181. Reducing The Physical And Emotional Burdens of HPV Infection Through An Integrated Primary And Secondary Cervical Cancer Prevention Texting System Initiative In A Primary Care Setting, A Pilot Study

High-risk human papillomavirus strains are widely known to be the causative agents responsible for cervical cancer development. Aggregated damage caused by papillomaviruses solely is estimated in at least 5% of all malignancies of the human body and 16% in cancers that affect the female genital area. Enhanced understanding of the complex issue on how the high extent of carcinogenicity is eventually formed due to the infection by the Papoviridae family would contribute to enhancing current prevention strategies not only towards cervical cancer, but also other HPV associated cancers. This review article is aimed at presenting the key points in two directions: the current cervical cancer prevention and related aspects of HPV behavior. Virtually all applied technologies related to HPV diagnostics and screening programs, such as HPV tests, colposcopy-based tests (VIA/VILI), conventional and liquid-based cytology, currently available are presented. Issues of availability, advantages, and drawbacks of the screening programs, as well as vaccination strategies, are also reviewed in the article based on the analyzed sources. The current point of view regarding HPV is discussed with emphasis on the most problematic aspect of the HPV family concerning the observed increasing number of highly carcinogenic types. Present trends in HPV infection diagnostics throughout the human fluids and tissues are also reported, including the latest novelties in this field, such as HPV assay/self-sample device combinations. Besides, a brief outline of the related prevention issues in Kazakhstan, the leading country of Central Asia, is presented. Kazakhstan, as one of the post-soviet middle-income countries, may serve as an example of the current situation in those terrains, concerning the implementation of globally accepted cervical cancer prevention strategies. Along with positive achievements, such as the development of a nationwide screening program, a range of drawbacks is also analyzed and discussed.

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Working towards a comprehensive understanding of HPV and cervical cancer among Indigenous women: a qualitative systematic review

BMJ Open ◽

10.1136/bmjopen-2021-050113 ◽

2021 ◽

Vol 11 (6) ◽

pp. e050113

Author(s):

Sneha Sethi ◽

Brianna Poirier ◽

Karen Canfell ◽

Megan Smith ◽

Gail Garvey ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Prevention ◽

Ecological Model ◽

Cervical Screening ◽

Hpv Infection ◽

Cervical Cancer Prevention ◽

Social Ecological Model ◽

Indigenous Women ◽

Indigenous Populations ◽

Social Ecological

RationaleIndigenous peoples carry a disproportionate burden of infectious diseases and cancers and are over-represented among the socially disadvantaged of most countries. Human papillomavirus (HPV) is a risk factor and causative agent of cervical, oropharyngeal and other cancers. Recent literature shows evidence of Indigenous populations being at increased risk of HPV infections and its associated cancers.ObjectiveThis is a qualitative systematic review. The objective of this study was to explore the experiences and barriers Indigenous women face in relation to HPV awareness, knowledge and cervical screening, in order to better understand factors that may mitigate against or facilitate prevention efforts for HPV infection and associated cancers.MethodsTwo investigators independently searched MEDLINE, PubMed, SCOPUS and Web of Science databases (for articles published from inception until 30 June 2020) using a prespecified search strategy to identify qualitative studies on narratives of Indigenous women regarding HPV infection awareness, knowledge and cervical screening, across all geographic and income-level settings. Using a ‘meta-study’ approach, a social ecological model of cervical screening, infection and associated cancer prevention among Indigenous populations was formulated.ResultsFive core themes were identified and formulated within the social ecological model; intrapersonal factors, interpersonal factors, institutional/organisational factors, sociocultural/community factors and public policy. These collectively formed the proposed social ecological model of HPV infection awareness and cervical cancer prevention among Indigenous women. This model has been synthesised by taking into account personal stories of Indigenous women and healthcare workers, thus offering a more nuanced, organised, structured and culturally sensitive approach to policy translation.ConclusionThe social ecological model of HPV infection awareness and cervical cancer prevention among Indigenous women offers a holistic and practical approach for Indigenous health policy makers. It clearly addresses the high risk of Indigenous populations at a global level in experience of both HPV infection and HPV-related cancers.PROSPERO registration numberCRD42020207643.

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Innovative prototypes for cervical cancer prevention in low-income primary care settings

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1081 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M Arrivillaga ◽

P C Bermudez ◽

J P García-Cifuentes

Keyword(s):

Public Health ◽

Primary Care ◽

Cervical Cancer ◽

Cancer Prevention ◽

Design Process ◽

Low Income ◽

Subsequent Development ◽

Cervical Cancer Prevention ◽

Public Healthcare ◽

Waiting Room

Abstract Issue In 2018, the mortality due to cervical cancer rose by 6.9 compared to the previous year, with 311.365 deaths in total. By 2030, it is estimated that there will be a 21.3% increase in incidence and 26.7% in mortality. In Colombia, cervical cancer is the second cause of death by cancer in women. Description of the Problem We present the design process of innovative prototypes for cervical cancer prevention in primary care centers located in low-income settings in Cali, Colombia, using the Human-Centered Design (HCD) approach. The practice was developed in collaboration with a public healthcare network comprised of 38 urban and rural centers with women between the ages of 25 and 65 years, healthcare providers of the cancer program, healthcare managers. We conducted five HCD stages: research, need synthesis, ideation and co-design process, prototyping and in-context usability testing. We used observations, open-ended interviews and conversations, multi-stakeholder workshops, focus groups, systematic text condensation analyses and tests in real contexts. Results We designed four prototypes: (1) 'Encanto': An educational manicure service, (2) 'No le des la espalda a la citología': A media-based strategy, (3) An educational wireless queuing device in the waiting room, and (4) Citobot: A cervical cancer early detection device, system, and method. Lessons The tests carried out with each prototype showed their value, limitations and possibilities in terms of subsequent development and validation through public health research or clinical research. We recognize that a longer-term evaluation is required in order to determine whether the prototypes will be used regularly, integrated into cervical cancer screening services and effectively improve access to cytology as a screening test. Key messages HCD is a useful methodology for design-based prevention in the field of cervical cancer. Integration of HCD with public health practice would allow the generation of evidence prior to the formulation of policies and programs as well as optimize existing interventions.

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Depressive symptom reversal for women in a primary care setting: A pilot study

Archives of Psychiatric Nursing ◽

10.1016/s0883-9417(98)80034-4 ◽

1998 ◽

Vol 12 (5) ◽

pp. 247-254 ◽

Cited By ~ 9

Author(s):

Linda S. Beeber ◽

Melissa L. Charlie

Keyword(s):

Primary Care ◽

Depressive Symptom ◽

Pilot Study ◽

Care Setting ◽

Primary Care Setting

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A Pilot Study on Using the Patient Health Questionnaire in the Primary Care Setting in Japan

General Medicine ◽

10.14442/general2000.6.9 ◽

2005 ◽

Vol 6 (1) ◽

pp. 9-16

Author(s):

Kazuhiro Waza ◽

Graham Antonnette ◽

Zyzanski Stephen ◽

Kazuo Inoue ◽

Masato Sasaki ◽

...

Keyword(s):

Primary Care ◽

Pilot Study ◽

Care Setting ◽

Primary Care Setting ◽

Patient Health Questionnaire ◽

Health Questionnaire ◽

Patient Health

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Efficacy of Using Physical Activity Mentors to Increase the Daily Steps of Older Adults in the Primary Care Setting: A Pilot Study

Journal of Aging and Physical Activity ◽

10.1123/japa.2012-0120 ◽

2014 ◽

Vol 22 (1) ◽

pp. 16-24 ◽

Cited By ~ 5

Author(s):

Karen A. Croteau ◽

Vijiayurani Suresh ◽

Elanna Farnham

Keyword(s):

Physical Activity ◽

Older Adults ◽

Primary Care ◽

Pilot Study ◽

Repeated Measures ◽

Care Setting ◽

Primary Care Setting ◽

Chronic Illnesses ◽

Main Effects

The purpose of this pilot study was to determine if using physical activity (PA) mentors has any additional impact on daily steps of older adults participating in the Maine in Motion (MIM) program in the primary care setting. Participants were randomly assigned to a MIM-only group (n= 14) or a MIM+ mentor group (n= 14). The MIM intervention lasted 6 months with follow-up at 12 months. Average age of participants was 64 ± 8.8 years and most participants had multiple chronic illnesses. At baseline, mean body mass index (BMI) was 32.2 ± 5.1 and average daily steps were 4,236 ± 2,266. Repeated-measures ANOVA revealed significant main effects for steps,F(2.324, 59.104) = 4.168,p= .015, but no main effects for group,F(1, 25) = 2.988,p= .096, or time-by-group interaction,F(2.324, 59.104) = 0.905,p= .151. All participants significantly increased daily steps over the course of the intervention, with MIM+ participants maintaining increases at follow-up. No significant findings were found for BMI.

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Progress on human papillomavirus (HPV) infection and cervical cancer prevention in sub-Saharan Africa: Highlights of the 27th International Papillomavirus Conference in Berlin, 17–22 September 2011

Journal of Epidemiology and Global Health ◽

10.1016/j.jegh.2012.04.001 ◽

2012 ◽

Vol 2 (2) ◽

pp. 99 ◽

Cited By ~ 6

Author(s):

Ziad El-Khatib ◽

Joseph E. Tota ◽

Andreas M. Kaufmann

Keyword(s):

Cervical Cancer ◽

Human Papillomavirus ◽

Cancer Prevention ◽

Hpv Infection ◽

Cervical Cancer Prevention ◽

Sub Saharan Africa ◽

Sub Saharan

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HPV and Cervical Cancer Prevention Counseling With Younger Adolescents: Implications for Primary Care

The Annals of Family Medicine ◽

10.1370/afm.723 ◽

2007 ◽

Vol 5 (4) ◽

pp. 298-304 ◽

Cited By ~ 35

Author(s):

A. L. Sussman ◽

D. Helitzer ◽

M. Sanders ◽

B. Urquieta ◽

M. Salvador ◽

...

Keyword(s):

Primary Care ◽

Cervical Cancer ◽

Cancer Prevention ◽

Cervical Cancer Prevention ◽

Prevention Counseling

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Patients’ Utilization and Perception of an Artificial Intelligence–Based Symptom Assessment and Advice Technology in a British Primary Care Waiting Room: Exploratory Pilot Study

JMIR Human Factors ◽

10.2196/19713 ◽

2020 ◽

Vol 7 (3) ◽

pp. e19713 ◽

Cited By ~ 4

Author(s):

Stephen Miller ◽

Stephen Gilbert ◽

Vishaal Virani ◽

Paul Wicks

Keyword(s):

Artificial Intelligence ◽

Primary Care ◽

Pilot Study ◽

Health System ◽

Care Setting ◽

Primary Care Setting ◽

Symptom Assessment ◽

Medical Attention ◽

Self Assessment ◽

Care Clinic

Background When someone needs to know whether and when to seek medical attention, there are a range of options to consider. Each will have consequences for the individual (primarily considering trust, convenience, usefulness, and opportunity costs) and for the wider health system (affecting clinical throughput, cost, and system efficiency). Digital symptom assessment technologies that leverage artificial intelligence may help patients navigate to the right type of care with the correct degree of urgency. However, a recent review highlighted a gap in the literature on the real-world usability of these technologies. Objective We sought to explore the usability, acceptability, and utility of one such symptom assessment technology, Ada, in a primary care setting. Methods Patients with a new complaint attending a primary care clinic in South London were invited to use a custom version of the Ada symptom assessment mobile app. This exploratory pilot study was conducted between November 2017 and January 2018 in a practice with 20,000 registered patients. Participants were asked to complete an Ada self-assessment about their presenting complaint on a study smartphone, with assistance provided if required. Perceptions on the app and its utility were collected through a self-completed study questionnaire following completion of the Ada self-assessment. Results Over a 3-month period, 523 patients participated. Most were female (n=325, 62.1%), mean age 39.79 years (SD 17.7 years), with a larger proportion (413/506, 81.6%) of working-age individuals (aged 15-64) than the general population (66.0%). Participants rated Ada’s ease of use highly, with most (511/522, 97.8%) reporting it was very or quite easy. Most would use Ada again (443/503, 88.1%) and agreed they would recommend it to a friend or relative (444/520, 85.3%). We identified a number of age-related trends among respondents, with a directional trend for more young respondents to report Ada had provided helpful advice (50/54, 93%, 18-24-year olds reported helpful) than older respondents (19/32, 59%, adults aged 70+ reported helpful). We found no sex differences on any of the usability questions fielded. While most respondents reported that using the symptom checker would not have made a difference in their care-seeking behavior (425/494, 86.0%), a sizable minority (63/494, 12.8%) reported they would have used lower-intensity care such as self-care, pharmacy, or delaying their appointment. The proportion was higher for patients aged 18-24 (11/50, 22%) than aged 70+ (0/28, 0%). Conclusions In this exploratory pilot study, the digital symptom checker was rated as highly usable and acceptable by patients in a primary care setting. Further research is needed to confirm whether the app might appropriately direct patients to timely care, and understand how this might save resources for the health system. More work is also needed to ensure the benefits accrue equally to older age groups.

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