Improving Uptake of Cervical Cancer Prevention Services - Diversity Supplement Canedo

Adherence to Follow Up after Positive HPV Testing among Hispanic Women The purpose of this application is to request a Research Supplement to promote diversity in health-related research to support Dr. Juan Canedo. His long-term career goals are to become an independently-funded investigator in a tenure-track faculty position and to reduce cancer health disparities among vulnerable populations, specifically the Hispanic population. The supplement is requested for the parent grant, “Improving Uptake of Cervical Cancer Prevention Services in Appalachia” grant (P01CA229143; PIs: Paskett, Dignan, Anderson, Kennedy). The goal of the overall P01 grant is to address the burden of cervical cancer incidence and mortality in Appalachia through the delivery of a clinic-based integrated prevention program that focuses on the major causes of cervical cancer (tobacco smoking, human papillomavirus (HPV) infection, and lack of cervical cancer screening) designed to target individual, social and community, health system and broader contextual- level barriers. Within the P01 grant, Dr. Canedo’s proposed project will specifically work with Project 3, entitled, “Multilevel HPV Self-Testing Intervention to Increase Cervical Screening Among Women in Appalachia” (PI: Reiter). Dr. Canedo’s research agenda focuses on the prevention and early detection of HPV-related cancers to reduce racial/ethnic disparities, particularly in the Hispanic population. The proposed supplement project is in the scope of the parent P01 grant because it focuses on disparities in cervical cancer screening, specifically Project 3’s focus on high-risk HPV (hrHPV) testing and expands the focus to ethnic disparities. Clinician-collected and self-collected hrHPV testing offer the potential to overcome some traditional barriers to cervical cancer screening, but they are only effective when women with positive results have appropriate clinical follow up. Previous studies have shown high acceptance among Hispanic women of hrHPV testing, particularly for self-collected hrHPV testing; however, a gap exists in the literature in understanding of adherence to follow up among this group after a positive test. Given the strong influence of family and gender roles and stigma around sexually-transmitted infections in Hispanic cultures, it is important to take into consideration the perspectives of both Hispanic women and their spouses/partners. Previous interventions have successfully increased uptake of hrHPV testing among Hispanic women, but there remains a need for interventions to improve follow up after positive results from hrHPV testing (both clinician-collected and self-collected). The specific aims of this study are to: 1) Increase understanding of barriers and facilitators that influence adherence to recommendations to obtain follow up care after positive hrHPV test results among Hispanic women, including perspectives from Hispanic women and their spouses/partners, and 2) Create a logic model of change for an intervention to increase adherence to follow up after hrHPV testing among Hispanic women, using the Intervention Mapping process. This supplement will enable Dr. Canedo to gain experience in the development of health behavior interventions, gather pilot data, enhance his publication portfolio, and prepare a K award application.