Improving cervical cancer prevention among women living with chronic conditions

University Of Florida, Gainesville FL

Investigators

Abstract

Despite advances across the cervical cancer care continuum – screening, treatment, and survivorship care, people with obesity or type 2 diabetes (T2D), and people living in poverty or rural areas are significantly more likely to die from cervical cancer. More than 41% of people in the United States have obesity, and obesity and T2D often co-occur. People living in poverty or rural areas are more likely to be diagnosed with these conditions. Thus, there is a critical need to adapt evidence-based interventions that address challenges to engaging in cervical cancer screening among people with obesity or T2D living in rural areas or in poverty. Training: I am shifting my research from examining the etiology of chronic conditions (cancer, obesity, and T2D) and associated health-protective behaviors to developing and adapting interventions that prevent cancer in individuals with chronic conditions. The proposed K01 career development training builds upon my prior experience by focusing on three areas that require additional training: (1) enhancing skills in biomedical informatics and biostatistics, (2) building skills in developing evidence-based interventions to address cancer prevention, and (3) developing expertise in multi-level implementation science theories and methods. Accordingly, the proposed K01 will provide protected time to receive the necessary training to advance my expertise and propel me to become an independent cancer implementation scientist. Research: The availability of large real-world health data sets with electronic health records and claims data provides an opportunity to better identify populations to be targeted for interventions. We will analyze OneFlorida+ Clinical Research Network data using latent class analysis to examine which degree combinations of factors (obesity, T2D, poverty, or rurality) are associated with risk profiles of cervical cancer diagnosis. We will then use Intervention Mapping to guide the process of adapting the PatIent Navigation for the Prevention of CervIcal CaNcer intervention (PINPOINT). The Health Belief Model will be used to address factors influencing screening behaviors. Proctor’s Framework for Implementation Outcomes will be used to evaluate the PINPOINT intervention. The overarching hypothesis of this proposal is that the PINPOINT intervention will be acceptable and feasible in supporting cervical cancer screening for people with T2D or obesity who are living in poverty or rural areas. Summary: Findings will inform an R01 grant application to the NCI to test the effectiveness of the developed intervention in a fully powered sample. By the end of this award, I will have developed expertise, positioning myself to become an independent cancer prevention implementation scientist.