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CompletedNCT03540069Updated Jun 14, 2022

Reducing Barriers and Sustaining Utilization of a Cervical Cancer Screening Program in Rural Senegal

An interventional study of Care Group Cervical Cancer Screening Education Curriculum in Cervical Cancer and Behavior, sponsored by University of Illinois at Chicago. Completed at 3 sites in 2 countries. Open to participants aged 30 Years to 59 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2022-06-14.

Sponsored by University of Illinois at Chicago · Not applicable, Interventional, and Screening

Phase
Not applicable
Study type
Interventional
Enrollment
160
Allocation
Randomized
Ages
30 Years to 59 Years
Sex
All
01

Study summary

This research project will investigate the determinants of cervical cancer screening uptake and sustained utilization in this region and develop and evaluate a context-specific peer education behavioral intervention to improve uptake. Research supports the effectiveness of peer education in increasing cancer screening rates but, currently, no cervical cancer screening peer education program specific to rural Senegal exists. To inform the participatory development of this program, the investigators will assess barriers and facilitators of screening at multiple levels: individuals (women aged 30 to 59), households (family or principle social unit of at-risk women), and the community (immediate village or neighborhood with common amenities of at-risk women). We hypothesize that a peer education program that adapts to changing contexts over time and is targeted at a multi-level audience will result in early, widespread uptake and sustained use of the VIA cervical cancer screening program. Study findings will inform programmatic planning in Kedougou and the peer education curriculum we develop can serve as a template for maximizing early impact of new cervical cancer screening services implemented in other areas of rural Senegal. Our long-term goal is to inform national-level policy to guide the implementation of cervical cancer screening programs in other rural Senegal regions.

Read the detailed description

The goal of this study is to inform the sustainable implementation of cervical cancer screening services in low-resource areas of Senegal naïve to cancer screening programs by

  1. investigating the access barriers and determinants of initial uptake and
  2. developing and adapting a peer education health promotion intervention to diverse and dynamic contexts to achieve sustained utilization.

Framework: Implementation Science is the study of how proven technical solutions are applicable to real world settings. The investigators will study how the implementation of VIA, as a proven intervention, can be optimized and how the screening service can best "fit" into the local context. Established complementary frameworks will guide our study. The investigators will apply

  1. the Patient-Centered Access Framework to assess the demand-side barriers and facilitators of uptake in aim 1,
  2. the Integrated Theory of Health Behavior Change to evaluate how a peer education program facilitates self-management behavior of women in aim 2, and
  3. the Dynamic Sustainability Framework to evaluate the initial uptake and sustained utilization of the health service in aim 3.

The investigators seek to understand the dynamic nature of the influential factors within the local context and the process by which the investigators can facilitate responsive adaptations to the intervention in order to reduce barriers, maximize early uptake, and sustain utilization.

Overview of Study Data Collection: To achieve all aims, the investigators will conduct a cluster-randomized stepped wedge study across three representative clusters (each containing a district center and two rural sites) in the Kedougou region. For each aim the investigators will collect data at baseline and at 6-month intervals in each cluster (data collection intervals coincide with the initiation of the intervention in a new cluster). In aim 1, the investigators will develop (through a participatory approach), pilot, and conduct surveys of eligible clients and household questionnaires as well as focus groups (FG) (women ages 30-44 and 45-59) and in-depth interviews of men (ages 30-59). For aim 2, the investigators will describe the development, piloting, implementation, and adaptation of an aim 1-informed context-specific multi-level peer education curriculum across clusters through the stepped wedge approach in the Kedougou region. The investigators will collect quantitative program reach data and qualitative process evaluation data at each time period. These data will be used to adapt the intervention over time. To achieve aim 3, the investigators will collect aggregated health service level utilization data and individual surveys.

02

Conditions studied

  • Cervical Cancer
  • Behavior
03

In context

Uterine Cervical Neoplasms

1,881 studies on the registry are indexed under Uterine Cervical Neoplasms; 567 are open to participants now.

This study's enrollment of 160 is above the median of 100 across 1,377 interventional studies indexed under Uterine Cervical Neoplasms.

Browse Uterine Cervical Neoplasms studies →

Lead sponsor

University of Illinois at Chicago is the lead sponsor of 515 studies on the registry; 133 are open to participants now.

Of its 31 completed or terminated interventional studies of FDA-regulated products, 18 (58%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
30 Years to 59 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

Women. Criteria for inclusion include:

  • female Senegal citizen between the ages of 30 and 59,
  • Resident in Kedougou Region,
  • eligible to seek cervical cancer prevention services at a designated intervention or control health center in the Kedougou Region, Senegal,
  • willing to participate in survey assessments; 5) able to give informed consent.

Men. Criteria for inclusion include:

  • male Senegal citizen between the ages of 30 and 59,
  • Resident in Kedougou Region,
  • living in a household with at least one woman eligible to seek cervical cancer prevention services at a designated intervention or control health center in the Kedougou Region, Senegal,
  • willing to participate in survey assessments;
  • able to give informed consent.

Exclusion criteria

Exclusion Criteria:

  • No additional exclusion criteria exist.
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Study design

Phase
Not applicable
Primary purpose
Screening
Allocation
Randomized
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
160 participants (actual)

Study arms

  • Experimental
    Cervical Cancer Screening Education

    Context-specific multi-level peer education cervical cancer screening education curriculum is implemented by Care Groups. This is conducted through a cluster-randomized stepped wedge study. Cluster 1 (randomly selected) crosses to the intervention arm at Period 2, Cluster 2 (randomly selected) crosses over to the intervention arm at Period 3, and so on. By the end of the study, all clusters will cross over to the intervention arm (one-way), though in random order. At the end of the final time period, the outcome of interest is compared between the intervention and control periods within each cluster. Differences in service utilization and recommendation will be compared, whereby clusters serve as their own controls as they cross over from the control to intervention group.

    Behavioral: Care Group Cervical Cancer Screening Education Curriculum

  • No intervention
    Control

    No educational program is implemented for each cluster prior to crossover to intervention.

Interventions

  • BehavioralCare Group Cervical Cancer Screening Education Curriculum

    a multi-modal peer education curriculum directed at a multi-level audience and aimed at motivating women to seek cervical cancer screening services.

06

What researchers measure

Primary outcomes

  1. Change in the number of women screened for the first time, age stratified

    Number of women who are screened for cervical cancer

    Time frame: measured at baseline and every 6 months through 35 months.

Secondary outcomes

  1. Change in the number of women and men recommending the service

    Number of women and men recommending that women of screening age get cervical cancer screening

    Time frame: measured at baseline and every 6 months through 35 months.

  2. Change in the knowledge of cervical cancer

    Composite of Knowledge of cervical cancer score from the quantitative survey

    Time frame: measured at baseline and every 6 months through 35 months.

  3. Change in the number of women being re-screened, age stratified

    Number of women being re-screened at 2 years per regional policy

    Time frame: measured at baseline and every 6 months through 35 months.

  4. Change in the number of individuals directly receiving intervention

    Number of individuals communities directly receiving intervention

    Time frame: measured at baseline and every 6 months through 35 months.

  5. Change in the number of households directly receiving intervention

    Number of households directly receiving intervention

    Time frame: measured at baseline and every 6 months through 35 months.

  6. Change in the number communities directly receiving intervention

    Number of communities directly receiving intervention

    Time frame: measured at baseline and every 6 months through 35 months.

07

Study locations

3 sites
  • University of Illinois at Chicago
    Chicago, Illinois 60612, United States
  • Sénégal Ministère de la Santé et l'Action Sociale Département de Recherche
    Dakar, Senegal
  • Université Cheikh Anta Diop, Dakar, Senegal Cancer Institute & Institute of Health and Development
    Dakar, Senegal
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References and documents

Publications

  • Ongtengco N, Thiam H, Collins Z, De Jesus EL, Peterson CE, Wang T, Hendrix E, Ndiaye Y, Gueye B, Gassama O, Kasse AA, Faye A, Smith JS, Fitzgibbon M, Dykens JA. Role of gender in perspectives of discrimination, stigma, and attitudes relative to cervical cancer in rural Senegal. PLoS One. 2020 Apr 28;15(4):e0232291. doi: 10.1371/journal.pone.0232291. eCollection 2020. PubMed 32343755 ↗

Study documents

  • Study protocol · Apr 4, 2018

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Yes — We will share all IPD that underlie results in a publication

Supporting information: Study protocol, Sap, Icf, Csr, Analytic code

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 14, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03540069
Lead sponsor
University of Illinois at Chicago
Collaborators
Fogarty International Center of the National Institute of Health
Responsible party
Jon Andrew Dykens (Assistant Professor of Family Medicine, University of Illinois at Chicago) — Principal investigator
First posted
May 30, 2018
Start date
Oct 3, 2018
Primary completion
Dec 15, 2021
Completion
Dec 15, 2021
Last update
Jun 14, 2022

Study contacts

Jon A Dykens, MD, MPH
principal investigator · University of Illinois at Chicago

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

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