2018, Número 6
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salud publica mex 2018; 60 (6)
Adopción e implementación del ofrecimiento de la autotoma VPH por agentes sanitarios en Jujuy, Argentina
Curotto M, Zalacaín-Colombo J, Paolino M, Arrossi S
Idioma: Español
Referencias bibliográficas: 24
Paginas: 674-682
Archivo PDF: 393.24 Kb.
RESUMEN
Objetivo. Evaluar la adopción e implementación en escala
de la estrategia orientada a ofrecer puerta a puerta la autotoma
de la prueba del virus del papiloma humano (AT-VPH), por
parte de agentes sanitarios (AS), en Jujuy, Argentina.
Material
y métodos. Se aplicó una encuesta autoadministrada a 478
AS. Las dimensiones de adopción e implementación fueron
evaluadas con el modelo RE-AIM.
Resultados. Adopción:
81.8% de los AS ofreció la AT-VPH y 86.4% expresó gratificación
con la estrategia. Implementación: los problemas
encontrados fueron la demora en la entrega de tubos (61.3%)
y resultados (70.0%); falta de recursos humanos (28.3%), y
dificultades al obtener turnos para realizar el triage (26.1%).
El principal obstáculo fue la sobrecarga de trabajo (50.2%),
mientras que la capacitación (38.0%) y el listado de mujeres
a contactar (28.7%) fueron los elementos facilitadores.
Conclusiones.
La adopción de la AT-VPH fue alta entre los AS.
Deben reforzarse las estrategias programáticas para motivar a
los AS y reducir su carga de trabajo al implementar la AT-VPH.
REFERENCIAS (EN ESTE ARTÍCULO)
Ronco G, Giorgi-Rossi P, Carozzi F, Confortini M, Dalla Palma P, Del Mistro A, et al. Efficacy of human papillomavirus testing for the detection of invasive cervical cancers and cervical intraepithelial neoplasia: a randomised controlled trial. Lancet Oncol. 2010;11(3):249-57. https://doi. org/10.1016/S1470-2045(09)70360-2
Arbyn M, Verdoodt F, Snijders PJ, Verhoef VM, Suonio E, Dillner L, et al. Accuracy of human papillomavirus testing on self-collected versus clinician-collected samples: a meta-analysis. Lancet Oncol. 2014;15(2):172- 83. https://doi.org/10.1016/S1470-2045(13)70570-9
Bansil P, Wittet S, Lim JL, Winkler JL, Paul P, Jeronimo J. Acceptability of self-collection sampling for HPV-DNA testing in low-resource settings: a mixed methods approach. BMC Public Health. 2014;14:596. https://doi. org/10.1186/1471-2458-14-596
Snijders PJ, Verhoef VM, Arbyn M, Ogilvie G, Minozzi S, Banzi R, et al. High-risk HPV testing on self-sampled versus clinician-collected specimens: a review on the clinical accuracy and impact on population attendace in cervical cancer screening. Int J Cancer. 2013;132(10):2223-36. https://doi.org/10.1002/ijc.27790
Verdoodt F, Jentschke M, Hillemanns P, Racey CS, Snijders PJF, Arbyn M. Reaching women who do not participate in the regular cervical cancer screening programme by offering self-sampling kits: a systematic review and meta-analysis of randomized trials. Eur J Cancer. 2015;51(16):2375-85. https://doi.org/10.1016/j.ejca.2015.07.006
Arrossi S, Thouyaret L, Herrero R, Campanera A, Magdaleno A, Cuberli M, et al. Effect of self-collection of HPV DNA offered by community health workers at home visits on uptake of screening for cervical cancer (the EMA study): a population-based cluster-randomised trial. Lancet Glob Health. 2015;3(2):e85-e94. https://doi.org.10.1016/S2214- 109X(14)70354-7
Barbee L, Kobetz E, Menard J, Cook N, Blanco J, Barton B, et al. Assessing the acceptability of self-sampling for HPV among Haitian immigrant women: CBPR in action. Cancer Causes Control. 2010;21(3):421-31. https://doi.org/10.1007/s10552-009-9474-0
Mandingo M, Frett B, Laurent JR, Bishop I, Raymondville M, Marsh S et al. Pairing community health workers with HPV self-sampling for cervical cancer prevention in rural Haiti. Int J Gynaecol Obstet. 2015;128:206- 10. https://doi.org/10.1016/j.ijgo.2014.09.016
Milat AJ, Bauman A, Redman S. Narrative review of models and success factors for scaling up public health interventions. Implement Sci. 2015;10:113. https://doi.org/10.1186/s13012-015-0301-6
Arrossi S, Paolino M, Thouyaret L, Laudi R, Campanera A. Evaluation of scaling-up of HPV self-collection offered by community health workers at home visits to increase screening among socially vulnerable under-screened women in Jujuy Province, Argentina. Implement Sci. 2017;12(1):17. https://doi.org/10.1186/s13012-017-0548-1
Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999; 89(9):1322-27. https://doi.org/10.2105/AJPH.89.9.1322
World Health Organization. A guide to implementation research in the prevention and control of noncommunicable diseases. Ginebra: WHO, 2016.
Proctor EK, Powell BJ, Baumann AA, Hamilton AM, Santens RL. Writing implementation research grant proposals: ten key ingredients. Implement Sci. 2012;7:96. https://doi.org/10.1186/1748-5908-7-96
Arrossi S, Thouyaret L, Laudi R, Marín O, Ramírez J, Paolino M, et al. Implementation of HPV-testing for cervical cancer screening in programmatic contexts: the Jujuy demonstration project in Argentina. Int J Cancer. 2015;137(7):1709-18. https://doi.org.10.1002/ijc.29530
Arrossi S, Thouyaret L, Paul L. Prevención del cáncer cervicouterino: recomendaciones para el tamizaje, seguimiento y tratamiento de mujeres en el marco de programas de tamizaje basados en el test de VPH. Actualización 2015. Buenos Aires: INC, 2015.
Arrossi S, Curotto M, Thouyaret L, Paolino M, Cuberli M, Laudi R. Manual para la implementación del test de VPH en contexto programático. Buenos Aires: INC, 2016.
Curotto M, Barletta P, Paolino M, Arrossi S. La perspectiva de los agentes sanitarios sobre la incorporación programática de la autotoma del test de VPH. Cad Saude Publica. 2017;33(4):e00138515. https://doi. org/10.1590/0102-311X00138515
Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277-1288. https://doi. org/10.1177/1049732305276687
Proctor E, Brownson R. Measurement issues in dissemination and implementation research in health. En: Brownson RC, Colditz G, Procter E, eds. Dissemination and implementation research in health. Nueva York: Oxford University Press, 2012.
Jaskiewicz W, Tulenko K. Increasing community health worker productivity and effectiveness: a review of the influence of the work environment. Hum Resour Health. 2012;10:38. https://doi.org/10.1186/1478-4491-10-38
Kok MC, Dieleman M, Taegtmeyer M, Broerse J, Kane SS, Ormel H, et al. Which intervention design factors influence performance of community health workers in low- and middle-income countries? A systematic review. Health Policy Plan. 2015;30(9):1207-27. https://doi.org/10.1093/ heapol/czu126
Kok MC, Namakhoma I, Nyirenda L, Chikaphupha K, Broerse JEW, Dieleman M, et al. Health surveillance assistants as intermediates between the community and health sector in Malawi: exploring how relationships influence performance. BMC Health Serv Res. 2016;16:164. https://doi. org/10.1186/s12913-016-1402-x
Glenton C, Colvin CJ, Carlsen B, Swartz A, Lewin S, Noyes J, et al. Barriers and facilitators to the implementation of lay health worker programmes to improve access to maternal and child health: qualitative evidence synthesis. Cochrane Database Sys Rev. 2013;(10):CD010414. https://doi.org/10.1002/14651858.CD010414
Arrossi S. HPV testing in self-collected samples. HPV World. 2017;1:10-11.