Promoting Cervical Cancer Screening Among African American (AA) and Sub-Saharan African Immigrant (SAI) Women.

Cervical cancer (CC) is the fourth most common cancer among women worldwide. The highest incidence rates are in sub-Saharan Africa, South]Central Asia and South America. In the United States (U.S.), CC ranks 14th in frequency. However, in certain populations and geographic areas of the U.S., CC incidence and death rates are still high, due in part to racial and ethnic disparities in access, utilization, and quality of care, all of which contribute to worse health outcomes. Black women experience a disparate burden of CC incidence and mortality, having a higher risk of being diagnosed with and dying from CC than non-Hispanic White women. Appropriate and timely CC screening is a key factor in prevention - 93% of CCs could be avoided by HPV vaccination and screening. It is estimated that more than 50% of all new CCs are in women who have not been screened in the previous 5 years of their lives. Leveraging the positive benefits of CC screening may reduce the CC disparate burden among Blacks. Research studies typically treat Blacks as a homogeneous group, despite differences within this population. To begin to address a gap in the literature within the scope of a career development award, this study focuses on two sub groups of Black women - African Americans (AA) and Sub-Saharan African immigrants (SAI) given that there is paucity of research with SAI and they have shown cancer related disparities. To promote screening for these underserved and minority women, a innovative tailored intervention incorporating HPV self-sampling (the woman inserts a sampling device (swab, brush, or lavage) into her vagina to collect the sample for testing) in combination with peer-delivered education will be developed and tested for feasibility. The specific aims are to (1) examine general awareness and cultural factors related to cancer control and prevention among AA and SAIs; (2) examine the socioecological barriers and facilitators to CC screening with HPV self-sampling to tailor an evidenced based cervical health program to promote CC screening in these underserved subgroups; and (3) assess feasibility, acceptability, and preliminary efficacy of the intervention. The intervention, entitled Health is Wealth: A Cervical Health Program, will be examined with 60 AA and SAI women aged 30 to 65 years using a quasi-experimental design. These aims will also support the candidatefs career goal of developing an independent and extramurally funded program of research to promote cancer control and prevention for minority women. To further support this goal, a mentored career development plan consisting of training in mixed methods, adaptation and development of behavioral interventions, randomized clinical trial design, and research team management, is proposed. The rich research environment at the University of Kentucky and the expertise of the mentoring team will provide the supplemental resources and support needed for the candidate to successfully complete the proposed research and training plans. As such, this K01 award will provide the training, mentoring, and research experiences needed for the candidate to successfully compete for a larger R01-level CC screening intervention study and expedite her development as an independent cancer disparities researcher.