The effectiveness of health education interventions on cervical cancer prevention in Africa: A systematic review

Makadzange, Evidence Eve; Peeters, Anna; Joore, Manuela A.; Kimman, Merel

doi:10.1016/j.ypmed.2022.107219

Cited by 18 publications

(20 citation statements)

References 41 publications

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“…Several interventions have been implemented to increase early detection of CC among women globally, including health education interventions [ 4 , 5 ]; economic incentivization interventions [ 6 ]; and innovative service delivery models such as HPV self-sampling and integration of cervical screening with other services to make cervical screening more comfortable, convenient, and accessible [ 7 ]. Despite the availability of these interventions, uptake of CC screening among eligible women remains low in much of sub-Saharan Africa [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Mediators and moderators of the effect of the game changers for cervical cancer prevention intervention on cervical cancer screening among previously unscreened social network members in Uganda

et al. 2023

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Introduction Cervical cancer (CC) rates are high in Uganda, yet CC screening rates are very low. Our peer advocacy group intervention, Game Changers for Cervical Cancer Prevention (GC-CCP), was shown to increase CC screening uptake among social network members. In this secondary analysis, we examined mediators and moderators of this effect to better understand how and for whom the intervention was most successful in promoting CC screening. Methods We conducted a pilot randomized controlled trial of GC-CCP in Namayingo district, Eastern Uganda between September 2021 and April 2022. Forty adult women who had screened for CC in the past year (index participants) enrolled at baseline: 20 were randomized to receive the 7-session intervention to empower women to engage in CC prevention advocacy, and 20 were assigned to the waitlist control; from these index participants, 103 unscreened social network members (alters) also enrolled. All participants were assessed at baseline and month 6 follow-up. Change in cognitive and behavioral CC-related constructs from baseline to month 6 were examined as mediators, using multivariate linear regression analysis. Index and alter demographics and index CC treatment status were examined as moderators. Results Increased alter engagement in CC prevention advocacy fully mediated the intervention effect on alter uptake of CC screening, and was associated with an increased likelihood of alter CC screening. CC treatment status of the index participant was the sole moderator of the intervention effect, as those in the intervention group who had screened positive and received treatment for pre-cancerous lesions were more likely to have alters who got screened for CC by month 6. Conclusion The effect of GC-CCP on alter CC screening is greater when the alter reports increased engagement in her own advocacy for CC prevention with others. The intervention effects on increased engagement in CC prevention advocacy among both index and alter participants suggest a diffusion of advocacy, which bodes well for dissemination of knowledge and screening activation throughout a network and the larger community.

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Section: Introductionmentioning

confidence: 99%

Mediators and moderators of the effect of the game changers for cervical cancer prevention intervention on cervical cancer screening among previously unscreened social network members in Uganda

et al. 2023

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“…The most common reason is lack of knowledge (Garg et al, 2020; Suk et al, 2022). In order to increase the number of people who get screened and the number of timely cervical cancer diagnoses, researchers suggest the expansion of surveillance systems; using reminder mechanisms; and developing community-based, culturally tailored intervention programs including health education campaigns and home visits (Bruni et al, 2022; Desai et al, 2022; Makadzange et al, 2022; Silvera et al, 2022; Suk et al, 2022; Zeno et al, 2022). They also recommend transitioning to using HPV-research-based screening (specifically DNA detection) rather than the Pap test because it is more cost-effective, can be self-collected, and allows high-grade persistent lesions to be identified earlier (ACS, 2023; Cascardi et al, 2022; Desai et al, 2022; Makadzange et al, 2022; Poniewierza & Panek, 2022; Ramos-Pibernus et al, 2021; Wood et al, 2018).…”

Section: Barriers To Screening and Vaccinationmentioning

confidence: 99%

“…Research literature reveals a breadth of information regarding cervical cancer screening beliefs and behaviors (Calderón-Mora et al, 2020; Desai et al, 2022; Giuliano, 2023; Shokar et al, 2021; Silvera et al, 2023; Stenzel et al, 2022; Suk et al, 2022; Zeno et al, 2022). Many reasons why people do not get screened include lack of healthcare system literacy; lack of insurance; resource and logistic barriers including provider shortages and lack of capacity, communication, coordination, and facility access; fear of and a fatalistic attitude about cancer; linguistic, religious, and cultural barriers including perceived discrimination; feeling less susceptible; fearing that the test will be painful or uncomfortable; lack of confidence or knowledge about cervical cancer, HPV, and test availability; negative interactions with healthcare providers; and partner disapproval (Allahqoli et al, 2022; Desai et al, 2022; Makadzange et al, 2022; Ramos-Pibernus et al, 2021; Silvera et al, 2022; Stenzel et al, 2022; Suk et al, 2022; Zeno et al, 2022). The most common reason is lack of knowledge (Garg et al, 2020; Suk et al, 2022).…”

Section: Barriers To Screening and Vaccinationmentioning

confidence: 99%

“…Some factors that improve screening rates in Hispanic women include being recommended by a primary care physician or having had a well-woman visit in the last year; community outreach programs that are socially reinforced by Hispanic, bilingual promotoras de salud (lay health workers); print material in Spanish; use of culturally specific media and educational interventions that utilize role models; greater acculturation; believing that many other Hispanic women also get Pap tests and hearing positive stories from them; being able to collect the test sample oneself; spousal encouragement; intention to screen; and having health insurance (Calderón-Mora et al, 2020; Desai et al, 2022; Garg et al, 2020; Makadzange et al, 2022; Shokar et al, 2021; Suk et al, 2022; Wood et al, 2018; Zeno et al, 2022). Increasing demand for screening involves using reminder and recall systems, incentives, and both one-on-one and group education (Community Preventive Services Task Force, 2022).…”

Section: Factors That Increase Screening and Vaccinationmentioning

confidence: 99%

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Cervical Cancer Prevention and Treatment Needs among Hispanic Women Living on the US-Mexico Border

Whitney,

Chávez-Baray,

Villarreal

et al. 2023

SAGE Open

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Cervical cancer is the fourth most common type of female cancer and has a disproportionate impact on Hispanic women living on the US-Mexico border, especially those who are migrants or low-income. However, cervical cancer is primarily caused by the human papillomavirus (HPV), a sexually transmitted infection that can be successfully prevented and treated early with vaccination and screening. Several studies have explored factors affecting HPV prevention and cervical cancer screening among Hispanic women, but the experiences of Hispanic women who have had cervical cancer have rarely been studied. This paper will present the experiences of Hispanic women (N = 10) who survived cervical cancer, including barriers to care, services needed and received, self-care measures taken, and a series of recommendations for policy makers and the surrounding medical community to help prevent and treat this illness that, without proper treatment, can be fatal.

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“…Several interventions have been implemented to increase early detection of CC among women globally, including health education interventions [4,5]; economic incentivization interventions [6]; and innovative service delivery models such as HPV self-sampling and integration of cervical screening with other services to make cervical screening more comfortable, convenient, and accessible [7]. Despite the availability of these interventions, uptake of CC screening among eligible women remains low in much of sub-Saharan Africa [8,9].…”

Section: Introductionmentioning

confidence: 99%

Mediators and Moderators of the Effect of the Game Changers for Cervical Cancer Prevention Intervention on Cervical Cancer Screening Among Previously Unscreened Social Network Members in Uganda

Matovu

Wagner

Juncker

et al. 2022

Preprint

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Introduction: Cervical cancer (CC) rates are high in Uganda, yet CC screening rates are very low. Our peer advocacy group intervention, Game Changers for Cervical Cancer Prevention (GC-CCP), was shown to increase CC screening uptake among social network members. In this secondary analysis, we examined mediators and moderators of this effect to better understand how and for whom the intervention was most successful in promoting CC screening. Methods: We conducted a pilot randomized controlled trial of GC-CCP in Namayingo district, Eastern Uganda between September 2021 and April 2022. Forty adult women who had screened for CC in the past year (index participants) enrolled at baseline: 20 were randomized to receive the 7-session intervention to empower women to engage in CC prevention advocacy, and 20 were assigned to the waitlist control; from these index participants, 103 unscreened social network members (alters) also enrolled. All participants were assessed at baseline and month 6 follow-up. Change in cognitive and behavioral CC-related constructs from baseline to month 6 were examined as mediators, using multivariate linear regression analysis. Index and alter demographics and index CC treatment status were examined as moderators. Results: Increased alter engagement in CC prevention advocacy fully mediated the intervention effect on alter uptake of CC screening, and was associated with an increased likelihood of alter CC screening. CC treatment status of the index participant was the sole moderator of the intervention effect, as those in the intervention group who had screened positive and received treatment for pre-cancerous lesions were more likely to have alters who got screened for CC by month 6. Conclusion: The effect of GC-CCP on alter CC screening is enhanced when the alter has been spurned on to increase her own advocacy for CC prevention. The intervention effects on increased engagement in CC prevention advocacy among both index and alter participants suggest a diffusion of advocacy, which bodes well for dissemination of knowledge and screening activation throughout a network and the larger community.

show abstract

The effectiveness of health education interventions on cervical cancer prevention in Africa: A systematic review

Cited by 18 publications

References 41 publications

Mediators and moderators of the effect of the game changers for cervical cancer prevention intervention on cervical cancer screening among previously unscreened social network members in Uganda

Mediators and moderators of the effect of the game changers for cervical cancer prevention intervention on cervical cancer screening among previously unscreened social network members in Uganda

Cervical Cancer Prevention and Treatment Needs among Hispanic Women Living on the US-Mexico Border

Mediators and Moderators of the Effect of the Game Changers for Cervical Cancer Prevention Intervention on Cervical Cancer Screening Among Previously Unscreened Social Network Members in Uganda

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