2017 Nigeria

Impact of educational intervention on self-sampling for cervical cancer screening in Nigeria

Led by Clement A. Adebamowo, BM, ChB, ScD, FWACS, FACS, School of Medicine

Students (school affiliation): Syed Salam (medicine) and Toya Sherrill (nursing)

Project summary

There are several barriers to cervical cancer screening in developing countries. These barriers include health system barriers such as lack of infrastructure for screening, requirements for multiple clinic visits, and personal barriers such as costs, sociocultural beliefs and practices. One approach to overcome some of these barriers is the use of self-collection of cervico-vaginal samples for HPV DNA based testing. We hypothesize that while African women may have concerns about self-sampling, these concerns can be mitigated by education. In this project, we used a before and after quasi-experimental design to investigate the effect of an education intervention, as would be feasible in a population based cervical cancer screening program, on the acceptability and attitudes towards self-collection of samples for HPV DNA based testing among Nigerian women. 

Objectives

  1. To learn and acquire skills required for research study initiation and implementation
    • Development of research protocol and data collection tools
    • Development of a culturally acceptable information brochure for cervical cancer prevention suitable for low literacy populations
  2. To build communication and team work skills in a collaborative research project
    • Oral presentation of research findings/experience at team meetings
    • Effectively work with other research assistants at clinical sites for study implementation
    • Weekly feedback meetings with project coordinators
  3. To interact with women in the target population to understand the dynamics of public health among women in resource limited settings
    • Conducted four focus group discussions to evaluate IEC materials for cervical cancer prevention among women in Nigeria
    • Recruitment of participants into the project
  4. To acquire skills in data collection and maintain data integrity in the conduct of research studies
    • Questionnaire administration to research participants
    • Data entry into project database
    • Perform logical checks, and other data quality assurance checks using in built quality assurance modules in project database
  5. To acquire skills in data analysis and dissemination of research findings
    • Preparation of report of field placement experience
    • Data cleaning
    • Transcription of focus group discussions and preparation for qualitative data analyses

Outcomes

Student learning outcomes included acquiring skills in health literacy and communication, production and evaluation of health education materials suitable for users with restricted literacy skills, interprofessional communication, data collection and basic data management practices, implementation and reveiw of quality assurance techniques and collection of statistics for evaluating the study's progress. Students developed their capacity for community-based participatory research in the development of health interventions, ability to identify and discuss current trends on the use of self-sampling based methods to increase cervical cancer screening coverage in resource-limited environments, and their aptitude to communicate relevant health care issues with women in the study's target population.

The students were well-received by the community participants and were able to increase cervical cancer awareness and improved willingness to be screened among the participants. The community received culturally appropriate information, education, communication (IEC) materials for use in increasing cervical cancer screening uptake and thus early identification of health issues.

‌Reflections

"It was a highly rewarding experience for both the interns and the project staff. Global health is the future because there is much to learn from each other." - Dr. Clement Adebamowo, faculty leader, School of Medicine

"Whenever one is exposed to a new and unfamiliar environment, a good rule of thumb is to approach this environment with a non-judgmental perspective and a certain level of receptivity." - Toya Sherrill

"I never saw myself as an educator before, but now I hope that my career includes research and health education while providing healthcare services abroad to help increase the benefits to the community I work with. Research will allow me and other providers to learn more about the specific needs and characteristics of the community to direct the healthcare that we provide, while education will empower the community by enhancing their understanding of health and the options that they have." - Salam Syed

Read the 2017 Nigeria team presentation from the UMB Global Forum in October.

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