Implementing a Patient Navigation Program to Improve Cervical Cancer Screening in Urban and Rural Senegal

What this Trial Is About

This research aims to prevent unnecessary deaths from cervical cancer in Senegal by addressing barriers to early screening, follow-up, and treatment among women. The study applies the Dynamic Adaptation Process within the Exploration, Preparation, Implementation, Sustainment EPIS framework to adapt an evidence-based cervical cancer patient navigation program in both urban and rural settings. It evaluates the programs effectiveness and implementation outcomes, focusing on how adaptations address stigma, misinformation, and womens autonomy in healthcare decisions. The study involves adapting the Chicago Chinatown Patient Navigation Program to fit the contexts of Kedougou and Dakar regions in Senegal. It uses a stepped-wedge randomized pragmatic trial across six districts, where clusters transition from standard care to the adapted navigation program. Patient navigators work with community health workers to help women overcome personal and community barriers to screening and follow-up care. The study also measures implementation factors such as feasibility, acceptability, fidelity, sustainability, and costs. Participants will complete surveys and medical record reviews at baseline and every 12 months for three years to assess screening uptake, time to treatment, stigma, decision-making autonomy, awareness, knowledge, and communication about cervical cancer. The research collects data from women and men involved in cervical cancer prevention services and evaluates the adapted programs success throughout exploration, preparation, implementation, and sustainment phases. The total study duration spans multiple years with repeated assessments to understand both health and community impacts.

Adaptation and Implementation of a Patient Navigation Program for Cervical Cancer Screening Across Contexts in Senegal