I spent the summer living in Cusco, Peru and participating in two research projects associated with a clinic called CerviCusco, a Peruvian NGO that provides women’s health services and has a focus on reducing the incidence and prevalence of cervical cancer among Peruvian women. On a typical day, I would either work in the clinic itself or at a mobile campaign in another area of Cusco or in a surrounding region. I worked primarily with survey administration for both the HPV vaccination compliance, and Papanicolaou test follow-up projects.
The first project sought to evaluate levels of HPV vaccination series compliance, quantify knowledge about HPV and the HPV vaccine among the patient population, understand attitudes toward HPV vaccination, and identify barriers to compliance with the vaccination dosing schedule. The survey was administered to patients between the ages of 18 and 26 who were receiving their second or third dose of the HPV vaccine. There were two version of the survey; both versions contained some of the same questions, such as patient demographic information and those to measure patient knowledge of HPV and understanding of the HPV vaccine. The surveys differed depending on whether the patient was successfully following the recommended dosing schedule for the vaccine series. For compliant patients, the survey sought to identify factors that facilitated their compliance, while for noncompliant patient, the survey tried to identify barriers to compliance.
The second project also involved survey administration but focused on the possibility of implementing an incentive system to enhance Papanicolaou test follow-up. The clinic provides many Papanicolaou tests both in the clinic and at mobile campaigns, that are currently offered either free or at very low cost. However, the problem has arisen that many women do not return to receive the results of their exams and therefore many women who are found to have cervical cancer never receive treatment. To mitigate this issue, this project sought to identify attitudes toward and feasibility of implementing an incentive system among this patient population. Under this system, the women would pay a fee for their Papanicolaou exam, and this money would be reimbursed to them when they received their test result. In addition to demographics and some patient history information regarding experiences with Papanicolaou tests in the past, the survey sought to determine whether, for example, the women in this patient population would be willing and able to participate in such a system, and whether they believed an incentive would facilitate their receipt of their results. Survey administration for this study was at times more challenging, particularly at campaigns in more rural areas, in which much of the patient population could not read or write. In this case, I also had to read/explain the survey questions for the patients and fill in their answers. Data analysis is currently ongoing for both projects.
These projects sought to contribute one of the missions of the clinic: to reduce cervical cancer among Peruvian women. As the leading cause of cancer deaths among women in Peru, cervical cancer is a very prevalent issue in this patient population. However, it is also preventable in the majority of cases, with vaccination prior to infection. These projects tackle this issue from both a prevention and treatment standpoint, by trying to identify ways to increase HPV vaccination compliance and increase follow-up after Papanicolaou exams.