NCT05952141

Brief Summary

Investigators will test the effectiveness of adaptive strategies on timely adoption of cervical cancer treatment in Botswana using a pragmatic trial design.

Trial Health

80
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
610

participants targeted

Target at P75+ for not_applicable

Timeline
16mo left

Started Sep 2023

Longer than P75 for not_applicable

Geographic Reach
2 countries

3 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress67%
Sep 2023Aug 2027

First Submitted

Initial submission to the registry

July 11, 2023

Completed
8 days until next milestone

First Posted

Study publicly available on registry

July 19, 2023

Completed
1 month until next milestone

Study Start

First participant enrolled

September 1, 2023

Completed
3.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2026

Expected
8 months until next milestone

Study Completion

Last participant's last visit for all outcomes

August 31, 2027

Last Updated

March 30, 2026

Status Verified

May 1, 2025

Enrollment Period

3.3 years

First QC Date

July 11, 2023

Last Update Submit

March 27, 2026

Conditions

Keywords

ScreeningBotswanaTreatmentPatient

Outcome Measures

Primary Outcomes (1)

  • Adoption

    Defined as the initiation of cervical cancer treatment within 90 days of randomization.

    Within 90 days of randomization

Secondary Outcomes (5)

  • Fidelity

    12 months after randomization

  • Reach: First Appointment

    12 months after randomization

  • Reach: First Stage

    12 months after randomization

  • Reach: Second Stage

    12 months after randomization

  • Reach: Results

    12 months after randomization

Other Outcomes (2)

  • Clinical Outcomes: Treatment

    12 months after randomization

  • Clinical Outcomes: Survival

    12 months after randomization

Study Arms (4)

Stage 1 Clinic Outreach + Stage 2 Low Touch

EXPERIMENTAL

All participants receive direct clinic outreach to communicate readiness of results (stage 1). Participants who do not attend the clinic by 30 days (non-responders) will receive asynchronous text message reminders using framed messaging (stage 2).

Behavioral: Clinic OutreachBehavioral: Low-Touch Strategy

Stage 1 Clinic Outreach + Stage 2 High Touch

EXPERIMENTAL

All participants receive direct clinic outreach to communicate readiness of results (stage 1). Participants who do not attend the clinic by 30 days (non-responders) will receive asynchronous text message reminders using framed messaging in combination with synchronous patient navigation (stage 2).

Behavioral: Clinic OutreachBehavioral: High-Touch Strategy

Stage 1 Enhanced Outreach + Stage 2 Low-Touch

EXPERIMENTAL

All participants receive direct clinic outreach plus enhanced outreach to communicate readiness of results (stage 1). Participants who do not attend the clinic by 30 days (non-responders) will receive asynchronous text message reminders using framed messaging (stage 2).

Behavioral: Enhanced OutreachBehavioral: Low-Touch Strategy

Stage 1 Enhanced Outreach + Stage 2 High-Touch

EXPERIMENTAL

All participants receive direct clinic outreach plus enhanced outreach to communicate readiness of results (stage 1). Participants who do not attend the clinic by 30 days (non-responders) will receive asynchronous text message reminders using framed messaging in combination with synchronous patient navigation.

Behavioral: Enhanced OutreachBehavioral: High-Touch Strategy

Interventions

Clinic OutreachBEHAVIORAL

A member of the pathology team will contact the referring clinic to communicate the readiness of results.

Stage 1 Clinic Outreach + Stage 2 High TouchStage 1 Clinic Outreach + Stage 2 Low Touch

A member of the pathology team will contact both the referring clinic and the patient directly to communicate the readiness of results.

Stage 1 Enhanced Outreach + Stage 2 High-TouchStage 1 Enhanced Outreach + Stage 2 Low-Touch

Patient will be sent asynchronous text messaging reminders related to the importance of timely care using framed messaging in combination with synchronous telephone-based patient navigation.

Stage 1 Clinic Outreach + Stage 2 High TouchStage 1 Enhanced Outreach + Stage 2 High-Touch

Patient will be sent asynchronous text messaging reminders related to the importance of timely care using framed messaging.

Stage 1 Clinic Outreach + Stage 2 Low TouchStage 1 Enhanced Outreach + Stage 2 Low-Touch

Eligibility Criteria

Age18 Years+
Sexfemale
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients will be eligible if they:
  • are biological females
  • are aged 18 or older
  • have pathology-confirmed invasive cervical cancer diagnosis
  • have pathology results evaluated at National Health Laboratory in Botswana
  • are citizens of Botswana
  • have no prior history of invasive cervical cancer

You may not qualify if:

  • Patients will be excluded if they:
  • are biological males or otherwise born without a cervix
  • are below the age of 18 due to the rarity of cervical cancer in this population

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (3)

University of Pennsylvania

Philadelphia, Pennsylvania, 19104, United States

ACTIVE NOT RECRUITING

Nyangabgwe Referral Hospital

Francistown, North-East District, Botswana

RECRUITING

Princess Marina Hospital

Gaborone, Botswana

RECRUITING

Related Publications (1)

  • Rendle KA, Ramogola-Masire D, Grover S; Thibang Diphatlha Collective. Thibang Diphatlha: a sequential multiple assignment randomized trial designed to increase timely adoption of cervical cancer treatment in Botswana. Implement Sci Commun. 2024 Nov 12;5(1):128. doi: 10.1186/s43058-024-00659-9.

MeSH Terms

Conditions

Uterine Cervical Neoplasms

Condition Hierarchy (Ancestors)

Uterine NeoplasmsGenital Neoplasms, FemaleUrogenital NeoplasmsNeoplasms by SiteNeoplasmsUterine Cervical DiseasesUterine DiseasesGenital Diseases, FemaleFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesGenital Diseases

Study Officials

  • Katharine Rendle, PhD,MSW,MPH

    University of Pennsylvania

    PRINCIPAL INVESTIGATOR
  • Surbhi Grover, MD, MPH

    University of Pennsylvania

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
SEQUENTIAL
Model Details: Pragmatic Sequential Multiple Assignment Randomized Trial (SMART). This study uses a sequential randomization design in which all eligible participants will be randomized into one of two interventions at Stage 1 and then participants that do not respond to Stage 1 interventions will be randomized to receive Stage 2 interventions
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

July 11, 2023

First Posted

July 19, 2023

Study Start

September 1, 2023

Primary Completion (Estimated)

December 31, 2026

Study Completion (Estimated)

August 31, 2027

Last Updated

March 30, 2026

Record last verified: 2025-05

Data Sharing

IPD Sharing
Will not share

Locations