应用FRAME-IS来描述提供者主导的适应在肯尼亚的宫癌预防干预
Harriet Fridah Adhiambo1, Kathy Thomas2, Megan M Coe1,3
1Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, Washington, United States of America.
Research square
|July 25, 2025
概括
在环境上精细的实施策略是低资源环境中预防宫癌的关键. 这项研究使用了FRAME-IS框架来跟踪对查和治疗方法的适应,发现教育和资源修改对于改善交付至关重要.
科学领域:
- 公共卫生 公共卫生
- 实施科学 实施科学
- 全球健康 全球健康
背景情况:
- 在低资源环境中优化基于证据的干预措施 (EBIs) 需要在上下文上改进的实施策略.
- 宫癌的预防是一个关键的全球卫生挑战,特别是在资源有限的地区.
- 可持续的服务提供需要适应性策略的干预措施,如单次访问,查和治疗方法与热废除 (SV-SAT+TA).
研究的目的:
- 应用基于证据的实施策略的调整和修改报告框架 (FRAME-IS),以捕获和传播战略调整.
- 记录了对SV-SAT+TA战略的调整,以便在肯尼亚建立可持续的宫癌预防服务.
- 在实施阶段分析适应趋势及其特征.
主要方法:
- 利用基于FRAME-IS的跟踪电子表格在10个设施收集数据.
- 通过技术助理的现场访问,电话和每月与医疗保健提供者的会议收集数据.
- 采用描述性统计和精确的Poisson测试来分析适应趋势,并根据设施级别和实施阶段比较速度.
主要成果:
- 确定了28项调整,其中70%发生在早期实施阶段.
- 教育 (57%) 和资源相关 (21%) 适应是最常见的,通常针对提供商,旨在增加采用.
- 随着时间的推移,适应率显著下降,从早期阶段的2.0个设施到晚期的0.80个设施 (p=0.02).
结论:
- 教育和资源相关的适应对于成功实施SV-SAT+TA至关重要.
- 进一步的研究应该评估调整对结果的影响,并完善FRAME-IS框架.
- 开发一个"适应组"可以指导可扩展的策略,用于在类似的环境中预防宫癌.
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