Development of Systems and Education for Cervical Cancer Prevention (DOSE-CC)

NCT ID: NCT07226037

Last Updated: 2025-11-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

80000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2027-05-31

Study Completion Date

2030-01-31

Brief Summary

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Cervical cancer disproportionately impacts those who have not accessed screening or follow-up. Universal screening has the potential to decrease the overall burden of cervical cancer. However, more than half of the individuals who develop cervical cancer have not been screened in more than 5 years, and 20% did not follow-up after an abnormal result.

To address this problem, the investigators will adapt and test an intervention to improve cervical screening and follow-up in three different settings: Northeastern US urban inner city (Boston), Southeastern US suburban (Florida), and remote west, rural (Hawaii). Our research group previously developed a successful intervention to improve primary cervical cancer prevention, which will be adapted for cervical cancer screening. The intervention combines education and quality improvement methods using a mechanism called Performance Improvement Continuing Medical Education. This type of intervention is attractive to clinicians because they are able to improve their cancer prevention practices while fulfilling requirements for maintaining board certification.

When applied to primary prevention, the intervention improved rates by over 10 percentage points, and gains continued for over 4 years after the intervention concluded. The goal of the proposed research is to adapt the intervention to cervical cancer screening, and to evaluate its effectiveness in improving cervical cancer screening and follow-up after abnormal results.

The proposed intervention represents an innovative and scalable model for promoting cancer prevention and screening activities by clinicians. Unlike programs that increase administrative burdens on busy clinicians, the proposed intervention allows clinicians to improve cancer prevention practices while simultaneously fulfilling requirements to maintain their board certification and improving the quality of cancer prevention care. It therefore has great potential for widespread dissemination.

Detailed Description

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The research will specifically address the following objectives.

First, the investigators' successful primary prevention intervention will be adapted to address cervical cancer screening (DOSE-CC \[Development of Systems and Education for Cervical Cancer Prevention\]). Key stakeholders will be interviewed to explore facilitators and barriers to screening and follow-up at the patient, clinician, and healthcare setting levels and use these findings and Advisory Board input to develop the DOSE-CC intervention.

Second, the investigators will validate DOSE-CC using a Hybrid Type 1 effectiveness-implementation, stepped wedge randomized controlled trial design of the 6-month intervention, reaching over 40,000 patients.

Third, guided by the RE-AIM QuEST (Reach, Effectiveness, Adoption, Implementation Qualitative Evaluation for Systemic Translation) framework, the investigators will conduct semi-structured interviews of key stakeholders to examine intervention reach, adoption, implementation, maintenance and sustainability, and barriers and facilitators of intervention success.

Conditions

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Cervical Cancer Screening Cervical Cancer

Keywords

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DOSE-CC cervical cancer prevention

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Step wedge randomized trial
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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DOSE-CC Intervention: Educational Sessions

The primary goals of the DOSE-CC intervention are to 1) use education and training to increase clinician motivation to provide guideline-concordant screening and follow-up and reduce missed opportunities, and 2) support systems changes to improve screening and follow-up processes. Repeated contacts with clinicians will be used to reinforce learned concepts and motivate participants to achieve their goals. The first two sessions will follow a standardized curriculum, while the last three sessions will include development and implementation of tailored activities designed to address systems barriers and meet individual practice needs.

Group Type EXPERIMENTAL

DOSE-CC Intervention: Educational Sessions

Intervention Type BEHAVIORAL

Session 1: Introduction to the project, and feedback/discussion around clinic screening rates.

Session 2: Education on cervical cancer, impact of screening on cancer prevention and health equity, different methods of screening, and recent updates to screening and follow-up guidelines.

Session 3: Action plan development. Sessions 4 and 5: Quality improvement through plan-do-study-act cycles and assessment of the success of the action plan.

Interventions

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DOSE-CC Intervention: Educational Sessions

Session 1: Introduction to the project, and feedback/discussion around clinic screening rates.

Session 2: Education on cervical cancer, impact of screening on cancer prevention and health equity, different methods of screening, and recent updates to screening and follow-up guidelines.

Session 3: Action plan development. Sessions 4 and 5: Quality improvement through plan-do-study-act cycles and assessment of the success of the action plan.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Active patients (defined as having a primary care provider assigned at the clinical site and with an appointment in the past 18 months)
* Eligible for cervical cancer screening (e.g., has a cervix and not up to date with screening)

Exclusion Criteria

* None
Minimum Eligible Age

21 Years

Maximum Eligible Age

65 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Boston Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lunze Karsten, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Boston Medical Center, General Internal Medicine

Central Contacts

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Rebecca Perkins, MD, MSc

Role: CONTACT

Phone: 617-568-4441

Email: [email protected]

Other Identifiers

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R01CA299475

Identifier Type: NIH

Identifier Source: secondary_id

View Link

H-46139

Identifier Type: -

Identifier Source: org_study_id