Cervical cancer (CC) is the most common cancer among women in Uganda, yet lifetime CC screening is as low as 5%. Training women who have screened for CC to engage in peer advocacy could increase uptake of CC screening in social networks. We conducted a randomized controlled trial of a peer-facilitated, manualized, 7-session group intervention to train women to engage in CC prevention advocacy. Forty women recently screened for CC (index participants) enrolled and were assigned to receive the intervention (n = 20) or wait-list control (n = 20). Each index was asked to recruit up to three female social network members (alters) who had not been screened for CC (n = 103 enrolled alters). All index and alter participants were assessed at baseline and month-6 follow-up. All but one (n = 39; 98%) index and 98 (95%) alter participants completed the month 6 assessment. In multivariate regression models controlling for baseline outcome measures and demographic covariates, intervention alters were more likely to have been screened for CC at month 6 [67% vs. 16%; adjusted OR (95% CI) = 12.13 (4.07, 36.16)], compared to control alters. Data also revealed significant increased engagement in CC prevention advocacy, among both index and alter participants in the intervention group at month 6, compared to the control group. The intervention was highly effective in increasing CC screening uptake among social network members, and engagement in CC prevention advocacy among not only intervention recipients, but also targets of advocacy, suggesting the potential for wide dissemination of CC knowledge.

Trial Registration. NIH Clinical Trial Registry NCT04960748 (clinicaltrials.gov).

宫颈癌 (CC) 是乌干达女性最常见的癌症，但终生宫颈癌筛查率低至 5%。对接受过 CC 筛查的女性进行培训，让她们参与同伴宣传，可以提高社交网络中 CC 筛查的接受度。我们进行了一项随机对照试验，采用同伴协助、手动、7 次小组干预的方式来培训女性参与 CC 预防宣传。最近对 40 名女性进行了 CC（索引参与者）筛查，并被分配接受干预组 (n = 20) 或等待名单对照组 (n = 20)。每个索引都被要求招募最多三名未接受 CC 筛查的女性社交网络成员（改变者）（n = 103 名登记改变者）。所有索引和更改参与者均在基线和第 6 个月随访时进行评估。除一名 (n = 39; 98%) 指数参与者和 98 名改变参与者 (95%) 外，所有参与者都完成了第 6 个月的评估。在控制基线结果测量和人口统计协变量的多变量回归模型中，干预改变者更有可能在第 6 个月进行 CC 筛查 [67% vs. 16%；与对照改变相比，调整后的 OR (95% CI) = 12.13 (4.07, 36.16)]。数据还显示，与对照组相比，第 6 个月干预组中的指数参与者和改变参与者对 CC 预防宣传的参与度显着增加。该干预措施非常有效地提高了社交网络成员对 CC 筛查的接受度，并且不仅在干预接受者中，而且在宣传目标中也参与了 CC 预防宣传，这表明 CC 知识广泛传播的潜力。

试用注册。NIH 临床试验注册中心 NCT04960748 (clinicaltrials.gov)。