Preventing Cervical Cancer through HPV Self-collection and Patient Navigation among Women Living with Chronic Conditions and Social Vulnerability

PROJECT SUMMARY/ABSTRACT Despite advances across the cervical cancer care continuum – screening, treatment, and survivorship care, women with social vulnerability (i.e. poverty, rural residence, racial or ethnically underserved), and women with obesity or type 2 diabetes (T2D) are significantly more likely to die from cervical cancer. Obesity and T2D often

co-occur, and women with social vulnerability i.e., living in poverty, rural areas, and racial/ethnic minoritized groups, are more likely to be diagnosed with the conditions. Thus, there is a critical need to adapt evidence- based interventions that address SDoH barriers to engaging in the cervical cancer care continuum among

women with chronic conditions and social vulnerability. Training: I am shifting my research from examining the etiology of chronic conditions (cancer, obesity, and T2D) and associated health-protective behaviors to focusing on adapting evidence-based interventions to mitigate cancer outcomes 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) Enhance skills in biomedical informatics and biostatistics, (2) Build skills in developing evidence-based interventions to address cancer disparities, and (3) Develop

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 implementation scientist focused on improving cancer outcomes in populations living with T2D,

obesity, and social vulnerability. 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, or SV) are associated with risk profiles of cervical cancer diagnosis. We will then use Intervention Mapping to guide the process of adapting the PINPOINT intervention – (Preventing CervIcal caNcer through HPV self-cOllection and patIent NavigaTion) for

women with high-risk profiles for cervical cancer. The Health Belief Model to understand factors influencing implementation outcomes. 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 the cervical cancer continuum of care for women with multiple vulnerabilities. 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 develop expertise in

implementation science, positioning myself to become an independent implementation scientist.