Table 2 Implementation strategies
Arm | Strategy | Definition | Actor | Action | Target | Dose | Delivery |
|---|---|---|---|---|---|---|---|
Core and Core+ | Provide ongoing consultation | Provide ongoing support to address specific site CCST training needs | Practice-based Research Network Site clinical team | Conduct real-time support and periodic training sessions on CCST through the review of cases captured on AVIVA app (a mobile app that allows images (native cervix, acetic acid- and Lugol iodine-stained cervix) to be uploaded for expert’s review) [59] | Site clinical team | Clinic days (real time) Quarterly (periodic sessions) | Virtual |
Core and Core+ | Conduct educational meetings | Hold meetings among healthcare providers to improve CCST service provision | Site clinical team | Conduct site clinical review meetings on CCST cases, number screened and treated within review period and any other quality improvement issue | Site clinical team | Monthly | In-person |
Core and Core+ | Strengthen ties with stakeholders | Hold meetings with policymakers and donor partners to facilitate availability of commodities and equipment for CCST | Research team | Conduct stakeholder meetings | Ministry of Health PEPFAR IPs Site clinical teams Site medical directors | Quarterly | Virtual |
Core and Core+ | Strengthen referral system | Facilitate referral and easy navigation at referral centers to ensure referred WLHIV with suspected cancer complete referral | Site clinical team | Identify and prepare individuals as referral coordinators to track and support easy navigation at referral centers | WLHIV | Continuous | In-person |
Core and Core+ | Prepare patients to be active participants | Prepare patients to be active participants in their care | Site clinical team | Distribute flyers/leaflets/flip charts on CCST | WLHIV Partners of WLHIV | Continuous | In-person |
Core+ | Community engagement through Healthy Beginning Initiative (HBI) | Engage communities of WLHIV through a congregational-based approach [60,61,62] to educate and create awareness about CC and CCST | Site clinical team Community health team | Conduct HBI incorporating CC and CCST education at HIV support group meetings | PLHIV | Quarterly | In-person |
Core+ | Engage patient using an mHealth platform | Use patient-held smartcard [63, 64] linked to an mHealth platform to record CCST services and track and send appointment reminders to WLHIV | Research team/clinical team | Scan patients’ smartcards and capture CCST information at every study visit Send appointment reminders to patients | WLHIV | Continuous | In person |