Overview
Investigators will test the effectiveness of adaptive strategies on timely adoption of cervical cancer treatment in Botswana using a pragmatic trial design.
Description
Investigators will test the effectiveness of adaptive strategies on timely adoption of cervical cancer treatment in Botswana using a hybrid (type III) and pragmatic Sequential Multiple Assignment Randomized Trial (SMART) design. The adaptive strategies are designed to target patient- and system-level determinants identified in preliminary data, including delayed communication of results, individual and structural barriers to accessing treatment, and suboptimal care coordination between referring and cancer treatment clinics. The strategies draw upon key principles in behavioral economics and are supported by systematic evidence of the effectiveness of nudge strategies in preventive, HIV, and cancer care. The overarching rationale for the study is that enhancing coordination, communication, and navigation through centralized outreach and nudge strategies will increase timely treatment adoption and be scalable and sustainable in the long-term.
Eligibility
Inclusion Criteria:
Patients will be eligible if they:
- are biological females
- are aged 18 or older
- have pathology-confirmed invasive cervical cancer diagnosis
- have pathology results evaluated at National Health Laboratory in Botswana
- are citizens of Botswana
- have no prior history of invasive cervical cancer
Exclusion Criteria:
Patients will be excluded if they:
- are biological males or otherwise born without a cervix
- are below the age of 18 due to the rarity of cervical cancer in this population
- do not meet study inclusion criteria