Hariprasad Roopa, Srinivasan Manikandan, Ravi Priyanka, Tamang Harki, Sharma Arpana, Pradhan Sangeeta, Dhanasekaran Kavitha
Centre for Evidence for Guidelines, ICMR, Department of Health Research, New Delhi, India.
JIPMER International School of Public Health, JIPMER, Puducherry , India.
Sci Rep. 2025 May 8;15(1):15985. doi: 10.1038/s41598-025-87041-4.
Cervical cancer is a major public health concern in India, hampered by limitations in traditional screening methods and healthcare infrastructure. This study aimed to evaluate the feasibility and challenges of implementing Human Papillomavirus self-sampling (HPV) self-sampling, conducted by ASHA workers (Accredited Social-Health Activists) in Sikkim, India, using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. In-depth interviews were conducted between February and May 2023 with ASHA workers involved in HPV self-sampling implementation within Sikkim. The data was analysed using qualitative methods and tagged under relevant RE-AIM categories. Twenty ASHA workers participated in the study. Facilitators included participant autonomy, positive community attitudes, and logistical advantages of home-based testing. ASHA workers' efforts in health education, counselling, and community engagement were crucial. Successful implementation was supported by adequate training, community trust, and mobile technology for result transmission. Barriers included poor health literacy, logistical challenges for ASHA workers, and inadequate incentives. The study highlights the importance of tailored screening procedures, community engagement, and programmatic support in enhancing acceptance of HPV self-sampling. Addressing barriers requires multifaceted interventions at individual, community, and systemic levels.
宫颈癌是印度主要的公共卫生问题，传统筛查方法和医疗基础设施的局限性对其造成了阻碍。本研究旨在利用“覆盖、效果、采用、实施和维持”（RE-AIM）框架，评估在印度锡金邦由经认证的社会健康活动家（ASHA工作者）开展人乳头瘤病毒（HPV）自我采样的可行性和挑战。2023年2月至5月期间，对锡金邦参与HPV自我采样实施工作的ASHA工作者进行了深入访谈。使用定性方法对数据进行分析，并归类到相关的RE-AIM类别下。20名ASHA工作者参与了该研究。促进因素包括参与者的自主性、社区的积极态度以及居家检测的后勤优势。ASHA工作者在健康教育、咨询和社区参与方面的努力至关重要。充足的培训、社区信任以及用于结果传输的移动技术对成功实施提供了支持。障碍包括健康素养低下、ASHA工作者面临的后勤挑战以及激励措施不足。该研究强调了量身定制筛查程序、社区参与和项目支持在提高HPV自我采样接受度方面的重要性。应对障碍需要在个人、社区和系统层面采取多方面的干预措施。
