Sunrise Oncology Applied Research (SOAR) Center
Sunrise Oncology
Applied Research
(SOAR) Center.
We are able to tackle some of the most difficult scientific and social problems in the world by combining the intellectual prowess of top scientists and specialists in important practice areas. We oversee projects for a variety of clients, including international NGOs, foundations, government organizations, and private businesses.
We provide complete services and skills in all of these professional areas to support our clients’ missions and objectives.
Motivated by our personal goal of enhancing human welfare, we endeavor to develop and implement technological and programmatic solutions that will have a beneficial global impact.
Meet the SOAR TEAM
Associate Director SOAR Center
Senior Research Investigator, SOAR Center
Research Manager, SOAR Center
Integrating Palliative Care into care of HIV-Positive Women in Primary/Secondary Health Facilities in Nigeria (The INTERWOVEN Study)
Overview
The INTERWOVEN Study is a one-year (August 2023 – September 2024) World Health Organization-sponsored supplement grant aimed at identifying gaps in knowledge, awareness, and access to palliative care of Women Living With HIV (WLHIV), determining the barriers and facilitators influencing the integration of palliative care into routine HIV care in PHC, and exploring implementation strategies that can be employed to integrate and sustain palliative care into routine HIV care in primary and secondary health facilities in Nigeria. This study is being conducted in the six geo-political zones of Nigeria at the ICON-3 Practice-Based Research Networks of the Nigeria Implementation Science Alliance (NISA)..
Background
The four major non-communicable diseases (NCDs) in Nigeria namely cancers, diabetes, cardiovascular diseases and chronic respiratory diseases account for about 29% of deaths annually. Cancer is responsible for 72,000 deaths, with an estimated 102, 000 new cases annually in Nigeria. Cervical cancer (CC) is the 4th most common cancer in the world and 2nd most common cancer among Nigerian women. The risk of CC is greater in women living with HIV (WLHIV) infection compared to women without the infection. Early detection, treatment, and palliative care (PC) have been shown toimprove outcomes, increase the chances of patients’ survival, and enhance a clinician’s knowledge, skills, and confidence, resulting in improved patient satisfaction with clinical care. The lack of integration of PC into primary health care (PHC) is undermining real opportunities to improve the quality of life and survival among WLWH, especially those with cervical cancer.
Approach and Study Aims
The INTERWOVEN Study is being implemented across the six
geopolitical zones in Nigeria and leverage the ICON-3 Practice Based Research Network of the Nigeria Implementation Science Alliance (NISA). The INTERWOVEN Study is a sequential mixed method study guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. The study core
aims are:
• Identify gaps in knowledge, awareness, and access to palliative care: A validated questionnaire was distributed among childbearing women (15-49yrs) who are receiving care in study sites, to access gaps, barriers, and facilitators of integrating palliative care into HIV programs in the primary and secondary health facilities.
• Determine barriers and facilitators that influence the integration of palliative care: FGDs were conducted with women (15-49yrs) who access the NISA-MIRCs sites for care, Key informant
interviews were used to solicit information from clinicians who provide care to women in the site. In-depth interviews were conducted with Primary healthcare workers in the PHC centers
around the study sites to further understand gaps, barriers, facilitators, and possible sustainable strategies for integrating palliative care in routine HIV care.
• Explore implementation strategies that can be employed to integrate and sustain palliative care into routine HIV care in PHCs: Using an NGT process, the team will conduct an implementation
mapping to match the well-defined ERIC set of strategies to barriers identified from Aim 2.
Study Measures and Outcomes:
The INTERWOVEN Study implementation will be evaluated based
on its outcomes.
1. Gaps in awareness, knowledge and access to Palliative Care services among HIV+ women.
2. Contextual barriers and facilitators to integration of palliative care into routine HIV care
3. Implementation mapping to identify strategies to integrate and sustain palliative care in HIV care.
For more information about the INTERWOVEN Study, contact: admin@ivaninstitute.org
PI: Ngozi Idemili-Aronu, PhD; University of Nigeria, Nsukka, Enugu: ngozi.idemiliaronu@unn.edu.ng
Feasibility and Acceptability of Culturally Adapted and integrated Palliative Care Services to promote well-being of Women living with HIV and Cervical Cancers (PACE-2 Study)
Overview
The PACE-2 Study is a one-year (September 2023 – September 2024) supplement to the 5-year National Institutes of Health sponsored grant – Accelerating Cervical Cancer Elimination through
the Integration of Screen-and-treat Services (ACCESS Study).
Background
Cervical cancer (CC) is the 4th most common cancer in the world and 2nd most common cancer among Nigerian women. The risk of CC is six times greater in women living with HIV (WLHIV)
compared to non-HIV-infected women, with an estimated 5% of CC linked directly to HIV infection. Early detection, treatment, and provision of palliative care service (PC) have been shown to improve
outcomes and enhance chances of survival. Improvement in clinician’s knowledge, skills, and confidence in providing appropriate PC results in improved patient satisfaction with clinical care. The
National Comprehensive Cancer Network (NCCN) developed clinical practice guidelines for sub-Saharan Africa that promote access to quality, evidence-based PC. Despite the adoption of this
guideline in Nigeria, PC services remain underdeveloped and inaccessible at most healthcare facilities including the 12 NISA-MIRCs where the parent study is being implemented.
Approach and Study Aims
The PACE-2 Study is being implemented across the six geopolitical zones in Nigeria and will leverage the ICON-3 Practice Based Research Networks of the Nigeria Implementation Science Alliance (NISA). The study core aims are:
• Co-create and develop a feasible, culturally adapted, and sustainable palliative care service package with WLHIV and cervical cancer from the NISA-MIRCs. We will utilize well-established mixed method approaches to adapt core elements of palliative care services recommended in the NCCN guideline.
• Pilot the adapted multicomponent palliative care service package to determine feasibility and acceptability at two NISA-MIRCs.
Study Measures
The PACE-2 Study implementation will be evaluated using FIM (Feasibility Intervention Measure) and AIM (Acceptability Intervention Measure) Assessment tools.
• The development of a co-created, feasible, culturally adapted, and sustainable palliative care service package.
• Demonstrate the feasibility and acceptability of the co-created palliative care service package.
Key Study Outcomes
• A context-specific, co-created palliative care service package developed.
• A feasible and acceptable, palliative care service package pilot tested.
For more information about the PACE-2 Study, contact: admin@ivaninstitute.org
PI: Ngozi Idemili-Aronu; IVAN Research Institute, University of Nigeria; ctair@unn.edu.ng
MPI: Gregory Aarons, PhD; University of California, San Diego: gaarons@health.ucsd.edu
MPI: Echezona Ezeanolue, MD; IVAN Research Institute, University of Nigeria; ctair@unn.edu.ng
Accelerating Cervical Cancer Elimination through the integration of Screen-and-treat Services (ACCESS Study)
Overview
The ACCESS Study is a five-year project (2022–2027) funded by the National Institute of Health (NIH) to identify and test promising implementation strategies to enhance the integration of cervical cancer screening and treatment (CCST) into existing HIV programs in Nigeria.
Background
Cervical cancer (CC) is the second most common cancer in women in Africa and a large contributor to cancer deaths in the region. While age-standardized mortality trends have declined in high-income countries, mortality is on the rise in most low-income countries.
By 2030, CC will account for more than 106,000 deaths annually in Africa—an increase of 38% from the estimated 77,000 deaths in 2020. Compared with HIV-negative women, women living
with HIV (WLHIV) are six times as likely to develop CC and are at increased risk of mortality from CC. About 25% of CC cases in Africa are diagnosed with WLHIV, and 21% are attributable
to HIV. Cervical cancer screening in Nigeria is affected by various factors, such as the unavailability of screening services, screening not being offered by healthcare providers, and poor awareness of the disease and screening services.
Approach and Study Aims:
The ACCESS Study is being implemented across the six
geopolitical zones in Nigeria and leverage the ICON-3 Practice Based Research Network of the Nigeria Implementation Science Alliance (NISA). ACCESS Study is a hybrid type III cluster-
randomized trial guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) and RE-AIMS frameworks to access the comparative effectiveness of a set of core versus core+ Implementation strategies on CCS. The study core aims are:
1. Refine strategies to integrate cervical cancer screening and treatment into HIV treatment programs.
2. Determine the comparative effectiveness of the Core vs Core+ implementation strategies on CCST.
3. Assess sustainment of the integration of cervical cancer screening and treatment of cervical precancer into HIV programs.
Study Measures
The ACCESS Study implementation and clinical outcomes will be evaluated using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance/Sustainment) framework.
a. Reach (screening rate)
b. Adoption (uptake of implementation strategies)
c. Implementation strategies fidelity (delivery of implementation strategies according to ACCESS Study protocol)
d. Clinical intervention fidelity (delivery of CC screening, onsite treatment, and referral according to ACCESS Study protocol).
e. Clinical Effectiveness (Negative post-treatment follow-up)
Key Study Outcomes
• Improve capacity of clinical team on CCST
• Improve CCST service provision.
• Improve Referral completion and navigation at referral centers.
• Increase awareness and knowledge of participants about CC and CCST
• To improve retention in care.
For more information about the ACCESS Study, contact: admin@ivaninstitute.org
MPI: Gregory Aarons, PhD; University of California, San Diego: gaarons@health.ucsd.edu
MPI: Echezona Ezeanolue, MD; University of Nigeria; ctair@unn.edu.ng