The candidate is a research assistant professor with academic training in health promotion, education, and behavior, as well as postdoctoral training in HIV/AIDS prevention, health disparities, and health services research. She also has data management expertise and clinical immunology experience. The candidate has completed two pilot studies that examined HPV infection and cervical cancer prevention knowledge, beliefs and screening behaviors among women living with HIV (WLH). The candidate is seeking additional training needed to develop and implement effective cancer health (including mHealth) communication and community navigation strategies to improve WLH's timely use of cancer screening, diagnostic and treatment services and procedures. The candidate's long-term goal is to obtain extramural research funding for her independent research program focusing on the prevention and control of HPV-mediated cancers among WLH over the next 5-10 years. Promotion to associate professor (tenure- or research-track) is an intermediate goal that the candidate is striving to attain within the next five years. A combination of formal didactic trainig and experiential learning opportunities will be used to acquire cancer prevention and control research skills in the following areas: cancer health (including mHealth) communication, cancer epidemiology, HPV-mediated cancer biology, community navigation, advanced epidemiological research skills (e.g., social epidemiology, n- of-1 research study designs, and, multilevel modeling). The candidate will use the cancer prevention and control research and health communication knowledge and skills acquired through the proposed career development award to conduct formative research needed to inform intervention development in which she will examine cancer health information seeking and sharing among WLH as well as their non-clinical HIV service providers (e.g., HIV/STI risk reduction counselors). Non-clinical HIV service providers will be included because, in addition to the fact that these individuals are already promoting safe sexual practices among WLH, they are also able to reach marginalized groups of WLH such as those who are homeless. This includes sheltered and unsheltered homeless WLH. The candidate's mentors and co-mentors have scientific expertise and community-based participatory research experience that will increase the likelihood of the proposed specific aims being successfully completed. The candidate will first examine HPV-mediated cancer prevention knowledge, beliefs and behaviors, as well as cancer health communication seeking and sharing behaviors (including the use of technology to find health information) (Aim 1). These formative research data will then be used to inform the development (Aim 2) and subsequent pilot testing and evaluation (Aim 3) of an HPV- mediated cancer prevention mHealth education intervention aimed at training WLH who already serve as peer leaders and non-clinical HIV service providers to use mHealth tools and community navigation strategies to disseminate HPV-mediated cancer prevention education. As community navigators, these individuals will use cancer health (including mHealth) communication and community navigation strategies to increase awareness about HPV-mediated cancer risk. This will include promoting cancer risk reducing behaviors such as safe sexual practices and the timely use of recommended cancer screening, diagnostic, and treatment services and procedures). Recall and reminder messages will be sent for screening and follow-up cancer care appointments. User-defined social support messages will also be sent to WLH who may be encountering access to cancer care barriers. The candidate will disseminate the scientific research findings to local, regional, national, and international audiences via presentations that she will give at scientific conferences and annual meetings as well as peer-reviewed publications that she will produce. Most relevant to the candidate's long-term goal of attaining research independence is increasing her number of peer-reviewed publications from her current publication rate of approximately three per year to four or more produced annually by the end of the 5-year training period and the submission of at least one grant proposal (e.g., R01-level funding) by the end of the 5-year training period. The proposed career development/training and research activities will enable the candidate to realize her long-term career goal of becoming an independent cancer researcher with expertise in using cancer health communication, community navigation, and mHealth technologies to address health system failures encountered by vulnerable, medically-underserved WLH along the cancer care continuum. Continued mentoring and opportunities for team science research collaborations will facilitate the candidate's successful progression to being an independent cancer researcher. WLH and non-clinical HIV service providers will be recruited from Ryan White funded clinics and AIDS-service organizations located in urban and rural geographical areas of South Carolina that represent a microcosm of disparities in HIV/AIDS, cancer, and other chronic illness that disproportionately burden medically underserved minority populations. Addressing health system failures that occur along the cancer care continuum that result in missed opportunities to prevent, detect, diagnose and treat HPV-mediated cancers will help to reduce the burden of cancer incidence and mortality among this high cancer risk, vulnerable group of WLH. The proposed HPV-mediated cancer mHealth prevention education intervention will be conducted in a community-based setting and builds upon an existing academic-community partnership between the candidate and a local AIDS-service organization. The candidate has a supportive, resource-intensive scientific environment for her cancer research training.
HIV-positive women, who are predominantly African-American (AA) with an already disproportionate burden of cervical cancer, have a greater risk for developing cervical cancer as well as other HPV-mediated anogenital and head-and-neck cancers because of their weakened immune systems that decrease their body's ability to clear potentially oncogenic HPV infection. Innovative community-driven mHealth solutions focused on addressing cancer prevention knowledge deficits and promoting adherence to recommended cancer screening, detection and treatment services and procedures will be developed and evaluated. Mobile technologies are a promising, cost-effective approach to reducing these cancer health disparities among women living with HIV/AIDS by improving HPV-mediated cancer health outcomes and timely use of cancer care services for this high cancer risk, vulnerable group of largely medically underserved women.
