Promoting Cervical Cancer Screening among African American and Sub-Saharan African Immigrant women

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PROJECT SUMMARY/ABSTRACT
The highest incidence rates of cervical cancer (CC) are in sub-Saharan Africa, South Central Asia and South
America. In the United States (U.S.), CC ranks 14th in frequency. However, in certain populations and geographic
areas of the U.S., CC incidence and death rates are significantly higher, due in part to racial and ethnic disparities
in access, utilization, and quality of care, all of which contribute to worse health outcomes. Black women
experience a disparate burden of CC incidence and mortality, having a higher risk of being diagnosed with and
dying from CC than non-Hispanic White women. Appropriate and timely CC screening is a key factor in
prevention. Leveraging the positive benefits of CC screening may reduce the CC disparate burden among
Blacks. Research studies typically treat Blacks as a homogeneous group, despite differences within this
population. To begin to address a gap in the literature within the scope of a career development award, this
study focuses specifically on two subgroups of Black women - African Americans (AA) and Sub-Saharan African
immigrants (SAI) given that there is paucity of research with SAI despite known cancer related disparities among
SAI women. To promote screening for these underserved minority women, we will conduct research to better
understand factors that influence engagement in cancer screening practices and willingness to conduct HPV
self-sampling in which women self-collect samples for HPV testing using a swab, brush or lavage. Guided by the
findings, we will develop and pilot test an innovative tailored intervention incorporating HPV self-sampling with
peer-delivered education. The specific aims are to (1) examine general awareness and cultural factors related
to cancer control and prevention among AA and SAIs; (2) examine the socioecological barriers and facilitators to
CC screening with HPV self-sampling to tailor an evidenced based cervical health promotion program in these
underserved subgroups; and (3) assess feasibility, acceptability, and preliminary efficacy of the intervention. The
intervention, entitled Health is Wealth: A Cervical Health Program, will be pilot tested with 30 AA and 30 SAI
women aged 30 to 65 years using a quasi-experimental design. These aims will also support the candidate’s
career goal of developing an independent and extramurally funded program of research to promote cancer
control and prevention for minority women. To further support this goal, a mentored career development plan
consisting of training in mixed methods, adaptation and development of behavioral interventions, randomized
clinical trial design, and research team management, is proposed. The rich research environment at the
University of Kentucky and the expertise of the mentoring team will provide the supplemental resources and
support needed for the candidate to successfully complete the proposed research and training plans. As such,
this K01 award will provide the training, mentoring, and research experiences needed for the candidate to
successfully compete for a R01-level CC screening intervention study and expedite her career development.

Grant Number: 5K01CA251487-05
NIH Institute/Center: NIH
Principal Investigator: Adebola Adegboyega