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Leveraging Project ECHO for Improved Cervical Cancer Screening in Ethiopia

Enrolling By InvitationNA

Sponsor: Albert Einstein College of Medicine

Conditions: Cervical Carcinoma, Human Papilloma Virus (HPV)

Interventions: TICHILALECH ECHO

Countries: Ethiopia

Project TICHILALECH ("she can" in Amharic), a five-year, implementation science study, is focused on improving cervical cancer screening, triage, and treatment and integration with human immunodeficiency virus (HIV) care at five Ethiopian hospitals, with a focus on human papillomavirus (HPV) self-collection as the recommended screening strategy for people living with HIV (PLHIV). To improve implementation of screening and treatment, Project ECHO (Extension for Community Healthcare Outcomes), a peer-based, virtual, knowledge sharing model, will be used to convene healthcare providers and stakeholders over a period of approximately three years (2026-2029). A customized curriculum is developed featuring didactic lectures, case-based presentations, and experience sharing for peer-mentoring. A pre/post study design will measure changes in delivery of clinical services, such as the proportion of HPV-positive patients that are appropriately triaged and treated, before and after each hospital's participation in the TICHILALECH ECHO intervention.

Eligibility overview

Sex: ALL

Age: 18 Years to —

Healthy volunteers: Yes

Study type: INTERVENTIONAL

Eligibility criteria

Inclusion Criteria for Project ECHO and associated surveys, interviews, and focus group discussions:

* 18 years or older
* Willingness and ability to provide informed consent and participate in virtual, peer-mentoring through Project ECHO
* Profession: Healthcare provider, any education/training/cadre with experience relevant to the delivery of cervical cancer screening and treatment or HIV care (e.g., cervical cancer screening, gynecologist, gynecological oncologist, or HIV/ ART provider), or other stakeholder (e.g., personnel at laboratories or health bureaus, administrators, ART data clerks)
* Can communicate in English or Amharic (national language of Ethiopia)
* Able and willing to meaningfully contribute in the virtual, peer-learning community of Project ECHO

Inclusion criteria for end service users (PLHIV) for focus group discussion and routine clinical service delivery data:

* 25 years or older (in accordance with Ethiopia's national cervical cancer screening guidelines for PLHIV)
* Have been diagnosed with HIV
* Have a history of cervical cancer screening that was performed at one of the five study sites, either during the course of our study or previously
* Were screened with primary HPV DNA testing during the course of the study intervention period
* Are eligible for cervical cancer screening in accordance with Ethiopia's national cervical cancer screening guidelines (e.g., have an intact cervix)

Exclusion criteria for end service users (PLHIV) for focus group discussion:

* HIV negative status
* Age under 25 years
* Any physical or mental disability that prevents the individual from consenting to cervical cancer screening and/or study participation
* Patients without an intact cervix (e.g. a history of hysterectomy)
* Anyone ineligible for cervical cancer screening in accordance with Ethiopia's national cervical cancer screening guidelines

Note: Routine clinical service delivery data of PLHIV will be reviewed to determine intervention effect of providers participating in Project ECHO. PLHIV are not considered participants of the trial and are not consented.

Locations (1)

Addis Ababa, Ethiopia