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Using community engagement to inform and implement a community-randomized controlled trial in the anishinaabek cervical cancer screening study.

Wood B, Burchell AN, Escott N, Little J, Maar M, Ogilvie G, Severini A, Bishop L, Morrisseau K, Zehbe I - Front Oncol (2014)

Bottom Line: Social, political, and economic factors are directly and indirectly associated with the quality and distribution of health resources across Canada.First Nations (FN) women in particular, endure a disproportionate burden of ill health in contrast to the mainstream population.Interviews with healthcare providers and community members revealed that prior to any formal data collection education must be offered.

View Article: PubMed Central - PubMed

Affiliation: Thunder Bay Regional Research Institute , Thunder Bay, ON , Canada.

ABSTRACT
Social, political, and economic factors are directly and indirectly associated with the quality and distribution of health resources across Canada. First Nations (FN) women in particular, endure a disproportionate burden of ill health in contrast to the mainstream population. The complex relationship of health, social, and historical determinants are inherent to increased cervical cancer in FN women. This can be traced back to the colonial oppression suffered by Canadian FN and the social inequalities they have since faced. Screening - the Papinacolaou (Pap) test - and early immunization have rendered cervical cancer almost entirely preventable but despite these options, FN women endure notably higher rates of diagnosis and mortality due to cervical cancer. The Anishinaabek Cervical Cancer Screening Study (ACCSS) is a participatory action research project investigating the factors underlying the cervical cancer burden in FN women. ACCSS is a collaboration with 11 FN communities in Northwest Ontario, Canada, and a multidisciplinary research team from across Canada with expertise in cancer biology, epidemiology, medical anthropology, public health, virology, women's health, and pathology. Interviews with healthcare providers and community members revealed that prior to any formal data collection education must be offered. Consequently, an educational component was integrated into the existing quantitative design of the study: a two-armed, community-randomized trial that compares the uptake of two different cervical screening modalities. In ACCSS, the Research Team integrates community engagement and the flexible nature of participatory research with the scientific rigor of a randomized controlled trial. ACCSS findings will inform culturally appropriate screening strategies, aiming to reduce the disproportionate burden of cervical disease in concert with priorities of the partner FN communities.

No MeSH data available.


Related in: MedlinePlus

The map of our partner communities of the Robinson-Superior Treaty in Northwestern Ontario, Canada. Our partner communities are contained in the Thunder Bay District census area, which has a land area of 103,720 km2. All of our partner communities are accessible by road. Pic Mobert First Nation is the farthest distance away from the study center in Thunder Bay at approximately 360 km east of the city, and Fort William First Nation is adjacent to Thunder Bay.
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Figure 2: The map of our partner communities of the Robinson-Superior Treaty in Northwestern Ontario, Canada. Our partner communities are contained in the Thunder Bay District census area, which has a land area of 103,720 km2. All of our partner communities are accessible by road. Pic Mobert First Nation is the farthest distance away from the study center in Thunder Bay at approximately 360 km east of the city, and Fort William First Nation is adjacent to Thunder Bay.

Mentions: The female membership in our partner communities ranged from 102 to 1096 (31, 32). Females between 25 and 69 years who are registered with 1 of the 11 FN communities (see Table 1) or live on-reserve (e.g., married to someone in the community) who have an Ontario Health Insurance Plan were invited to participate in the ACCSS CRCT. Women under 25 were excluded because high rates of transient HPV infections in this age group could result in a high false positive rate (33); women 70 years or older were excluded as a reflection of the low likelihood of incident high-grade abnormalities and in accordance with provincial guidelines (33–36). Though Ontario recommendations suggest that sexually active women should begin cervical screening at 21 years of age, the Canadian Task Force for Preventative Medicine recommends that routine cervical screening should begin at age 25 (36). Women who are currently pregnant are asked to take part after they give birth, and women with known complete hysterectomies are not invited to participate. Several Health Directors expressed concern that many of their band members live off-reserve, either temporarily or permanently, in the urban areas in the Robinson-Superior Treaty. Consequently, we have opened our study to women in the metropolitan areas of the Thunder Bay District (in which the Robinson-Superior Treaty is contained – see Figure 2), which broadens and diversifies our sample.


Using community engagement to inform and implement a community-randomized controlled trial in the anishinaabek cervical cancer screening study.

Wood B, Burchell AN, Escott N, Little J, Maar M, Ogilvie G, Severini A, Bishop L, Morrisseau K, Zehbe I - Front Oncol (2014)

The map of our partner communities of the Robinson-Superior Treaty in Northwestern Ontario, Canada. Our partner communities are contained in the Thunder Bay District census area, which has a land area of 103,720 km2. All of our partner communities are accessible by road. Pic Mobert First Nation is the farthest distance away from the study center in Thunder Bay at approximately 360 km east of the city, and Fort William First Nation is adjacent to Thunder Bay.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3928568&req=5

Figure 2: The map of our partner communities of the Robinson-Superior Treaty in Northwestern Ontario, Canada. Our partner communities are contained in the Thunder Bay District census area, which has a land area of 103,720 km2. All of our partner communities are accessible by road. Pic Mobert First Nation is the farthest distance away from the study center in Thunder Bay at approximately 360 km east of the city, and Fort William First Nation is adjacent to Thunder Bay.
Mentions: The female membership in our partner communities ranged from 102 to 1096 (31, 32). Females between 25 and 69 years who are registered with 1 of the 11 FN communities (see Table 1) or live on-reserve (e.g., married to someone in the community) who have an Ontario Health Insurance Plan were invited to participate in the ACCSS CRCT. Women under 25 were excluded because high rates of transient HPV infections in this age group could result in a high false positive rate (33); women 70 years or older were excluded as a reflection of the low likelihood of incident high-grade abnormalities and in accordance with provincial guidelines (33–36). Though Ontario recommendations suggest that sexually active women should begin cervical screening at 21 years of age, the Canadian Task Force for Preventative Medicine recommends that routine cervical screening should begin at age 25 (36). Women who are currently pregnant are asked to take part after they give birth, and women with known complete hysterectomies are not invited to participate. Several Health Directors expressed concern that many of their band members live off-reserve, either temporarily or permanently, in the urban areas in the Robinson-Superior Treaty. Consequently, we have opened our study to women in the metropolitan areas of the Thunder Bay District (in which the Robinson-Superior Treaty is contained – see Figure 2), which broadens and diversifies our sample.

Bottom Line: Social, political, and economic factors are directly and indirectly associated with the quality and distribution of health resources across Canada.First Nations (FN) women in particular, endure a disproportionate burden of ill health in contrast to the mainstream population.Interviews with healthcare providers and community members revealed that prior to any formal data collection education must be offered.

View Article: PubMed Central - PubMed

Affiliation: Thunder Bay Regional Research Institute , Thunder Bay, ON , Canada.

ABSTRACT
Social, political, and economic factors are directly and indirectly associated with the quality and distribution of health resources across Canada. First Nations (FN) women in particular, endure a disproportionate burden of ill health in contrast to the mainstream population. The complex relationship of health, social, and historical determinants are inherent to increased cervical cancer in FN women. This can be traced back to the colonial oppression suffered by Canadian FN and the social inequalities they have since faced. Screening - the Papinacolaou (Pap) test - and early immunization have rendered cervical cancer almost entirely preventable but despite these options, FN women endure notably higher rates of diagnosis and mortality due to cervical cancer. The Anishinaabek Cervical Cancer Screening Study (ACCSS) is a participatory action research project investigating the factors underlying the cervical cancer burden in FN women. ACCSS is a collaboration with 11 FN communities in Northwest Ontario, Canada, and a multidisciplinary research team from across Canada with expertise in cancer biology, epidemiology, medical anthropology, public health, virology, women's health, and pathology. Interviews with healthcare providers and community members revealed that prior to any formal data collection education must be offered. Consequently, an educational component was integrated into the existing quantitative design of the study: a two-armed, community-randomized trial that compares the uptake of two different cervical screening modalities. In ACCSS, the Research Team integrates community engagement and the flexible nature of participatory research with the scientific rigor of a randomized controlled trial. ACCSS findings will inform culturally appropriate screening strategies, aiming to reduce the disproportionate burden of cervical disease in concert with priorities of the partner FN communities.

No MeSH data available.


Related in: MedlinePlus