Evidence map›Paper›PMID 36241145›Full record

ArticleContemporary clinical trials2022

Design of a pragmatic randomized controlled trial of home-based human papillomavirus (HPV) self-sampling for increasing cervical cancer screening uptake in a U.S. healthcare system: The STEP trial.

Rachel L Winer, John Lin, Melissa L Anderson, Jasmin A Tiro, Richard T Meenan, Kristina Hansen, Hongyuan Gao, Angela Sparks, Dina N Greene, Sony Kilgore-Martin and 2 more

Abstract readClinical Trial Protocol
In one paragraph

Article in Contemporary clinical trials, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Rachel L WinerDepartment of Epidemiology, University of Washington, Box 351619, 3980 15th Ave NE, Seattle, WA 98195, USA; Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA. Electronic address: rlw@uw.edu.
John LinDepartment of Epidemiology, University of Washington, Box 351619, 3980 15th Ave NE, Seattle, WA 98195, USA. Electronic address: indigo@uw.edu.
Melissa L AndersonKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA. Electronic address: Melissa.L.Anderson@kp.org.
Jasmin A TiroDepartment of Population & Data Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA. Electronic address: jtiro@uchicago.edu.
Richard T MeenanCenter for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Ave, Portland, OR 97227, USA. Electronic address: Richard.Meenan@kpchr.org.
Kristina HansenKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA. Electronic address: Kris.L.Hansen@kp.org.
Hongyuan GaoKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA. Electronic address: Hongyuan.Gao@kp.org.
Angela SparksWashington Permanente Medical Group, 320 Westlake Ave N #100, Seattle, WA 98109, USA. Electronic address: angela_sparks@uhc.com.
Dina N GreeneDepartment of Laboratory Medicine, University of Washington, Box 357110, 1959 NE Pacific St, NW120, Seattle, WA 98195, USA; Kaiser Foundation Health Plan of Washington Laboratory, Box 34944, Seattle, WA 98124, USA. Electronic address: dngreene@uw.edu.
Sony Kilgore-MartinWashington Permanente Medical Group, 320 Westlake Ave N #100, Seattle, WA 98109, USA. Electronic address: Sony.P.Kilgore-Martin@kp.org.
Beverly B GreenKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA; Washington Permanente Medical Group, 320 Westlake Ave N #100, Seattle, WA 98109, USA; Department of Health Systems Science, Kaiser Permanente Bernard J Tyson School of Medicine, 98 S Los Robles Ave, Pasadena, CA 91101, USA. Electronic address: Bev.B.Green@kp.org.
Diana S M BuistDepartment of Epidemiology, University of Washington, Box 351619, 3980 15th Ave NE, Seattle, WA 98195, USA; Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA. Electronic address: dsmbuist@gmail.com.

Funding

Self-Testing Options in the era of Primary HPV screening for cervical cancer: the STEP trialR01CA240375 · NCI · KAISER FOUNDATION RESEARCH INSTITUTE · PI GREEN, BEVERLY BETH, WINER, RACHEL L. · 2019 to 2023
$3.0M
NCI NIH HHS R01 CA240375
6 · The paper itself

Abstract

backgroundMailing HPV self-sampling kits to overdue individuals increases cervical cancer screening adherence; offering self-sampling to previously adherent individuals has not been evaluated in the U.S. Given heterogeneity of the U.S. health system and population, data are needed to optimize how HPV self-sampling is offered to individuals who are overdue, due after successful past screening, or have an unknown screening history.

methodsSTEP is a pragmatic randomized controlled trial set within a U.S. integrated healthcare delivery system, designed to compare different outreach approaches for offering HPV self-sampling in populations defined by prior screening behavior (previously-adherent, overdue, or unknown screening history). Over 14 months, eligible individuals were identified through electronic medical record (EMR) data and randomized to Usual Care (UC), Education (UC + educational materials about cervical cancer screening), Direct-Mail (UC + Education + a mailed self-sampling kit) or Opt-In (UC + Education + option to request a kit), depending on screening history. The primary objective is to compare screening completion by outreach approach and screening history. Secondary objectives include evaluating incremental cost-effectiveness of outreach approaches, and identifying patient preference for, and satisfaction with, HPV self-screening, and barriers to abnormal results follow-up (measured through interviews and focus groups).

conclusionsThe trial was designed to generate data that U.S. health systems can use to inform primary HPV screening implementation strategies that incorporate HPV self-sampling options to improve screening access, adherence, and patient satisfaction. The objective of this report is to describe the rationale and design of this pragmatic trial.

Indexed as

AlphapapillomavirusPapillomavirus InfectionsUterine Cervical NeoplasmsDelivery of Health CareEarly Detection of CancerFemaleHumansMass ScreeningPapillomaviridaePragmatic Clinical Trials as TopicRandomized Controlled Trials as TopicSelf CareCervical cancerHuman papillomavirusPragmatic clinical trialScreeningSelf-sampling

Identifiers

PMID36241145
PMCPMC10164445

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.