Game Changers for Cervical Cancer Prevention (GC-CCP)

A Hybrid Implementation-Effectiveness Trial of Game Changers for Cervical Cancer Prevention in Uganda

Makerere University, African Palliative Care Association, Rays of Hope Hospice Jinja, Indiana University, Bloomington

This randomized controlled trial will evaluate Game Changers for Cervical Cancer Prevention (GC-CCP) for increasing cervical cancer (CC) screening advocacy among intervention recipients (index participants) towards female social network members, and uptake of CC screening among enrolled female social network members (alter participants) who have not previously been screened. The main research questions are: Is the GC-CCP network-based peer advocacy intervention superior to usual care (no intervention) in improving uptake of CC screening among alter participants, across urban/rural and public/private clinics? What are the mediators and moderators (among index, alter and network characteristics) of intervention effects on (a) alter CC screening; and (b) engagement in CC prevention advocacy among index participants?

This randomized controlled trial will evaluate Game Changers for Cervical Cancer Prevention (GC-CCP) for increasing cervical cancer (CC) screening among previously unscreened social network members. The trial will be conducted at 4 study clinics [2 public, 2 private-not-for-profit (PNFP), one each in an urban and rural location]. At each clinic, 40 women screened for CC in the past year will be enrolled in the RCT as index participants (n=160 index) and randomized to the intervention (in two groups of 10) or wait-list control. The intervention will consist of 7 weekly group sessions that focus on CC stigma reduction, sharing of CC screening experience with others, knowledge of CC facts and myths, and skills building for engagement in CC prevention advocacy with female social network members (alters). Each index will recruit up to three alters (n~440 alters) at baseline who have not screened for CC; these index and alter participants will be followed up at months 6 and 12.

Individual randomization to one of two parallel groups, the intervention or usual care (no intervention) control group

The assessment interviewer will be blinded to study arm allocation of the participants at baseline only

usual care (no intervention); control participants will be offered the chance to receive the intervention at the conclusion of month 12 follow-up data collection

The peer advocacy training sessions focus on reduction of internalized stigma, disclosure decision making, education on cervical cancer facts and myths, and building skills for cervical cancer prevention advocacy.

6-item Self-reported scale of engagement in CC prevention advocacy (each item using a 1-5 scale), among index participants

Inclusion Criteria: screened for cervical cancer in the past year (index participants only) is a member of social network of enrolled index participant (social network member participants only) Exclusion Criteria: advanced stage cervical cancer (index participants only) screened for cervical cancer in the past (social network member participants only)