一个模型赋权农村解决方案预防宫癌 (He Tapu Te Whare Tangata):一个集群随机交叉试验的协议
Beverley Lawton1, Evelyn Jane MacDonald1, Francesca Storey1
1National Women's Health Research Centre, Faculty of Health, Victoria University of Wellington, Wellington, New Zealand.
一个新的社区控制的宫癌查途径改善了毛利妇女的及时性,利用医疗点高风险人乳头瘤病毒 (hrHPV) 测试. 这种以毛利为中心的方法旨在减少宫癌的不平等.
科学领域:
- 公共卫生 公共卫生
- 妇科瘤学 妇科瘤学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 与非毛利妇女相比,Wāhine Māori (毛利妇女) 患子宫癌和死亡率较高.
- 农村毛利居民面临着严重的医疗保健接入障碍,导致子宫癌的结果更差.
- 现有的查和转诊流程导致高风险人类乳头瘤病毒 (hrHPV) 检测的护理延迟.
研究的目的:
- 为了比较可接受性,可行性,及时性,以及在社区控制的途径和标准护理之间在 hrHPV 检测后进行大肠镜检查的转诊/出席率.
- 评估一个以毛利为中心的方法,整合自我测试,照顾点 (POC) 诊断和立即转诊.
主要方法:
- 一个集群随机交叉试验,涉及两个初级保健实践.
- 途径1:HPV自我测试1小时的POC结果,面对面的支持,以及立即的结肠镜转诊.
- 途径2:通过实验室分析和标准转诊途径进行HPV自我测试. 主要结局:20个工作日内对 hrHPV阳性结果进行肠镜检查.
主要成果:
- 在最初的15个月内,有743个符合条件的HPV自我测试 (370个在Pathway 1,373个在Pathway 2) 进行.
- 高风险的人类乳头瘤病毒 (hrHPV) 阳性率为7.3% (54/743).
- 第二阶段的数据收集和定性访谈正在进行中.
结论:
- 这项以毛利人为中心的研究比较了宫癌查的两种临床途径,从 hrHPV检测到结肠镜检查.
- 社区控制的途径利用农村优势和 whānau ora 方法,结合面对面的参与和社区卫生工作者.
- 研究结果将为创新技术使用的农村模式提供信息,解决宫癌的不平等问题,促进毛利人的健康,并可能适用于其他土著和农村人口.
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