Strategies for Community Education Prior to Clinical Trial Recruitment for a Cervical Cancer Screening Intervention in Uganda

Abstract

IntroductionCommunity engagement and education can improve acceptability and participation in clinical trials conducted in Kisenyi, Uganda. In preparation for a randomized controlled trial exploring different methods for cervical cancer screening, we explored optimal engagement strategies from the perspective of community members and health professionals.MethodsWe conducted key informant interviews followed by serial community forums with purposeful sampling and compared the perspectives of women in Kisenyi (N = 26) to health-care workers (HCW) at the local and tertiary care center levels (N = 61) in a participatory, iterative process.ResultsKey themes identified included format, content, language, message delivery, and target population. Women in Kisenyi see demonstration as a key part of an educational intervention and not solely a didactic session, whereas health professionals emphasized the biomedical content and natural history of cervical cancer. Using local language and lay leaders with locally accessible terminology was more of a priority for women in Kisenyi than clinicians. Simple language with a clear message was essential for both groups. Localization of language and reciprocal communication using demonstration between community members and HCW was a key theme.ConclusionAlthough perceptions of the format are similar between women and HCW, the content, language, and messaging that should be incorporated in a health education strategy differ markedly. The call for lay leaders to participate in health promotion is a clear step toward transforming this cervical cancer screening project to be a fully participatory process. This is important in scaling up cervical cancer screening programs in Kisenyi and will be central in developing health education interventions for this purpose.

Understanding Men’s Perceptions of Human Papillomavirus and Cervical Cancer Screening in Kampala, Uganda

“… 19 In prior ASPIRE research on community engagement and education leading up to a cervical cancer clinical trial, women in the Kisenyi district indicated male involvement was central to the success of any cervical cancer screening intervention. 9 In this group of men, even after the education session, some were still unsure of the risk factors for cervical cancer, and there remained confusion around how HPV transmission and treatment occurred. These findings highlight that a one-time didactic education session may not be sufficient for knowledge translation and the need for ongoing culturally appropriate education programs for both men and women about cervical cancer and HPV.…”

“…Previous research led by this team explored strategies for community engagement and education from the perspective of women and health care providers and identified that the lack of male involvement was a key barrier to cervical cancer screening. 9 …”

Great Role in Gynecological Cancer Prophylaxis of a Unique Health Check-Up Institute, Ningen Dock in Japan (Review)

“…More than half of the women diagnosed with cervical cancer have not attended screening in the past 3 years. A community-based screening strategy is one of the greatest success stories in cancer prevention, and widespread screening reduces the cervical cancer incidence worldwide [38][39][40][41][42]. The mean time between the virus infection and invasive cancer takes about 15 years, and within 2-4 years of detection 15.5-25.5% of low-grade epithelial lesions become high-grade lesions.…”

Integrating primary care, shared decision making, and community engagement to facilitate equitable access to multi-cancer early detection clinical trials

“…Numerous other examples of community engagement that improves cancer screening trial recruitment in underserved populations can be cited, including many studies aiming to account for cultural differences in a trial ( 38 ). For example, Wood et al.…”