Results of breast and cervical cancer Health Promotion Model for older Turkish women

Kıssal, Aygül; Beşer, Ayşe

doi:10.14687/jhs.v14i3.4430

Cited by 2 publications

(3 citation statements)

References 28 publications

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“…It was chosen because it suits the tailoring of public health interventions and dissemination [ 35 ]. Public health experts, especially public health nurses, can play an important role in educating women through clinic-based strategies that suit our social and cultural setting [ 36 ]. As a result, this would contribute to the promotion of health among women living with HIV.…”

Section: The Health Promotion Model For the Clinic-based Hpv Self-sam...mentioning

confidence: 99%

“…The model could also ex-amine the relationship between personal factors and health-promoting behavior; situational influences and health-promoting behavior; and personal factors and health promotion. Additionally, the HPM has been widely used in health promotion research involving people of different age groups regarding participation in HPV self-sampling and CC screening [36]. Health-promoting behavior could be interpreted as activities related to HPV selfsampling, at the clinic or at home, among HIV-infected women.…”

Section: The Health Promotion Model For the Clinic-based Hpv Self-sam...mentioning

confidence: 99%

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Effectiveness of Clinic-Based Patient-Led Human Papillomavirus DNA Self-Sampling among HIV-Infected Women in Uganda

Nyabigambo,

Mayega,

Ginindza

2023

IJERPH

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In Uganda, the uptake of cervical cancer (CC) screening services is low, at 46.7%, among HIV-infected women, and only 9% of these women adhere to annual CC screening. Some studies have evaluated the possibility of community or home-based human papillomavirus (HPV) self-collected vaginal swabs, but not clinic-based HPV self-collected vaginal swabs. Therefore, we propose a study to determine the efficacy of clinic-based versus home-based HPV DNA self-sampling among HIV-infected women attending a rural HIV clinic in Uganda. We believe that a randomized, single-blinded trial would achieve this objective, and so we have chosen it to guide the study. Including a total of 382 participants from a rural HIV clinic, randomized into a ratio of 1:1 for clinic- and home-based HPV self-sampling, would allow us to appropriately ascertain the difference in the uptake of HPV self-sampling between the two arms. The Integrated Biorepository of H3 Africa Uganda Laboratory would be used as a reference laboratory for the HPV DNA extraction, typing, and sequencing. At baseline, modified Poisson regression models would be used to measure factors associated with the prevalence of HPV and uptake in both arms at baseline. Visual inspection under acetic acid (VIA), as a gold-standard test for CC to grade for CIN, would be performed at 0 and 6 months among a random sample of 75 women with a self-collected HPV sample. The difference in uptake could be determined using the intention-to-treat analysis. The difference in the groups by each variable would be summarized as the standardized mean difference (i.e., the mean difference divided by the pooled standard deviation). The predictors of the time for which participants would continue with HPV self-sampling in both arms, recovery, and Cox proportional hazards regression would be used. At the bivariate level, the associations between each independent variable and time, with the time of continuing HPV self-sampling, would be computed. Crude hazard ratios and their 95% confidence interval would be used in the presentation of the results, with p-values < 0.05 considered significant at the bivariate level. Incremental cost-effectiveness analysis (CEA) using a Markov model would be used to determine the cost of clinic-based HPV self-sampling. We believe that screening approaches to disease stratification could provide an insight into the merits and limitations of current approaches to the diagnosis of cervical cancer, and how these could eventually be implemented into HIV clinics in Uganda and other developing African countries. It is anticipated that the findings would guide the development of step-by-step guidelines for the HPV self-sampling approach.

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Section: The Health Promotion Model For the Clinic-based Hpv Self-sam...mentioning

confidence: 99%

Section: The Health Promotion Model For the Clinic-based Hpv Self-sam...mentioning

confidence: 99%

Effectiveness of Clinic-Based Patient-Led Human Papillomavirus DNA Self-Sampling among HIV-Infected Women in Uganda

Nyabigambo,

Mayega,

Ginindza

2023

IJERPH

View full text Add to dashboard Cite

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“…The model also examined the relationship between personal factors; situational influences health-promoting behavior; personal factors and health promotion. Additionally, the HPM has been widely used in health promotion research involving people of different age groups to participate in the CC screening [26]. The diagram below shows a synopsis of relationships in concepts that are examined in this research.…”

Section: Conceptual Framework Based On the Health Promotion Model (Pe...mentioning

confidence: 99%

The efficacy of the clinic-based HPV self-sampling approach among HIV- infected rural women in Uganda.

Nyabigambo,

Mayega,

Obuya

et al. 2023

Preprint

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Objective: The main objective of this study was to determine the effectiveness of the clinic-based HPV self-sampling approach at a rural HIV clinic in Uganda. Methods: A simple single-blind randomized controlled trial was used to estimate the efficacy of a clinic-based (intervention) compared to a home-based (control) HPV self-sampling approach among 150 HIV-infected women aged 25-49 years at the rural HIV clinic. The Health Promotion Model (HPM) guided the broad conceptualization. The participants were randomized to either clinic or home-based HPV self-sampling using a ratio of 1:1. The assignment was concealed and handed over to the midwife. The outcome was a continuation rate for HPV self-sampling at 6 months follow-up among participants tested for HPV. Survival analysis was used to determine the effectiveness of the clinic-based HPV self-sampling. The continuation rate was determined using the intention to treat analysis. The predictors of time to continue with HPV self-sampling in both arms, recovery, and Cox proportional hazards regression were used. The multivariable model was built using the forward modeling approach while controlling for confounding variables. The best model was selected after comparing the fitness of the final models (global test under chi-squared distribution). A Cox–Snell residual plot was fitted to ensure the final model did not violate the proportional hazards assumption. Adjusted Hazard ratios and their 95% confidence interval were reported. Results: The results show that of the HIV-infected women in the clinic-based arm, 92% (69/75) had attained at least a primary level education, 78.7% (59/75) were self-employed, and 74.4% (56/75) had a history of STIs compared to those in the home-based HPV self-sampling arm. The overall continuation rate was generally low at 30.7% (46/150) among HIV-infected women receiving HPV self-sampling in both arms. The continuation rate of HPV self-sampling was higher at 41.3% (31/75) among HIV-infected women randomized to receive clinic-based HPV self-sampling compared to the 20% (15/75) of those in the home-based arm. The average time for timely continuation of HPV self-sampling of 8.2 days while those in the home-based arm had 22 days. The factors that influenced the continuation of HPV self-sampling were residing between 6-10km (HR:0.11; CI: 0.014-0.84), a history of taking alcohol (HR: 7.74; CI: 1.06-56.54), age of a sexual debut above 18 years (HR:1.48; CI:1.08-2.03) and educated about HPV by the health worker (HR: 17:22; CI: 1.106-268.42). Conclusion: The overall continuation rate for HPV self-sampling is low. The clinic-based HPV self-sampling is more effective compared to the home-based HPV self-sampling approach. The factors influencing the increased continuation of HPV self-sampling are having a history of taking alcohol, age at sexual debut of >18 years, and receiving HPV education from health workers. Therefore, it is important to improve HPV self-sampling services at the HIV clinics and boost the capacity of health workers to educate HIV-infected women on HPV as well as provide integrated HPV self-sampling within the HIV clinics.

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Results of breast and cervical cancer Health Promotion Model for older Turkish women

Cited by 2 publications

References 28 publications

Effectiveness of Clinic-Based Patient-Led Human Papillomavirus DNA Self-Sampling among HIV-Infected Women in Uganda

Effectiveness of Clinic-Based Patient-Led Human Papillomavirus DNA Self-Sampling among HIV-Infected Women in Uganda

The efficacy of the clinic-based HPV self-sampling approach among HIV- infected rural women in Uganda.

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