NCT05952141

Strategies to Close the Gap From Cervical Cancer Diagnosis to Treatment in Botswana

Thibang Diphatlha: Testing Adaptive Strategies to Close the Gap From Cervical Cancer Diagnosis to Treatment in Botswana

• Status: Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 610 (estimated)
• Sponsor: Abramson Cancer Center at Penn Medicine · Academic / Other
• Sex: Female
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

Investigators will test the effectiveness of adaptive strategies on timely adoption of cervical cancer treatment in Botswana using a pragmatic trial design.

Detailed 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.

Conditions

• Cervical Cancer

Interventions

Type	Name	Description
BEHAVIORAL	Clinic Outreach	A member of the pathology team will contact the referring clinic to communicate the readiness of results.
BEHAVIORAL	Enhanced Outreach	A member of the pathology team will contact both the referring clinic and the patient directly to communicate the readiness of results.
BEHAVIORAL	Low-Touch Strategy	Patient will be sent asynchronous text messaging reminders related to the importance of timely care using framed messaging.
BEHAVIORAL	High-Touch Strategy	Patient will be sent asynchronous text messaging reminders related to the importance of timely care using framed messaging in combination with synchronous telephone-based patient navigation.

Timeline

• Start date: 2023-09-01
• Primary completion: 2026-12-31
• Completion: 2027-08-31
• First posted: 2023-07-19
• Last updated: 2026-03-30

Locations

3 sites across 2 countries: United States, Botswana