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Reducing Urban Cervical Cancer Disparities Using a Tailored mHealth Intervention to Enhance Colposcopy Attendance

Award Number: R01MD017675
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/15/2023
PERIOD OF PERFORMANCE END DATE: 12/31/2027

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Reducing Urban Cervical Cancer Disparities Using a Tailored mHealth Intervention to Enhance Colposcopy Attendance - PROJECT SUMMARY/ABSTRACT Cervical cancer is one of the most preventable cancers and when diagnosed early and appropriately treated, the likelihood of survival is close to 100%. However, nonattendance at abnormal follow-up appointments reaches 63% among Black and Hispanic women. Cervical cancer prevention and timely diagnosis requires that patients be monitored over time. Existing intervention protocols to promote attendance have significant limitations given a limited focus on Black and Hispanic patients and reduced sustainability in resource-limited settings. To fill this void, we propose a tailored mHealth intervention targeting follow-up attendance for abnormal test feedback at 3 clinic sites serving predominately Black and Hispanic women. We propose a hybrid Type 1 effectiveness-implementation trial that is theoretically-guided by the Cognitive-Social Health Information Processing model and the Exploration, Planning, Implementation and Sustainment Implementation Framework to operationalize and assess the efficacy of the Health Enhancement Resource System (HERS) intervention. HERS aims to increase patient follow-up after abnormal test results through text message-based counseling for women and supplemental telephone-based Health Coaching for women who miss their appointment. Using a sequential, multiple assignment, randomized trial (SMART) design and stakeholder-engaged approach our aims are to: (1) conduct a randomized control trial (RCT) using the SMART design to evaluate the efficacy of HERS; (2) qualitatively assess the contextual factors (patient factors, healthcare team resources, and organizational factors) affecting HERS implementation outcomes and potential for scalability and sustainability; and (3) explore patient-level moderators of the relationship between the HERS intervention and attendance at the colposcopy appointment. Women (N=546) scheduled for initial or repeat colposcopy following an abnormal test result will be recruited and randomized to one of 2 conditions (HERS text messages or Standard of Care) and, through the SMART design, will remain in their assigned group or re-randomized to HERS or HERS + Health Coaching, depending on initial appointment attendance. The primary outcome is attendance at the baseline colposcopy and the secondary outcome is long-term follow-up at 12-months. Additional research questions will evaluate the best initial intervention (e.g., Standard of Care or HERS) for increasing attendance at the baseline and 12-month follow-up appointments. In-depth interviews with healthcare stakeholders and exit interviews with patients will assess the impact of team and healthcare system context on the HERS implementation. Finally, exploratory analyses seek to identify moderators of intervention effect (e.g., demographic characteristics, health literacy) at baseline and 12-month follow-up appointments to evaluate which patients should receive the HERS intervention as a first-line intervention rather than Standard of Care.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $692,066 )
2026	2026	THE INSTITUTE FOR CANCER RESEARCH	333 COTTMAN AVE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Minority Health and Health Disparities Research	001	4	4/3/2026	NON-COMPETING CONTINUATION	$69,206
2026	2026	THE INSTITUTE FOR CANCER RESEARCH	333 COTTMAN AVE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Minority Health and Health Disparities Research	000	4	1/26/2026	NON-COMPETING CONTINUATION	$622,860
														Subtotal = $692,066

Issue Date FY: 2025 ( Subtotal = $693,423 )
2025	2025	THE INSTITUTE FOR CANCER RESEARCH	333 COTTMAN AVE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Minority Health and Health Disparities Research	000	3	12/17/2024	NON-COMPETING CONTINUATION	$624,082
2025	2025	THE INSTITUTE FOR CANCER RESEARCH	333 COTTMAN AVE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Minority Health and Health Disparities Research	001	3	8/12/2025	NON-COMPETING CONTINUATION	$69,341
														Subtotal = $693,423

Issue Date FY: 2024 ( Subtotal = $682,496 )
2024	2024	THE INSTITUTE FOR CANCER RESEARCH	333 COTTMAN AVE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Minority Health and Health Disparities Research	002	2	6/4/2024	NON-COMPETING CONTINUATION	$49,251
2024	2024	THE INSTITUTE FOR CANCER RESEARCH	333 COTTMAN AVE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Minority Health and Health Disparities Research	001	2	12/7/2023	NON-COMPETING CONTINUATION	$633,245
2024	2023	THE INSTITUTE FOR CANCER RESEARCH	333 COTTMAN AVE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Minority Health and Health Disparities Research	000	1	12/7/2023	NEW	$0
														Subtotal = $682,496

Issue Date FY: 2023 ( Subtotal = $709,137 )
2023	2023	INSTITUTE FOR CANCER RESEARCH, THE	333 COTTMAN AVE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Minority Health and Health Disparities Research	000	1	6/4/2023	NEW	$709,137
														Subtotal = $709,137

Grand Total All Awards = $2,777,122

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Reducing Urban Cervical Cancer Disparities Using a Tailored mHealth Intervention to Enhance Colposcopy Attendance

Award Number: R01MD017675

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 07/15/2023

PERIOD OF PERFORMANCE END DATE: 12/31/2027

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