Implementation Fidelity of a HPV Self-Collection Strategy in Buenos Aires, Argentina

PAOLINO MELISA; FIRMENICH BEATRIZ; SÁNCHEZ ANTELO, VICTORIA; CUBERLI, MILCA; MARIANA CUROTTO; LE PERA, ANABELLA; ARROSSI SILVINA

Simposio; 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021

Purpose: HPV self-collection (SC) has been proposed as a strategy to increase cervical cancer (CC) screening coverage among hard-to-reach women. However, evaluations of the implementation fidelity of this strategy in real-world contexts are scarce. The aim of the study was to evaluate the implementation fidelity of the core components of SC strategy (EMA strategy) in La Matanza, Buenos Aires, Argentina. We report preliminary results.Methods: We carried out a descriptive study. The core components included: 1) Training: Two workshops delivered to health promoters (HP) including scientific data on CC prevention; 2) Offer of SC during home visits: HP provide women with information about CC prevention, and a 10-minute step-by-step explanation on how to perform SC, 3) Sample handling and transportation (SH&T): Sample collectors labeled with the woman´s name and identifying number are transported at room temperature to the HPV laboratory (within 14 days) and 4) Follow-up of HPV+ women: cytology triage for HPV+ women. Data sources included: selfadministered questionnaires to evaluate knowledge acquired in the training (n=171), a structured checklist to evaluate offer of self-collection and SH&T (74 observations), and secondary data from the national screening information system (SITAM) to evaluate follow-up.. Quantitative analyses assessed whether activities were implemented as planned, using descriptive statistics.Results: Training: 95% of HP participated in the two workshops. More than 90% had adequate knowledge about the strategy (score of more than 70% on questionnaire). Offer of self-collection: 47% offered SC during home visit and 53% in community health meetings and waiting rooms of primary health care centers. HP had less time than stipulated in the training to offer self-collection (mean: 8 minutes; range: 1-17 minutes), so fewer pieces of information were provided. 79% of eligible women accepted self-collection. Sample handling and transportation: More than 96% adhered to the standardized protocol. Follow-up of HPV+ women: 57% of HPV+ women had a triage test registered in SITAM.Conclusion: The core components with the highest fidelity were Training and SH&T. We found adaptations in the offer of SC. Our results suggest that these adaptations do not affect the acceptability of SC. In addition, adherence to triage in the context of the SC strategy is a challenge