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Table 5 Adherence to the core components of EMA strategy and moderating factors

From: Assessing the implementation fidelity of HPV self-collection offered by community health workers during home visits (the EMA strategy): a case study in a low-middle-resource setting in Argentina

Adherence

Level of adherence (% range of adherence)

Moderating factors that affect level of adherence (+ positive / − negative)

Content: core components of the strategy

Training

92–100%

Context: Stakeholder engagement, Political will (+)

Political will (+) Participant responsiveness: motivation of health promoters, active participation of local stakeholders during planning and implementation of training (pre-implementation phase) (+)

Offer of HPV self-collection

54%

Context: urban insecurity (−) / reduction of number of health promoters that were involved in cervical cancer prevention (−) Previous experience in community work allowed changes in the place of the offer (+)

22–70%

Context: less time to do the offer (−) /reduction of information during the offer

Intervention complexity: several pieces of information (-)

27–82%

36–90%

Sample handling and transportation

96–98%

Facilitator strategies: feedback and supervision in different levels of the health system: health care centers—HPV lab—second-level hospitals (+)

Participant responsiveness: motivation and active participation of health promoters, supervisors, and local stakeholders (+)

Follow-up and treatment

Triage: 38% (318/830)

Intervention complexity: different levels of health system involved in screening—triage—diagnosis and treatment (−)

Diagnosis: 64% (34/49)

Treatment: 100% (13/13)

Dose

 Duration (mean)

8 min

 

Coverage

 Coverage (% of women who accepted SC)

79%