Measuring knowledge change and skills improvement in participants of a comprehensive cervical cancer prevention training program in low-resource areas in Texas and Mozambique

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There are more than 530,000 new cases of cervical cancer and 275,000 related deaths annually worldwide. More than 85% of cases and deaths occur in low- and middle-income countries and some areas of the United States. There is a shortage of medical specialists to provide prevention, screening, and treatment services in these regions. Needed are programs that are focused on increasing the clinical capacity to improve cancer prevention services via innovative, locally held, hands-on training courses in conjunction with regular telementoring. Locally held, hands-on training courses for colposcopy, cervical biopsy, and loop electrosurgical excisional procedures using innovative training models and theoretical practical lectures were held in conjunction with telementoring using Project ECHO (Extension for Community Health Outcomes). Methods

We initiated a cervical cancer prevention education program with two complementary components: locally held, hands-on training courses using innovative teaching aids that were developed by Rice University, and Project ECHO telementoring using regularly held videoconferences to ensure regular mentoring. These innovative training models are low cost (< $80 USD) and allow course participants to simulate different cervical cancer screening and early treatment techniques, including VIA, colposcopy, cervical biopsies, cryotherapy, and loop electrosurgical excisional procedures. Results

To date, four hands-on training programs have been held in Mozambique (n = 2) and underserved areas of Texas, including the Rio Grande Valley (n = 1) and Laredo (n = 1). In addition, since 2014, 99 ECHO telementoring sessions have been held with providers in the Rio Grande Valley and Laredo (average, n = 23 providers) as well as Mozambique (average, n = 11 providers). Conclusion

Through this cervical cancer prevention education program, we have found that locally held, hands-on training courses using innovative models, complemented with Project ECHO telementoring, is an innovative way to improve cervical cancer screening and prevention efforts in low-resource settings. Evaluation is ongoing to determine the efficacy of these programs compared with traditional training methods.


Funding: The Cancer Prevention Research Institute of Texas, The University of Texas MD Anderson Sister Institution Network Fund, The University of Texas MD Anderson Cancer Center Moon Shots program, and The Prevent Cancer Foundation.