# Implementation Evaluation of a Workplace Self-Sampling HPV Detection Program within the Mexican Social Security Institute

> **NIH NIH U54** · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · 2024 · $127,173

## Abstract

Cervical cancer (CC) is the second leading cause of cancer death among women in Mexico, yet screening
participation is alarmingly low, with less than 30% of women aged 20 or older having ever been screened in
2022. Human papillomavirus (HPV) self-sampling is an effective method that increases accessibility for
women facing barriers such as embarrassment, fear of pain, or logistical challenges. The Mexican Social
Security Institute (IMSS), the largest healthcare provider in Mexico, serves 31 million women and has begun to
implement programs to examine the potential of using HPV-based screening. In October 2022, IMSS launched
the IMSS Maquiladora HPV Screening Program (IMHSP) in Chihuahua, targeting 35,000 under-screened
women working in maquiladoras. As of April 2024, 11,878 workers were screened, but adoption,
implementation, and effectiveness varied widely across maquiladoras and there was sub-optimal follow-up to
abnormal results.
 Our long-term goal is to reduce CC morbidity and mortality in Mexico. The goal of the proposed study is
to identify factors influencing the adoption, implementation, and sustainment of the IMHSP, assess program
effectiveness and implementation outcomes, and design implementation strategies to improve program use
and sustainment. Using Implementation Mapping, the Consolidated Framework for Implementation Research
(CFIR), and RE-AIM, we will: 1) Identify barriers and facilitators to the adoption and implementation of the
IMHSP and describe implementation and effectiveness outcomes by conducting interviews, observations, and
discussion sessions with stakeholders and personnel in maquiladoras and IMSS clinics. 2) Explore factors
influencing program integration and screening completion from the perspectives of patients and IMSS
healthcare providers in clinical settings. We will conduct semi-structured interviews with female workers who
participated in the program and were HPV positive, and with clinical personnel at IMSS clinics; and, 3) Design
implementation strategies based on findings.
 This proposal if for an administrative supplement to a parent U54 LISTOS (Leveraging
Implementation Science to Optimize Strategies) for cancer control. LISTOS is a National Cancer Institute
(NCI)-funded center through the Global Implementation Science for Equitable Cancer Control (GlobalISE
Cancer Control) program to establish implementation science centers in low- and middle-income countries
(LMICs). The LISTOS center focuses on strengthening implementation research and research capacity in
Mexico and Latin America. This proposed study advances the goals of LISTOS and provides training
opportunities for our junior colleagues. This study addresses a pressing need for improved cervical cancer
control in Mexico and will inform scalable strategies to enhance screening participation across worksites
significantly advancing public health efforts and reducing cervical cancer mortality in underserved populations.

## Key facts

- **NIH application ID:** 11093854
- **Project number:** 3U54CA284109-02S1
- **Recipient organization:** UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
- **Principal Investigator:** Maria Eulalia Fernandez
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $127,173
- **Award type:** 3
- **Project period:** 2023-09-20 → 2028-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11093854

## Citation

> US National Institutes of Health, RePORTER application 11093854, Implementation Evaluation of a Workplace Self-Sampling HPV Detection Program within the Mexican Social Security Institute (3U54CA284109-02S1). Retrieved via AI Analytics 2026-06-01 from https://api.ai-analytics.org/grant/nih/11093854. Licensed CC0.

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