Increased Knowledge Mediates the Effect of Game Changers for Cervical Cancer Prevention on Diffusion of Cervical Cancer Screening Advocacy Among Social Network Members in a Pilot Trial

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Abstract

Background

Game Changers for Cervical Cancer Prevention (GC-CCP), a peer-led, group advocacy training intervention, increased cervical cancer (CC) prevention advocacy not only among intervention recipients, but also their social network members (referred to as “alters”) who were targeted with advocacy in a pilot randomized controlled trial. We examined mediators and moderators of this effect on alter advocacy, to understand how and for whom the intervention had such an effect.

Method

Forty women (index participants) who had recently screened for CC enrolled and were randomly assigned to receive the GC-CCP intervention ( n = 20) or the wait-list control ( n = 20). Up to three alters from each participant ( n = 103) were surveyed at baseline and month 6. Measures of CC-related cognitive constructs (knowledge, enacted stigma, and risk management self-efficacy), as well as extent of advocacy received from index participants, were assessed as mediators of the intervention effect on alter advocacy using multivariate regression analyses. Alter characteristics were examined as moderators.

Results

Increased CC-related knowledge partially mediated the intervention effect on increased alter engagement in CC prevention advocacy; those with greater gains in knowledge reported greater engagement in advocacy. No moderators of the intervention effect were identified.

Conclusion

The effect of GC-CCP on alter CC prevention advocacy is enhanced by increased alter knowledge pertaining to CC prevention, causes, and treatment and suggests this may be key for diffusion of intervention effects on increased CC prevention advocacy throughout a social network.

Trial Registration

NCT04960748 (registered on clinicaltrials.gov, 7/14/2021).

Supplementary Information

The online version contains supplementary material available at 10.1007/s12529-023-10217-7.

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Most cited references 23

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Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

Hyuna Sung, Jacques Ferlay, Rebecca Siegel … (2021)

This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.

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R W Brislin (1970)

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Author and article information

Contributors

Ishita Ghai:

ORCID: http://orcid.org/0000-0003-3052-721X

ighai@pardeerand.edu

Journal

Journal ID (nlm-ta): Int J Behav Med

Journal ID (iso-abbrev): Int J Behav Med

Title: International Journal of Behavioral Medicine

Publisher: Springer US (New York )

ISSN (Print): 1070-5503

ISSN (Electronic): 1532-7558

Publication date (Electronic): 1 September 2023

Publication date PMC-release: 1 September 2023

Publication date (Print): 2024

Volume: 31

Issue: 5

Pages: 753-763

Affiliations

[1 ]GRID grid.34474.30, ISNI 0000 0004 0370 7685, Frederick S. Pardee RAND Graduate School, RAND Corporation, ; Santa Monica, CA USA

[2 ]RAND Corporation, ( https://ror.org/00f2z7n96) Santa Monica, CA USA

[3 ]School of Public Health, Makerere University, ( https://ror.org/03dmz0111) Kampala, Uganda

[4 ]Faculty of Health Sciences, Busitema University, ( https://ror.org/035d9jb31) Mbale, Uganda

[5 ]Rays of Hope Hospice Jinja, Jinja, Uganda

[6 ]African Palliative Care Association, ( https://ror.org/04rp2t677) Kampala, Uganda

[7 ]Mulago Specialized Women and Neonatal Hospital, Kampala, Uganda

[8 ]School of Medicine, Makerere University, ( https://ror.org/03dmz0111) Kampala, Uganda

Author information

Ishita Ghai http://orcid.org/0000-0003-3052-721X

Article

Publisher ID: 10217

DOI: 10.1007/s12529-023-10217-7

PMC ID: 10904666

PubMed ID: 37656308

SO-VID: a713fc5f-6b55-4d3a-8c6c-29702d1a9a7f

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date accepted : 19 August 2023

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100000061, Fogarty International Center;

Award ID: R21TW011728

Award Recipient : Rhoda K. Wanyenze

Funded by: RAND Corporation

Open Access :

Open access funding provided by SCELC, Statewide California Electronic Library Consortium

Custom metadata

ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: cervical cancer,prevention,peer advocacy,intervention,randomized controlled trial,mediation,social diffusion,social networks

Data availability:

ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: cervical cancer, prevention, peer advocacy, intervention, randomized controlled trial, mediation, social diffusion, social networks

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Increased Knowledge Mediates the Effect of Game Changers for Cervical Cancer Prevention on Diffusion of Cervical Cancer Screening Advocacy Among Social Network Members in a Pilot Trial

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Abstract

Background

Method

Results

Conclusion

Trial Registration

Supplementary Information

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Technology, Mind, and Behavior

Most cited references 23

Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

Coefficient alpha and the internal structure of tests

Back-Translation for Cross-Cultural Research

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Contributors

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History

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