study, most implementation barriers were identified in the CFIR domains of intervention characteristics and inner setting. All but one barrier were addressed before mIVAA deployment by modifying the system design and adding supportive resources. Solutions involved improvements to infrastructure, including cellular data plans to avoid disruption from internet failure; improved process and flow, including an updated software interface; and better user role definition for image capture to be consistent with local health care laws. Conclusions The CFIR can serve as a comprehensive framework for organizing formative research data and identifying key implementation barriers during mHealth intervention design. In our case study of the mIVAA system in Peru, formative research contributing to the CFIR domains of intervention characteristics and inner setting elicited the most key barriers to implementation. The early identification of barriers enabled design iterations before system deployment. Future efforts to develop mHealth interventions for low- and middle-income countries may benefit from using the approach presented in this case study as well as prioritizing the CFIR domains of intervention characteristics and inner setting.

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