HPV Infection Clinical Trial
Official title:
A Pilot Study on HPV and Cervical Cancer Screening in Mumbai
The Study goals are to test feasibility and acceptability of point of care HPV testing with 227 women already accessing an existing cancer screening program in Mumbai, India. Describe HPV infection types in women screened. Compare if the quality of HPV clinician-collected and self-collected samples are equally efficient to detect HPV and cervical cancer precursor lesions. Compare the agreement between HPV GeneXpert and HPV HC2 test on the clinician-collected sample
In this pilot study, Investigators will assess the feasibility and acceptability of point of
care HPV testing in an existing SVA program. There is no control group since neither the
efficacy nor effectiveness is to be tested. In the pilot study the screen positive women will
be referred to the Tata Memorial Hospital for further diagnostic work-up to restrict the
programme logistics. While in the main study, Colposcopy and Cryotherapy will be conducted at
the community level. The evaluation framework will be based on a robust D&I model called
REAIM.
i.TMH staff will hold health camps to mobilize women to attend. Providers already trained in
the TMH outreach program will identify women eligible for screening. After obtaining the
consent, the medical social worker will collect baseline data and record the results of the
GeneXpert HPV testing on self sample and health care provider collected sample.
Data Collection:
ii. Quantitative data: Data will be collected in-person by the Medical Social worker.
De-identified data will be uploaded to Own Cloud, a file-sharing program in the University of
Arizona, College of Nursing.
ii. Qualitative data: There will be a discussion on cultural appropriateness and possible
adjustments to the procedures based on the healthcare providers' experiences with a small
subset of the 227 women already screened. Between one to two focus groups will be conducted
by the study investigators with assistance from local staff with a subset of women,
separately to qualitatively assess acceptability of HPV testing using GeneXpert.
The focus group discussions with women participants will be audio-recorded and transcribed
verbatim. The moderator will be guided by a semi-structured set of questions to facilitate
discussion, and will specifically probe to elicit distinctive/ unusual behaviors or symptoms
related to the program, screening and HPV testing.
In keeping with standards for objective evaluation, Dr. Menon or Kue will conduct a focus
group discussion with Medical Social workers at the end of the study period for program
evaluation (i.e., acceptability, potential changes in delivery, etc.). Discussions will be
recorded by a note-taker, not previously associated with the study.
Given the small numbers, a think-aloud group, in a question and answer format with a
note-taker to record the main points will be simply conducted with the providers. Both the
facilitator and note-taker will not be among TMH staff as this may introduce bias to the
conversation.
iii: Training of TMH staff to use GeneXpert: Personnel from the India office of Cepheid will
train providers on how to use GeneXpert using standardized training protocols. The quality of
the self- collected sample will be compared to the quality of the provider collected sample
(by running two separate GeneXpert tests on each sample) to establish the feasibility of
self-sampling.
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