title: Using community engagement to inform and implement a community-randomized controlled trial in the anishinaabek cervical cancer screening study.
abstract: Social, political, and economic factors are directly and indirectly associated with the quality and distribution of health resources across Canada. First Nations (FN) women in particular, endure a disproportionate burden of ill health in contrast to the mainstream population. The complex relationship of health, social, and historical determinants are inherent to increased cervical cancer in FN women. This can be traced back to the colonial oppression suffered by Canadian FN and the social inequalities they have since faced. Screening - the Papinacolaou (Pap) test - and early immunization have rendered cervical cancer almost entirely preventable but despite these options, FN women endure notably higher rates of diagnosis and mortality due to cervical cancer. The Anishinaabek Cervical Cancer Screening Study (ACCSS) is a participatory action research project investigating the factors underlying the cervical cancer burden in FN women. ACCSS is a collaboration with 11 FN communities in Northwest Ontario, Canada, and a multidisciplinary research team from across Canada with expertise in cancer biology, epidemiology, medical anthropology, public health, virology, women's health, and pathology. Interviews with healthcare providers and community members revealed that prior to any formal data collection education must be offered. Consequently, an educational component was integrated into the existing quantitative design of the study: a two-armed, community-randomized trial that compares the uptake of two different cervical screening modalities. In ACCSS, the Research Team integrates community engagement and the flexible nature of participatory research with the scientific rigor of a randomized controlled trial. ACCSS findings will inform culturally appropriate screening strategies, aiming to reduce the disproportionate burden of cervical disease in concert with priorities of the partner FN communities.
authors.affiliation: Thunder Bay Regional Research Institute , Thunder Bay, ON , Canada.
authors.forename: Brianne
authors.initials: B
authors.lastname: Wood
authors.affiliation: Ontario HIV Treatment Network , Toronto, ON , Canada ; Dalla Lana School of Public Health , Toronto, ON , Canada.
authors.forename: Ann N
authors.initials: AN
authors.lastname: Burchell
authors.affiliation: Department of Pathology and Laboratory Medicine, Thunder Bay Regional Health Sciences Centre , Thunder Bay, ON , Canada.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Escott
authors.affiliation: Department of Epidemiology and Community Medicine, University of Ottawa , Ottawa, ON , Canada.
authors.forename: Julian
authors.initials: J
authors.lastname: Little
authors.affiliation: Faculty of Human Sciences, Northern Ontario School of Medicine , Sudbury, ON , Canada.
authors.forename: Marion
authors.initials: M
authors.lastname: Maar
authors.affiliation: Clinical Prevention Services, BC Centre for Disease Control , Vancouver, BC , Canada.
authors.forename: Gina
authors.initials: G
authors.lastname: Ogilvie
authors.affiliation: Viral Exanthemata and STD Section, National Microbiology Laboratory, Public Health Agency of Canada , Winnipeg, MB , Canada.
authors.forename: Alberto
authors.initials: A
authors.lastname: Severini
authors.affiliation: Biology Department, Lakehead University , Thunder Bay, ON , Canada.
authors.forename: Lisa
authors.initials: L
authors.lastname: Bishop
authors.affiliation: Biology Department, Lakehead University , Thunder Bay, ON , Canada.
authors.forename: Kyla
authors.initials: K
authors.lastname: Morrisseau
authors.affiliation: Thunder Bay Regional Research Institute , Thunder Bay, ON , Canada.
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Zehbe
keywords: cervical screening; community engagement; indigenous health; social determinants of health disparities; women’s health