The goal of this project is to prevent unnecessary deaths due to cervical cancer in Senegal. This mixed methods research responds to identified intrapersonal- and community-level barriers to early cervical cancer screening uptake, follow-up, and treatment among women there. Investigators will apply the Dynamic Adaptation Process (DAP) as integrated into the Exploration, Preparation, Implementation, Sustainment (EPIS) framework to study the adaptation of an evidence-based cervical cancer patient navigation program in urban and rural contexts in Senegal, measure the intervention effectiveness, and evaluate programmatic implementation outcomes. By studying the process of adaptation of a patient navigation program in a low- and middle-income country (LMIC), investigators will build new knowledge while addressing an important public health issue. The project demonstrates innovation by advancing both adaptation and implementation process knowledge of an evidence-based patient navigation intervention in various contexts within a LMIC with a particular focus on how the adaptation responds to cancer-related stigma, misinformation, and women's autonomy in healthcare decision-making. Investigators will build knowledge through local learning which will further the long-term goal to inform the national cervical cancer prevention and control programs in two areas of Senegal and other similar LMICs.
None
No additional exclusion criteria exist.
Sequential
Patient Navigator Approach
BehavioralPatient navigators in collaboration with community health workers will work with women eligible for cervical cancer screening to overcome intrapersonal and community level barriers to screening in order to engage early with the health system for cervical cancer screening and follow-up of positive screens. Their support can help patients get the cancer screenings and follow-up care they need, while addressing prevalent barriers and community-level stigma associated with cancer within the Senegal context.
Change in the number of women screened for the first time, age stratified uptake through self-report questionnaire and confirmed through record review
Change in the number of women reporting cervical cancer screening uptake, age stratified
Change in time to treatment for dysplasia, age stratified, through record review
Change in the time from diagnosis of a positive cervical cancer screen to treatment for dysplasia, age stratified
Change in perceived stigma of cervical cancer as the fault of the individual, through questionnaire
Change in the number of women and men stating that if a woman gets cervical cancer it is probably their own fault, age stratified
Change in decision to get cervical cancer screen, age stratified, through questionnaire
Change in the number of women and men stating that women are able to make their own decisions regarding getting screened for cervical cancer, age stratified
Change in awareness of cervical cancer, age stratified, through questionnaire
Change in the number of women and men stating awareness of cervical cancer, age stratified"
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