Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.
Department of Laboratory Oncology, Dr BRAIRCH, All India Institute of Medical Sciences, New Delhi, India.
JCO Glob Oncol. 2024 Aug;10:e2400158. doi: 10.1200/GO.24.00158.
This pilot study is aimed to analyze a novel strategy of cervical cancer screening by training of Accredited Social Health Activist (ASHA) workers via telemedicine to counsel women for human papillomavirus (HPV) self-sampling.
This is a pilot, community-based, prospective, single-arm study. Physicians trained the ASHA workers regarding self-sampled HPV testing via a mobile application and telephonically using videos and e-pamphlets, who in turn trained the clients in community. The HPV kits were transported via prepaid courier service.
Four hundred and sixty-five women of age group 30-65 years were tested by 47 teletrained ASHA workers. The mean age of ASHA worker and clients was 39.47 ± 6.45 and 37.26 ± 8.38 years, respectively. Of the ASHA workers, 91.7% were satisfied with the information provided during telecounseling, 95.7% could understand the contents of mobile app easily, and 93.6% could fill the data of clients in app easily. Of the clients, 99.6% were satisfied with counseling by ASHA workers and 98% found it easy to self-sample. The acceptability of this strategy among clients was 58.2%. The feasibility of this strategy (percentage of clients who find it easy/those who did self-sampling) was around 99%. Among those screened, 11.8% were high-risk HPV-positive and 85.5% had follow-up at the study center.
The current study highlights a novel strategy of cervical cancer screening by incorporating the role of telemedicine in training ASHA workers and their role in improving the screening by home-based delivery of HPV kits with promising results.
本研究旨在通过培训认证社会卫生活动家(ASHA)工作人员,利用远程医疗对妇女进行人乳头瘤病毒(HPV)自我采样咨询,分析一种新的宫颈癌筛查策略。
这是一项基于社区的前瞻性单臂研究。医生通过移动应用程序和视频及电子小册子对 ASHA 工作人员进行自我采样 HPV 检测培训,然后由他们在社区对客户进行培训。HPV 检测试剂盒通过预付快递服务运输。
共有 465 名年龄在 30-65 岁的女性由 47 名经过远程培训的 ASHA 工作人员进行检测。ASHA 工作人员和客户的平均年龄分别为 39.47 ± 6.45 岁和 37.26 ± 8.38 岁。在 ASHA 工作人员中,91.7%对远程咨询中提供的信息表示满意,95.7%能够轻松理解移动应用程序的内容,93.6%能够轻松填写客户在应用程序中的数据。在客户中,99.6%对 ASHA 工作人员的咨询表示满意,98%认为自我采样很容易。该策略在客户中的接受度为 58.2%。该策略的可行性(认为容易的客户百分比/自行采样的客户百分比)约为 99%。在接受筛查的人群中,11.8%为高危 HPV 阳性,85.5%在研究中心进行了随访。
本研究强调了一种新的宫颈癌筛查策略,即通过远程医疗培训 ASHA 工作人员,并让他们发挥作用,通过家庭配送 HPV 检测试剂盒来提高筛查率,取得了有前景的结果。