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Barriers to Adoption of Evidence-based Practice for Cervical Cancer Prevention in the Dominican Republic: Practices and Perspectives of Providers in the Santo Domingo and Monte Plata Provinces
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| 자료유형 | 학위논문 |
|---|---|
| 서명/저자사항 | Barriers to Adoption of Evidence-based Practice for Cervical Cancer Prevention in the Dominican Republic: Practices and Perspectives of Providers in the Santo Domingo and Monte Plata Provinces. |
| 개인저자 | Liebermann, Erica J. |
| 단체저자명 | New York University. College of Nursing. |
| 발행사항 | [S.l.]: New York University., 2019. |
| 발행사항 | Ann Arbor: ProQuest Dissertations & Theses, 2019. |
| 형태사항 | 176 p. |
| 기본자료 저록 | Dissertations Abstracts International 81-04B. Dissertation Abstract International |
| ISBN | 9781687956286 |
| 학위논문주기 | Thesis (Ph.D.)--New York University, 2019. |
| 일반주기 |
Source: Dissertations Abstracts International, Volume: 81-04, Section: B.
Advisor: Van Devanter, Nancy. |
| 이용제한사항 | This item must not be sold to any third party vendors. |
| 요약 | BackgroundThe global call to action against cervical cancer is strong and gaining momentum. In 2018, nearly 570,000 women were diagnosed with cervical cancer worldwide, and annual incidence is expected to increase to 700,000 in the next decade if current trends are not interrupted. We now have the tools and knowledge to eradicate this highly preventable cancer, with human papillomavirus (HPV) vaccination for primary prevention and HPV testing for secondary prevention, but gaps remain in translating that scientific evidence to policy and practice in the places most impacted by cervical cancer. The Dominican Republic is a country with high rates of cervical cancer, despite the existence of Pap smear screening programs. This study examined Dominican providers' cervical cancer screening practices, their beliefs about evidence-based practice for cervical cancer screening (HPV testing for women over 30, every 5 years) and their opinions about barriers to effective cervical cancer prevention in the Dominican Republic.MethodsThis was a convergent mixed methods study, guided by the Theory of Planned Behavior (TPB) and the Consolidated Framework for Implementation Research (CFIR). In-depth qualitative interviews were conducted with 21 health care providers and GYN community leaders in Santo Domingo and Monte Plata provinces. A separate sample of 202 OB/GYNs, family physicians, general practice physicians, and OB/GYN residents in Santo Domingo and Monte Plata completed interviewer-administered quantitative surveys. Qualitative and quantitative data were analyzed separately, and then integrated across CFIR/TPB constructs, allowing for mixed methods comparison of results. ResultsBarriers to adoption of EBP were limited provider knowledge regarding global guidelines and the push towards HPV testing for primary screening, current practices of screening women at an early age and frequently, and provider doubts regarding the feasibility and appropriateness of a change toward HPV testing for women over 30 every 5 years in the Dominican population. Facilitators to a change in practice were a sense of urgency regarding cervical cancer incidence and mortality in the Dominican Republic, a medical culture of evidence-driven practice, and provider receptivity to integration of HPV testing into all health sectors. Conclusions and Implications This study provided better understanding of Dominican providers' current cervical cancer screening practices, awareness of and attitudes towards HPV testing and evolving evidence-based guidelines for screening, and provider perceptions of barriers to effective cervical cancer prevention in the Dominican Republic. Dominican Providers are clearly ready for change, are dissatisfied with current realities of cervical cancer mortality and would like to see stronger value placed on prevention, both at the individual and community level and at the structural level of health system investment. Further research is needed with additional stakeholders and data sources to explore whether the EBP defined here for cervical cancer screening is appropriate, acceptable and feasible in the Dominican Republic. |
| 일반주제명 | Nursing. Public health. |
| 언어 | 영어 |
| 바로가기 | 
: 이 자료의 원문은 한국교육학술정보원에서 제공합니다. |
