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Título : | Assessing the implementation fidelity of HPV self-collection offered by community health workers during home visits (the EMA strategy): a case study in a low-middle-resource setting in Argentina | Autor : | Arrossi, Silvina Cuberli, Milca Curotto, Mariana Le Pera, Anabella Paolino, Melisa Sánchez Antelo, Victoria Mazzadi, Juan David Binder, Fernando Firmenich, Beatriz |
Palabras clave : | COLPOSCOPÍA;EFECTIVIDAD;ESTUDIOS DE EVALUACIÓN;MUJERES;NEOPLASIAS DEL CUELLO UTERINO;TEST;PAPILLOMAVIRUS HUMANO;FIDELIDAD DE IMPLEMENTACIÓN | Fecha de publicación : | 12-Jan-2023 | Citación : | Firmenich B, Arrossi S. Assessing the implementation fidelity of HPV self-collection offered by community health workers during home visits (the EMA strategy): a case study in a low-middle-resource setting in Argentina. Implement Sci Commun. 2023 Jan 12;4(1):4. Disponible en: http://repositorio.cedes.org/handle/123456789/4710. | Citación : | Implement Sci Commun. 2023 Jan 12;4(1):4 | Resumen : | Background: In Argentina, HPV self-collection offered by community health workers was demonstrated to be effective to improve cervical cancer screening uptake. Based on these findings, the EMA strategy was scaled up in nine Argentinian provinces. However, there is no evidence about the degree of fidelity-in relation to the core components proposed by the National Program on Cervical Cancer Prevention-with which this strategy was implemented in the new jurisdictions. We carried out a fidelity evaluation of the EMA strategy scaling-up aimed at evaluating the level of adherence to the core components of the EMA strategy, and how different moderating factors affected the implementation fidelity. Methods: This descriptive study used a multi-method approach involving quantitative and qualitative evaluations of the implementation fidelity using the Conceptual Framework for Implementation Fidelity. Evaluation of the degree of adherence to the core components of the EMA strategy was carried out through the analysis of a self-administered survey of health promoters, observations, and secondary data from the National Screening Information System. The analysis of moderating factors was carried out through analysis of field notes, and semi-structured interviews with key stakeholders. Results: Our results showed that the core components with highest fidelity were training, sample handling, and transportation. Regarding the offer of HPV self-collection, we found some adaptations such as locations in which health promoters offered HPV self-collection, and fewer pieces of information provided to women during the offer. In the follow-up and treatment core component, we found a reduced adherence to triage and colposcopy. Some contextual factors had a negative impact on implementation fidelity, such as urban insecurity and the reduction in the number of health promoters that offered HPV self-collection. Moderating factors that contributed to achieve high level of fidelity included a well-defined strategy with clear steps to follow, permanent feedback and high level of engagement among implementers. Conclusions: Our study shows how the analysis of fidelity and adaptations of HPV self-collection in real-world contexts are key to measure and maximize its effectiveness in low-middle-income settings. | Descripción : | Fil: Paolino, Melisa. CEDES. Centro de Estudio de Estado y Sociedad. Área de Salud, Economía y Sociedad; Argentina. Fil: Sánchez‑Antelo, Victoria. CEDES. Centro de Estudios de Estado y Sociedad. Área de Salud, Economía y Sociedad; Argentina. Fil: Cuberli, Milca. Instituto Nacional del Cáncer. Programa Nacional de Prevención de Cáncer Cervicouterino; Argentina. Fil: Curotto, Mariana. Instituto Nacional del Cáncer. Programa Nacional de Prevención de Cáncer Cervicouterino; Argentina. Fil: Le Pera, Anabella. CEDES. Centro de Estudios de Estado y Sociedad. Área de Salud, Economía y Sociedad; Argentina. Fil: Binder, Fernando. CEDES. Centro de Estudios de Estado y Sociedad. Área de Salud, Economía y Sociedad; Argentina. Fil: Mazzadi, Juan David. CEDES. Centro de Estudios de Estado y Sociedad. Área de Salud, Economía y Sociedad; Argentina. Fil: Arrossi, Silvina. CEDES. Centro de Estudio de Estado y Sociedad. Área de Salud, Economía y Sociedad. Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET); Argentina. |
URI : | http://repositorio.cedes.org/handle/123456789/4710 | ISSN : | 2662-2211 | DOI: | 10.1186/s43058-022-00367-2 | Derechos: | info:eu-repo/semantics/openAccess https://creativecommons.org/licenses/by/4.0/ |
Appears in Collections: | Artículos en publicaciones periódicas |
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Implement Sci Commun 2023 Jan 12 4(1) 4.pdf | 3,14 MB | Adobe PDF | ![]() View/Open |
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