Strategies for community education prior to clinical trial recruitment for a cervical cancer screening intervention in Uganda

• Main Authors: Sheona M Mitchell, Heather N Pedersen, Musa eSekikubo, Christine eBiryabarema, Josaphat JK Byamugisha, David eMwesigwa, Malcolm eSteinberg, Deborah M Money, Gina S Ogilvie
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2016-04-01
• Series: Frontiers in Oncology
• Subjects: Health Education; qualitative research; recruitment; cervical cancer screening; Participation
• Online Access: http://journal.frontiersin.org/Journal/10.3389/fonc.2016.00090/full

Introduction: Community engagement and education can improve acceptability and participation in clinical trials conducted in Kisenyi, Uganda. In preparation for a randomized controlled trial exploring different methods for cervical cancer screening, we explored optimal engagement strategies from the perspective of community members and health professionals.Methods: We conducted key informant interviews followed by serial community forums with purposeful sampling and compared the perspectives of women in Kisenyi (N=26) to healthcare workers (HCW) at the local and tertiary care center levels (N=61) in a participatory, iterative process.Results: Key themes identified included format, content, language, message delivery and target population. Women in Kisenyi see demonstration as a key part of an educational intervention and not solely a didactic session whereas health professionals emphasized the biomedical content and natural history of cervical cancer. Using local language and lay leaders with locally accessible terminology was more of a priority for women in Kisenyi than clinicians. Simple language with a clear message was essential for both groups. Localization of language and reciprocal communication using demonstration between community members and HCW was a key theme.Conclusions: Although perceptions of the format are similar between women and HCW, the content, language and messaging that should be incorporated in a health education strategy differ markedly. The call for lay leaders to participate in health promotion is a clear step towards transforming this cervical cancer screening project to be a fully participatory process. This is important in scaling-up cervical cancer screening programs in Kisenyi and will be central in developing health education interventions for this purpose.