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Rapid implementation mapping to identify implementation determinants and strategies for cervical cancer control in Nigeria

BACKGROUND: Cervical cancer constitutes a huge burden among women in Nigeria, particularly HIV-infected women. However, the provision and uptake of cervical cancer screening and treatment is limited in Nigeria. Understanding implementation determinants is essential for the effective translation of s...

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Autores principales: Itanyi, Ijeoma Uchenna, Viglione, Clare, Rositch, Anne F., Olawepo, John Olajide, Olakunde, Babayemi Oluwaseun, Ikpeazu, Akudo, Nwokwu, Uche, Lasebikan, Nwamaka, Ezeanolue, Echezona Edozie, Aarons, Gregory A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10469679/
https://www.ncbi.nlm.nih.gov/pubmed/37663856
http://dx.doi.org/10.3389/fpubh.2023.1228434
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author Itanyi, Ijeoma Uchenna
Viglione, Clare
Rositch, Anne F.
Olawepo, John Olajide
Olakunde, Babayemi Oluwaseun
Ikpeazu, Akudo
Nwokwu, Uche
Lasebikan, Nwamaka
Ezeanolue, Echezona Edozie
Aarons, Gregory A.
author_facet Itanyi, Ijeoma Uchenna
Viglione, Clare
Rositch, Anne F.
Olawepo, John Olajide
Olakunde, Babayemi Oluwaseun
Ikpeazu, Akudo
Nwokwu, Uche
Lasebikan, Nwamaka
Ezeanolue, Echezona Edozie
Aarons, Gregory A.
author_sort Itanyi, Ijeoma Uchenna
collection PubMed
description BACKGROUND: Cervical cancer constitutes a huge burden among women in Nigeria, particularly HIV-infected women. However, the provision and uptake of cervical cancer screening and treatment is limited in Nigeria. Understanding implementation determinants is essential for the effective translation of such evidence-based interventions into practice, particularly in low-resource settings. COVID-19 pandemic necessitated online collaboration making implementation mapping challenging in some ways, while providing streamlining opportunities. In this study, we describe the use of a virtual online approach for implementation mapping (steps 1–3) to identify implementation determinants, mechanisms, and strategies to implement evidence-based cervical cancer screening and treatment in existing HIV infrastructure in Nigeria. METHODS: This study used a mixed methods study design with a virtual modified nominal group technique (NGT) process aligning with Implementation Mapping steps 1–3. Eleven stakeholders (six program staff and five healthcare providers and administrators) participated in a virtual NGT process which occurred in two phases. The first phase utilized online surveys, and the second phase utilized an NGT and implementation mapping process. The Exploration, Preparation, Implementation and Sustainment (EPIS) framework was used to elicit discussion around determinants and strategies from the outer context (i.e., country and regions), inner organizational context of existing HIV infrastructure, bridging factors that relate to bi-directional influences, and the health innovation to be implemented (in this case cervical cancer screening and treatment). During the NGT, the group ranked implementation barriers and voted on implementation strategies using Mentimeter. RESULTS: Eighteen determinants to integrating cervical cancer screening and treatment into existing comprehensive HIV programs were related to human resources capacity, access to cervical cancer services, logistics management, clinic, and client-related factors. The top 3 determinants included gaps in human resources capacity, poor access to cervical cancer services, and lack of demand for services resulting from lack of awareness about the disease and servicesA set of six core implementation strategies and two enhanced implementation strategies were identified. CONCLUSIONS: Rapid Implementation Mapping is a feasible and acceptable approach for identifying and articulating implementation determinants, mechanisms, and strategies for complex healthcare interventions in LMICs.
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spelling pubmed-104696792023-09-01 Rapid implementation mapping to identify implementation determinants and strategies for cervical cancer control in Nigeria Itanyi, Ijeoma Uchenna Viglione, Clare Rositch, Anne F. Olawepo, John Olajide Olakunde, Babayemi Oluwaseun Ikpeazu, Akudo Nwokwu, Uche Lasebikan, Nwamaka Ezeanolue, Echezona Edozie Aarons, Gregory A. Front Public Health Public Health BACKGROUND: Cervical cancer constitutes a huge burden among women in Nigeria, particularly HIV-infected women. However, the provision and uptake of cervical cancer screening and treatment is limited in Nigeria. Understanding implementation determinants is essential for the effective translation of such evidence-based interventions into practice, particularly in low-resource settings. COVID-19 pandemic necessitated online collaboration making implementation mapping challenging in some ways, while providing streamlining opportunities. In this study, we describe the use of a virtual online approach for implementation mapping (steps 1–3) to identify implementation determinants, mechanisms, and strategies to implement evidence-based cervical cancer screening and treatment in existing HIV infrastructure in Nigeria. METHODS: This study used a mixed methods study design with a virtual modified nominal group technique (NGT) process aligning with Implementation Mapping steps 1–3. Eleven stakeholders (six program staff and five healthcare providers and administrators) participated in a virtual NGT process which occurred in two phases. The first phase utilized online surveys, and the second phase utilized an NGT and implementation mapping process. The Exploration, Preparation, Implementation and Sustainment (EPIS) framework was used to elicit discussion around determinants and strategies from the outer context (i.e., country and regions), inner organizational context of existing HIV infrastructure, bridging factors that relate to bi-directional influences, and the health innovation to be implemented (in this case cervical cancer screening and treatment). During the NGT, the group ranked implementation barriers and voted on implementation strategies using Mentimeter. RESULTS: Eighteen determinants to integrating cervical cancer screening and treatment into existing comprehensive HIV programs were related to human resources capacity, access to cervical cancer services, logistics management, clinic, and client-related factors. The top 3 determinants included gaps in human resources capacity, poor access to cervical cancer services, and lack of demand for services resulting from lack of awareness about the disease and servicesA set of six core implementation strategies and two enhanced implementation strategies were identified. CONCLUSIONS: Rapid Implementation Mapping is a feasible and acceptable approach for identifying and articulating implementation determinants, mechanisms, and strategies for complex healthcare interventions in LMICs. Frontiers Media S.A. 2023-08-17 /pmc/articles/PMC10469679/ /pubmed/37663856 http://dx.doi.org/10.3389/fpubh.2023.1228434 Text en Copyright © 2023 Itanyi, Viglione, Rositch, Olawepo, Olakunde, Ikpeazu, Nwokwu, Lasebikan, Ezeanolue and Aarons. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Itanyi, Ijeoma Uchenna
Viglione, Clare
Rositch, Anne F.
Olawepo, John Olajide
Olakunde, Babayemi Oluwaseun
Ikpeazu, Akudo
Nwokwu, Uche
Lasebikan, Nwamaka
Ezeanolue, Echezona Edozie
Aarons, Gregory A.
Rapid implementation mapping to identify implementation determinants and strategies for cervical cancer control in Nigeria
title Rapid implementation mapping to identify implementation determinants and strategies for cervical cancer control in Nigeria
title_full Rapid implementation mapping to identify implementation determinants and strategies for cervical cancer control in Nigeria
title_fullStr Rapid implementation mapping to identify implementation determinants and strategies for cervical cancer control in Nigeria
title_full_unstemmed Rapid implementation mapping to identify implementation determinants and strategies for cervical cancer control in Nigeria
title_short Rapid implementation mapping to identify implementation determinants and strategies for cervical cancer control in Nigeria
title_sort rapid implementation mapping to identify implementation determinants and strategies for cervical cancer control in nigeria
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10469679/
https://www.ncbi.nlm.nih.gov/pubmed/37663856
http://dx.doi.org/10.3389/fpubh.2023.1228434
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