1. CPCRN Cervical Cancer Workgroup Presentation
Annual CPCRN Meeting, Chicago
Tuesday, May 24th
Lead: Karen Glanz, PhD, MPH
Participating Sites: UPenn, UNC, UWash, CDC, NCI
This presentation was supported by Cooperative Agreement Number U48 DP from the Centers for Disease Control and Prevention. The findings and conclusions in this presentation are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

2. Project Objectives & Aims (2015-2017)
Evaluate approaches and methods for increasing adherence to cervical cancer screening guidelines
Systematic review of drivers and strategies for de-escalation of low-value cervical cancer screening practices
Using a “positive deviance” approach, identify model organizational settings and learn from them
(2) Examine the current state of cervical cancer screening practice and key determinants, with a focus on:
Patient/provider perspectives on the new guidelines
Methods for changing the healthy default for cervical cancer screening
The role of insurance policies on reimbursements in guideline adherence
The relationship between patients and providers in communicating/understanding new guidelines
**To result in peer-reviewed publication(s) and grant proposals as applicable.

3. Work Completed/In-Progress
Systematic review of the drivers and strategies for de-escalation of low-value cervical cancer screening practices
Proposal Complete
Timeline: May 2016 to April 2017

4. Literature Review Purpose:
To understand the drivers of de-escalation and the strategies that can be used to increase adherence to cervical cancer screening guidelines.
Background
Existing literature has shown that adherence to 2012 Cervical Cancer Screening guidelines is low. Most providers do not adhere to the longer screening intervals.
Research is needed to understand the drivers of de-escalation and the strategies that can be used to increase adherence to cervical cancer

5. Literature Review Research Questions
What are the drivers of de-escalation of low-value cancer prevention services and practices?
What methods and approaches have been effective in the de- escalation of low-value cancer prevention services and practices?
What methods and approaches that have been effective in increasing cervical cancer screening could be applied to decreasing overuse of cervical cancer screenings?

6. Next Steps *Quality Check, Spot Checks Systematic Literature Steps
Due by
Workgroup Member Roles (Tentative)
Overall coordination of steps & methods
Julia Alber, Alyssa Yackle & Karen Glanz
Collection of articles’ citation and abstract
May 2016
Julia Alber
Initial screening of titles and abstracts (inclusion criteria 1-5)
June 2016
Julia Alber, Cathy Melvin, Linda Ko, & Chyke Doubeni (student) (*KG)
Full screening of titles and abstracts (remaining inclusion criteria/exclusion criteria)
August 2016
Julia Alber, Cathy Melvin & Noel Brewer (student), Anatasha Crawford & Others (*KG)
Full-text articles independently assessed by two researchers/students for eligibility
October 2016
Linda Ko & Noel Brewer (student) & Others (*KG)
Scanning of eligible articles’ reference lists
Linda Ko & Noel Brewer (student), Anatasha Crawford & Others (*KG)
Data extracted
December 2016
Jennifer Leeman (student)
& Others (*KG)
Data synthesized
February 2017
Jennifer Leeman (student), Jennifer Smith, & Others (*KG)
Article written, revised, and prepared for submission
April 2017
Karen Glanz, Cathy Melvin, Linda Ko, Noel Brewer, Julia Alber, Jennifer Smith, Chyke Doubeni, Anatasha Crawford
*Quality Check, Spot Checks

7. Contribution/Impact: D&I Science
(1) Evaluate approaches and methods for increasing adherence to cervical cancer screening guidelines
Systematic review:
Identifies the drivers and strategies for de-escalation of low- value screening practices
Will inform the process of adopting the new cervical cancer guidelines
(2) Examine the current state of cervical cancer screening practice and key determinants
Will inform the process of spreading knowledge related to the new guidelines

8. Contribution/Impact: Cancer Prevention and Control
Will provide better understanding the drivers of adoption of new guidelines
Will identify strategies for improving overall adherence to cervical cancer guidelines
Will determine the need for future research related to guideline adherence

9. Group Discussion
Problems/challenges/decisions
Input from group