Evaluating the HOPE Intervention to Increase Cervical Cancer Screening Among Women Living with HIV in Ghana Using a Hybrid Effectiveness and Implementation Trial

What this Trial Is About

Researchers are evaluating the HOPE intervention, a home-based self-sampling and education program aimed at increasing cervical cancer screening among women living with HIV WLWH in Ghana. This study addresses the low screening rates in this high-risk group by developing and testing implementation strategies to integrate HOPE into existing healthcare practices. The trial uses a hybrid type 2 effectiveness-implementation randomized controlled design to improve screening uptake and sustainment within the health system. The study involves four secondary-level HIV clinics in Ghana, which are cluster-randomized into two groups. In the intervention group, healthcare providers receive training and implementation support strategies ISS including management support, capacity-building, and social network support to help deliver the HOPE 2.0 program. The control group providers implement HOPE without receiving ISS or training. The trial includes phases for preparation, implementation, and sustainment, focusing on adapting strategies and assessing their impact on screening behaviors and provider confidence. Participants include women living with HIV aged 25 to 65 who have not undergone cervical cancer screening in the past five years and healthcare providers at the study sites. The study collects data on program adoption, implementation costs, fidelity, penetration, and sustainment over periods ranging up to 42 months post-randomization. Researchers will also measure provider self-efficacy, patient screening uptake, follow-up treatment, and patient satisfaction. Participation involves recruitment by trained providers, delivery of the intervention, and follow-up assessments to evaluate outcomes and sustainment.

Home-based Self-sampling for Cervical Cancer Prevention Education Intervention in Ghana