Assessing the implementation fidelity of HPV self-collection offered by community health workers during home visits (the EMA strategy): a case study in a low-middle-resource settin...

Autores
Paolino, Melisa Delia; Sánchez Antelo, Victoria Inés María; Cuberli Alonso, Milca Beatriz; Ferraresi Curotto, Mariana; Le Pera, Anabella Hebe; Binder, Fernando; Mazzadi, Juan David; Firmenich, Beatriz Marcela; Arrossi, Silvina
Año de publicación
2023
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background: In Argentina, HPV self-collection offered by community health workers was demonstrated to be effective to improve cervical cancer screening uptake. Based on these findings, the EMA strategy was scaled up in nine Argentinian provinces. However, there is no evidence about the degree of fidelity—in relation to the core components proposed by the National Program on Cervical Cancer Prevention—with which this strategy was implemented in the new jurisdictions. We carried out a fidelity evaluation of the EMA strategy scaling-up aimed at evaluating the level of adherence to the core components of the EMA strategy, and how different moderating factors affected the implementation fidelity. Methods: This descriptive study used a multi-method approach involving quantitative and qualitative evaluations of the implementation fidelity using the Conceptual Framework for Implementation Fidelity. Evaluation of the degree of adherence to the core components of the EMA strategy was carried out through the analysis of a self-administered survey of health promoters, observations, and secondary data from the National Screening Information System. The analysis of moderating factors was carried out through analysis of field notes, and semi-structured interviews with key stakeholders. Results: Our results showed that the core components with highest fidelity were training, sample handling, and transportation. Regarding the offer of HPV self-collection, we found some adaptations such as locations in which health promoters offered HPV self-collection, and fewer pieces of information provided to women during the offer. In the follow-up and treatment core component, we found a reduced adherence to triage and colposcopy. Some contextual factors had a negative impact on implementation fidelity, such as urban insecurity and the reduction in the number of health promoters that offered HPV self-collection. Moderating factors that contributed to achieve high level of fidelity included a well-defined strategy with clear steps to follow, permanent feedback and high level of engagement among implementers. Conclusions: Our study shows how the analysis of fidelity and adaptations of HPV self-collection in real-world contexts are key to measure and maximize its effectiveness in low-middle-income settings.
Fil: Paolino, Melisa Delia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudios de Estado y Sociedad; Argentina
Fil: Sánchez Antelo, Victoria Inés María. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudios de Estado y Sociedad; Argentina
Fil: Cuberli Alonso, Milca Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto Nacional del Cáncer; Argentina
Fil: Ferraresi Curotto, Mariana. Instituto Nacional del Cáncer; Argentina
Fil: Le Pera, Anabella Hebe. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudios de Estado y Sociedad; Argentina
Fil: Binder, Fernando. Centro de Estudios de Estado y Sociedad; Argentina
Fil: Mazzadi, Juan David. Centro de Estudios de Estado y Sociedad; Argentina
Fil: Firmenich, Beatriz Marcela. Municipalidad de la Matanza (buenos Aires). Secretaria de Salud Publica.; Argentina
Fil: Arrossi, Silvina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudios de Estado y Sociedad; Argentina
Materia
ARGENTINA
HPV SELF-COLLECTION TEST
IMPLEMENTATION FIDELITY
CERVICAL CANCER PREVENTION
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/218932
Acceder
id CONICETDig_d8cf299805fc48a023b61951684af46f
oai_identifier_str oai:ri.conicet.gov.ar:11336/218932
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Assessing the implementation fidelity of HPV self-collection offered by community health workers during home visits (the EMA strategy): a case study in a low-middle-resource setting in ArgentinaPaolino, Melisa DeliaSánchez Antelo, Victoria Inés MaríaCuberli Alonso, Milca BeatrizFerraresi Curotto, MarianaLe Pera, Anabella HebeBinder, FernandoMazzadi, Juan DavidFirmenich, Beatriz MarcelaArrossi, SilvinaARGENTINAHPV SELF-COLLECTION TESTIMPLEMENTATION FIDELITYCERVICAL CANCER PREVENTIONhttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Background: In Argentina, HPV self-collection offered by community health workers was demonstrated to be effective to improve cervical cancer screening uptake. Based on these findings, the EMA strategy was scaled up in nine Argentinian provinces. However, there is no evidence about the degree of fidelity—in relation to the core components proposed by the National Program on Cervical Cancer Prevention—with which this strategy was implemented in the new jurisdictions. We carried out a fidelity evaluation of the EMA strategy scaling-up aimed at evaluating the level of adherence to the core components of the EMA strategy, and how different moderating factors affected the implementation fidelity. Methods: This descriptive study used a multi-method approach involving quantitative and qualitative evaluations of the implementation fidelity using the Conceptual Framework for Implementation Fidelity. Evaluation of the degree of adherence to the core components of the EMA strategy was carried out through the analysis of a self-administered survey of health promoters, observations, and secondary data from the National Screening Information System. The analysis of moderating factors was carried out through analysis of field notes, and semi-structured interviews with key stakeholders. Results: Our results showed that the core components with highest fidelity were training, sample handling, and transportation. Regarding the offer of HPV self-collection, we found some adaptations such as locations in which health promoters offered HPV self-collection, and fewer pieces of information provided to women during the offer. In the follow-up and treatment core component, we found a reduced adherence to triage and colposcopy. Some contextual factors had a negative impact on implementation fidelity, such as urban insecurity and the reduction in the number of health promoters that offered HPV self-collection. Moderating factors that contributed to achieve high level of fidelity included a well-defined strategy with clear steps to follow, permanent feedback and high level of engagement among implementers. Conclusions: Our study shows how the analysis of fidelity and adaptations of HPV self-collection in real-world contexts are key to measure and maximize its effectiveness in low-middle-income settings.Fil: Paolino, Melisa Delia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudios de Estado y Sociedad; ArgentinaFil: Sánchez Antelo, Victoria Inés María. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudios de Estado y Sociedad; ArgentinaFil: Cuberli Alonso, Milca Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto Nacional del Cáncer; ArgentinaFil: Ferraresi Curotto, Mariana. Instituto Nacional del Cáncer; ArgentinaFil: Le Pera, Anabella Hebe. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudios de Estado y Sociedad; ArgentinaFil: Binder, Fernando. Centro de Estudios de Estado y Sociedad; ArgentinaFil: Mazzadi, Juan David. Centro de Estudios de Estado y Sociedad; ArgentinaFil: Firmenich, Beatriz Marcela. Municipalidad de la Matanza (buenos Aires). Secretaria de Salud Publica.; ArgentinaFil: Arrossi, Silvina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudios de Estado y Sociedad; ArgentinaBioMed Central2023-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/218932Paolino, Melisa Delia; Sánchez Antelo, Victoria Inés María; Cuberli Alonso, Milca Beatriz; Ferraresi Curotto, Mariana; Le Pera, Anabella Hebe; et al.; Assessing the implementation fidelity of HPV self-collection offered by community health workers during home visits (the EMA strategy): a case study in a low-middle-resource setting in Argentina; BioMed Central; Implementation Science Communications; 4; 1; 1-2023; 1-192662-2211CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://implementationsciencecomms.biomedcentral.com/articles/10.1186/s43058-022-00367-2info:eu-repo/semantics/altIdentifier/doi/10.1186/s43058-022-00367-2info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T09:49:50Zoai:ri.conicet.gov.ar:11336/218932instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-03 09:49:50.779CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Assessing the implementation fidelity of HPV self-collection offered by community health workers during home visits (the EMA strategy): a case study in a low-middle-resource setting in Argentina
title Assessing the implementation fidelity of HPV self-collection offered by community health workers during home visits (the EMA strategy): a case study in a low-middle-resource setting in Argentina
spellingShingle Assessing the implementation fidelity of HPV self-collection offered by community health workers during home visits (the EMA strategy): a case study in a low-middle-resource setting in Argentina
Paolino, Melisa Delia
ARGENTINA
HPV SELF-COLLECTION TEST
IMPLEMENTATION FIDELITY
CERVICAL CANCER PREVENTION
title_short Assessing the implementation fidelity of HPV self-collection offered by community health workers during home visits (the EMA strategy): a case study in a low-middle-resource setting in Argentina
title_full Assessing the implementation fidelity of HPV self-collection offered by community health workers during home visits (the EMA strategy): a case study in a low-middle-resource setting in Argentina
title_fullStr Assessing the implementation fidelity of HPV self-collection offered by community health workers during home visits (the EMA strategy): a case study in a low-middle-resource setting in Argentina
title_full_unstemmed Assessing the implementation fidelity of HPV self-collection offered by community health workers during home visits (the EMA strategy): a case study in a low-middle-resource setting in Argentina
title_sort Assessing the implementation fidelity of HPV self-collection offered by community health workers during home visits (the EMA strategy): a case study in a low-middle-resource setting in Argentina
dc.creator.none.fl_str_mv Paolino, Melisa Delia
Sánchez Antelo, Victoria Inés María
Cuberli Alonso, Milca Beatriz
Ferraresi Curotto, Mariana
Le Pera, Anabella Hebe
Binder, Fernando
Mazzadi, Juan David
Firmenich, Beatriz Marcela
Arrossi, Silvina
author Paolino, Melisa Delia
author_facet Paolino, Melisa Delia
Sánchez Antelo, Victoria Inés María
Cuberli Alonso, Milca Beatriz
Ferraresi Curotto, Mariana
Le Pera, Anabella Hebe
Binder, Fernando
Mazzadi, Juan David
Firmenich, Beatriz Marcela
Arrossi, Silvina
author_role author
author2 Sánchez Antelo, Victoria Inés María
Cuberli Alonso, Milca Beatriz
Ferraresi Curotto, Mariana
Le Pera, Anabella Hebe
Binder, Fernando
Mazzadi, Juan David
Firmenich, Beatriz Marcela
Arrossi, Silvina
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv ARGENTINA
HPV SELF-COLLECTION TEST
IMPLEMENTATION FIDELITY
CERVICAL CANCER PREVENTION
topic ARGENTINA
HPV SELF-COLLECTION TEST
IMPLEMENTATION FIDELITY
CERVICAL CANCER PREVENTION
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background: In Argentina, HPV self-collection offered by community health workers was demonstrated to be effective to improve cervical cancer screening uptake. Based on these findings, the EMA strategy was scaled up in nine Argentinian provinces. However, there is no evidence about the degree of fidelity—in relation to the core components proposed by the National Program on Cervical Cancer Prevention—with which this strategy was implemented in the new jurisdictions. We carried out a fidelity evaluation of the EMA strategy scaling-up aimed at evaluating the level of adherence to the core components of the EMA strategy, and how different moderating factors affected the implementation fidelity. Methods: This descriptive study used a multi-method approach involving quantitative and qualitative evaluations of the implementation fidelity using the Conceptual Framework for Implementation Fidelity. Evaluation of the degree of adherence to the core components of the EMA strategy was carried out through the analysis of a self-administered survey of health promoters, observations, and secondary data from the National Screening Information System. The analysis of moderating factors was carried out through analysis of field notes, and semi-structured interviews with key stakeholders. Results: Our results showed that the core components with highest fidelity were training, sample handling, and transportation. Regarding the offer of HPV self-collection, we found some adaptations such as locations in which health promoters offered HPV self-collection, and fewer pieces of information provided to women during the offer. In the follow-up and treatment core component, we found a reduced adherence to triage and colposcopy. Some contextual factors had a negative impact on implementation fidelity, such as urban insecurity and the reduction in the number of health promoters that offered HPV self-collection. Moderating factors that contributed to achieve high level of fidelity included a well-defined strategy with clear steps to follow, permanent feedback and high level of engagement among implementers. Conclusions: Our study shows how the analysis of fidelity and adaptations of HPV self-collection in real-world contexts are key to measure and maximize its effectiveness in low-middle-income settings.
Fil: Paolino, Melisa Delia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudios de Estado y Sociedad; Argentina
Fil: Sánchez Antelo, Victoria Inés María. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudios de Estado y Sociedad; Argentina
Fil: Cuberli Alonso, Milca Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto Nacional del Cáncer; Argentina
Fil: Ferraresi Curotto, Mariana. Instituto Nacional del Cáncer; Argentina
Fil: Le Pera, Anabella Hebe. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudios de Estado y Sociedad; Argentina
Fil: Binder, Fernando. Centro de Estudios de Estado y Sociedad; Argentina
Fil: Mazzadi, Juan David. Centro de Estudios de Estado y Sociedad; Argentina
Fil: Firmenich, Beatriz Marcela. Municipalidad de la Matanza (buenos Aires). Secretaria de Salud Publica.; Argentina
Fil: Arrossi, Silvina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudios de Estado y Sociedad; Argentina
description Background: In Argentina, HPV self-collection offered by community health workers was demonstrated to be effective to improve cervical cancer screening uptake. Based on these findings, the EMA strategy was scaled up in nine Argentinian provinces. However, there is no evidence about the degree of fidelity—in relation to the core components proposed by the National Program on Cervical Cancer Prevention—with which this strategy was implemented in the new jurisdictions. We carried out a fidelity evaluation of the EMA strategy scaling-up aimed at evaluating the level of adherence to the core components of the EMA strategy, and how different moderating factors affected the implementation fidelity. Methods: This descriptive study used a multi-method approach involving quantitative and qualitative evaluations of the implementation fidelity using the Conceptual Framework for Implementation Fidelity. Evaluation of the degree of adherence to the core components of the EMA strategy was carried out through the analysis of a self-administered survey of health promoters, observations, and secondary data from the National Screening Information System. The analysis of moderating factors was carried out through analysis of field notes, and semi-structured interviews with key stakeholders. Results: Our results showed that the core components with highest fidelity were training, sample handling, and transportation. Regarding the offer of HPV self-collection, we found some adaptations such as locations in which health promoters offered HPV self-collection, and fewer pieces of information provided to women during the offer. In the follow-up and treatment core component, we found a reduced adherence to triage and colposcopy. Some contextual factors had a negative impact on implementation fidelity, such as urban insecurity and the reduction in the number of health promoters that offered HPV self-collection. Moderating factors that contributed to achieve high level of fidelity included a well-defined strategy with clear steps to follow, permanent feedback and high level of engagement among implementers. Conclusions: Our study shows how the analysis of fidelity and adaptations of HPV self-collection in real-world contexts are key to measure and maximize its effectiveness in low-middle-income settings.
publishDate 2023
dc.date.none.fl_str_mv 2023-01
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/218932
Paolino, Melisa Delia; Sánchez Antelo, Victoria Inés María; Cuberli Alonso, Milca Beatriz; Ferraresi Curotto, Mariana; Le Pera, Anabella Hebe; et al.; Assessing the implementation fidelity of HPV self-collection offered by community health workers during home visits (the EMA strategy): a case study in a low-middle-resource setting in Argentina; BioMed Central; Implementation Science Communications; 4; 1; 1-2023; 1-19
2662-2211
CONICET Digital
CONICET
url http://hdl.handle.net/11336/218932
identifier_str_mv Paolino, Melisa Delia; Sánchez Antelo, Victoria Inés María; Cuberli Alonso, Milca Beatriz; Ferraresi Curotto, Mariana; Le Pera, Anabella Hebe; et al.; Assessing the implementation fidelity of HPV self-collection offered by community health workers during home visits (the EMA strategy): a case study in a low-middle-resource setting in Argentina; BioMed Central; Implementation Science Communications; 4; 1; 1-2023; 1-19
2662-2211
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://implementationsciencecomms.biomedcentral.com/articles/10.1186/s43058-022-00367-2
info:eu-repo/semantics/altIdentifier/doi/10.1186/s43058-022-00367-2
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/2.5/ar/
dc.format.none.fl_str_mv application/pdf
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dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
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reponame_str CONICET Digital (CONICET)
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instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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