175 lines
5.8 KiB
YAML
175 lines
5.8 KiB
YAML
abstract: 'Introduction: Health system delays in diagnosis of cancer contribute to
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the glaring disparities in cancer mortality between high-income
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countries and low- and middle-income countries. In Botswana,
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approximately 70\% of cancers are diagnosed at late stage and median
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time from first health facility visit for cancer-related symptoms to
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specialty cancer care was 160 days (IQR 59-653). We describe the
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implementation and early outcomes of training targeting primary care
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providers, which is a part of a multi-component implementation study in
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Kweneng-East district aiming to enhance timely diagnosis of cancers.
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Methods: Health-care providers from all public facilities within the
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district were invited to participate in an 8-h intensive short-course
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program developed by a multidisciplinary team and adapted to the
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Botswana health system context. Participants'' performance was assessed
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using a 25-multiple choice question tool, with pre- and post assessments
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paired by anonymous identifier. Statistical analysis with Wilcoxon
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signed-rank test to compare performance at the two time points across
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eight sub-domains (pathophysiology, epidemiology, social context,
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symptoms, evaluation, treatment, documentation, follow-up). Linear
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regression and negative binomial modeling were used to determine change
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in performance. Participants'' satisfaction with the program was measured
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on a separate survey using a 5-point Likert scale.
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Results: 176 participants attended the training over 5 days in April
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2016. Pooled linear regression controlling for test version showed an
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overall performance increase of 16.8\% after participation (95\% 01
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15.2-18.4). Statistically significant improvement was observed for seven
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out of eight subdomains on test A and all eight subdomains on test B.
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Overall, 71 (40.3\%) trainees achieved a score greater than 70\% on the
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pretest, and 161 (91.5\%) did so on the posttest. Participants reported
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a high degree of satisfaction with the training program''s content and
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its relevance to their daily work.
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Conclusion: We describe a successfully implemented primary health care
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provider focused training component of an innovative intervention aiming
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to reduce health systems delays in cancer diagnosis in sub-Saharan
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Africa. The training achieved district-wide participation, and
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improvement in the knowledge of primary health-care providers in this
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setting.'
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affiliation: 'Tapela, NM (Corresponding Author), Botswana Harvard AIDS Inst Partnership,
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Gaborone, Botswana.
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Tapela, NM (Corresponding Author), Brigham \& Womens Hosp, Div Global Hlth Equ,
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75 Francis St, Boston, MA 02115 USA.
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Tapela, Neo M.; Botebele, Kerapetse; Gabegwe, Kemiso; Nkele, Isaac; Mmalane, Mompati;
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Barak, Tomer; Lockman, Shahin; Dryden-Peterson, Scott, Botswana Harvard AIDS Inst
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Partnership, Gaborone, Botswana.
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Tapela, Neo M.; Peluso, Michael J., Brigham \& Womens Hosp, Div Global Hlth Equ,
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75 Francis St, Boston, MA 02115 USA.
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Peluso, Michael J., Brigham \& Womens Hosp, Dept Med, 75 Francis St, Boston, MA
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02115 USA.
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Kohler, Racquet E., Dana Farber Canc Inst, Ctr Community Based Res, Harvard TH Chan
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Sch Publ Hlth, Dept Social \& Behav Sci, Boston, MA 02115 USA.
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Setlhako, Irene I., Princess Marina Hosp, Minist Hlth \& Wellness, Gaborone, Botswana.
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Narasimhamurthy, Mohan, Univ Botswana, Fac Med, Dept Pathol, Gaborone, Botswana.
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Grover, Surbhi, Univ Penn, Philadelphia, PA 19104 USA.
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Grover, Surbhi, Botswana Upenn Partnership, Gaborone, Botswana.
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Barak, Tomer, Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA 02215 USA.
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Shulman, Lawrence N., Univ Penn, Abramson Canc Ctr, Ctr Global Canc Med, Philadelphia,
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PA 19104 USA.
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Lockman, Shahin; Dryden-Peterson, Scott, Harvard TH Chan Sch Publ Hlth, Boston,
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MA USA.
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Lockman, Shahin; Dryden-Peterson, Scott, Brigham \& Womens Hosp, Div Infect Dis,
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75 Francis St, Boston, MA 02115 USA.'
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article-number: '187'
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author: Tapela, Neo M. and Peluso, Michael J. and Kohler, Racquet E. and Setlhako,
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Irene I. and Botebele, Kerapetse and Gabegwe, Kemiso and Nkele, Isaac and Narasimhamurthy,
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Mohan and Mmalane, Mompati and Grover, Surbhi and Barak, Tomer and Shulman, Lawrence
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N. and Lockman, Shahin and Dryden-Peterson, Scott
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author-email: ntapela@gmail.com
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author_list:
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- family: Tapela
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given: Neo M.
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- family: Peluso
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given: Michael J.
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- family: Kohler
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given: Racquet E.
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- family: Setlhako
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given: Irene I.
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- family: Botebele
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given: Kerapetse
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- family: Gabegwe
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given: Kemiso
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- family: Nkele
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given: Isaac
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- family: Narasimhamurthy
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given: Mohan
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- family: Mmalane
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given: Mompati
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- family: Grover
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given: Surbhi
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- family: Barak
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given: Tomer
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- family: Shulman
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given: Lawrence N.
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- family: Lockman
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given: Shahin
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- family: Dryden-Peterson
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given: Scott
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da: '2023-09-28'
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doi: 10.3389/fonc.2018.00187
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files: []
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issn: 2234-943X
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journal: FRONTIERS IN ONCOLOGY
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keywords: 'cancer early diagnosis; health system delays; primary care; primary care
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providers; Botswana; sub-Saharan Africa; training'
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keywords-plus: 'BREAST-CANCER; ORAL-CANCER; DELAYS; INDIA; CHALLENGES; PATHOLOGY;
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SERVICES; ONCOLOGY; WORKERS; ACCESS'
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language: English
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month: MAY 29
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number-of-cited-references: '42'
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orcid-numbers: 'Dryden-Peterson, Scott/0000-0002-8487-9731
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Tapela, Neo/0000-0002-2048-3973'
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papis_id: 67f20cf58a42dcf87059ee7b372f9d0f
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ref: Tapela2018steptimely
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researcherid-numbers: 'narasimahmurthy, mohan/AAM-8077-2021
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'
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times-cited: '12'
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title: 'A Step Toward Timely Referral and Early Diagnosis of Cancer: Implementation
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and Impact on Knowledge of a Primary Care-Based Training Program in Botswana'
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type: article
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unique-id: WOS:000433304500001
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usage-count-last-180-days: '0'
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usage-count-since-2013: '4'
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volume: '8'
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web-of-science-categories: Oncology
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year: '2018'
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