Background: Adolescent and young adult (AYA; 14-24 years old) engagement in HIV programs is often transient, and socioeconomically marginalized AYA are less engaged. Few studies have examined whether engagement can be sustained over time in HIV prevention programs. This study examines correlates of sustained AYA engagement over 24 months in an HIV prevention program in Nigeria. Methods: We conducted a secondary data analysis of longitudinal data from an HIV prevention program among AYA in 32 local communities in Nigeria from 2021 to 2023. In the study, participants were invited to join crowdsourcing open calls, peer-led support meetings, and other activities. Engagement was assessed using a modified 12-item Tiffany-Eckenrode Program Participation Scale (0-4 per item) at months 3, 6, 12, 18, and 24. Sustained AYA engagement was defined as a mean score >/= 3.0/4.0 in at least three consecutive contacts (approximately 12 months). Longitudinal analysis was conducted using generalized estimating equations, and state-level contextual analysis was done using a linear mixed model. Results: A total of 1,259 AYA were included. The mean age was 19.8 years; most were students (n=954,75.8%) and unemployed (n=810,64.3%). The mean participation score remained consistently high throughout the 24 months (3.245 +/-0.535 to 3.319 +/-0.556), with 73.0% demonstrating sustained engagement. Students were less likely to sustain engagement compared to non-students (aRR = 0.91; 95% CI: 0.84-0.97). Unemployed AYA were more likely to sustain engagement than employed AYA (aRR= 1.09; 95% CI:1.03-1.14). States with higher poverty had significantly greater sustained AYA engagement. All the main findings were robust in sensitivity analyses. Conclusion: AYA engagement in the HIV self-testing implementation was high and sustained over 24 months, especially among socio-economically disadvantaged populations. This study supports the use of a participatory, AYA-led approach in sustaining AYA engagement in HIV prevention programs and has implications for the equity of HIV programs.

Incorporating culturally relevant music can enhance awareness and control in hypertension management and stroke preparedness. The Music4Health initiative created music-driven campaigns focused on youth and their caregivers. We outlined the components of songs developed through community participation to raise awareness about hypertension and stroke preparedness. The project was conducted in three phases: an open call, a designathon, and a bootcamp. From October 2023 to July 2024, a crowdsourcing open call was launched online and in person. Teams and individuals submitted ideas for creatively disseminating evidence-based prevention strategies for hypertension and stroke through music. Fifteen participants were invited to a 3-day designathon to refine their songs with expert mentors. The final phase, a bootcamp, involved community assessment and intensive workshops with the top six teams to develop and record complete songs with experts and producers. The lyrics from the bootcamp were analyzed using rapid thematic analysis guided by the PEN-3 cultural model, focusing on Relationships and Expectations and Cultural Empowerment domains. Thematic analysis of the seven finalist songs from the bootcamp identified themes using two PEN-3 model domains. The Relationship and Expectations domains included perceptions of hypertension severity, myths about hypertension (like the role of “juju”), and the necessity for healthy coping strategies. Enablers focused on the availability of hypertension prevention strategies, such as healthy diets, stress management, and avoidance of smoking. Nurturers emphasized raising awareness about hypertension among families, adopting healthy practices for loved ones, and the role of peers in promoting healthy habits. Unique cultural aspects included using Afrobeat and Fuji beats, pidgin English, and references to spirituality in adopting health practices. Culturally centered music may be an appealing channel for promoting the uptake of evidence-based health interventions. This study highlights the feasibility of using participatory approaches to co-create health dissemination strategies, leveraging music's cultural relevance and appeal to engage youth and their caregivers in hypertension and stroke prevention.

Sustaining evidence-based HIV prevention interventions remains a challenge, particularly among at-risk youth in Africa. The 4 Youth by Youth (4YBY) sustainment study is a hybrid type 2 cluster randomized controlled trial that evaluates the sustainability and cost-effectiveness of a crowdsourced approach to sustaining a package of evidence-based HIV prevention services. The study will be conducted across 40 community sites, supported by 18 community-based organizations (CBOs) providing HIV prevention services in Nigeria. Given their longstanding engagement with young people, CBOs serve as key partners in assessing long-term sustainability strategies for the 4YBY intervention, which has proven effective in increasing HIV prevention service uptake among youth. This protocol describes a cluster randomized controlled trial that will be conducted across 40 sites, all randomized into two arms. Half of the sites (20) will be assigned to receive the standard 4YBY intervention (4YBY-S), while the other 20 sites will receive the standard 4YBY intervention plus an enhanced sustainability strategy (4YBY-S + 4YBY-E). While the 4YBY-S group will continue implementing core intervention activities, the 4YBY-E group will receive additional sustainability-focused support. The Enhanced Sustainability Strategy in the 4YBY-E arm consists of four key components. First, “People” involves identifying and training sustainability teams within CBOs to champion intervention longevity. Second, “Learning”, where bi-weekly collaborative sessions will be established to foster knowledge-sharing and problem-solving among stakeholders. Third, “Adaptation Monitoring” will focus on continuously tracking and modifying intervention strategies to better align with local needs. Finally, “Nurturing Coaches” includes dedicated coaches who will provide technical assistance, conduct audits, and offer feedback to strengthen sustainability efforts. Evaluation will be guided by Youth Participatory Action Research (YPAR), the PEN-3 Cultural Model, Proctor’s Implementation Outcomes Framework, and the Consolidated Framework for Implementation Research (CFIR). The study hypothesizes that sites receiving the enhanced sustainability strategy (4YBY-S + 4YBY-E) will exhibit greater sustainability of core intervention components, defined as the continued delivery, adaptation, and integration of the intervention within community-based organizations—compared to sites receiving only the standard 4YBY intervention (4YBY-S). Additionally, the 4YBY-S + 4YBY-E arm is expected to achieve a higher uptake of HIV prevention services at 24 months, reflecting both the intervention’s effectiveness and its long-term viability within community settings. This protocol represents one of the first cluster randomized controlled trials evaluating intervention sustainment strategies for a youth-led, evidence-based HIV prevention program in Africa. Findings will advance implementation science by establishing a threshold for sustainable strategies and identifying the key factors that support the long-term integration and continuation of HIV prevention services for at-risk youth. The results critically impact scaling up community-led interventions and shaping policy frameworks to strengthen the global HIV response. The protocol was registered with clinicaltrials.gov under registration NCT07072481.

A growing number of researchers use public health critical race praxis (PHCRP), an antiracism framework derived in part from critical race theory, to conceptualize racism as a public health problem and examine its contributions to health and health care inequities. Critical race scholars define racism as “the state-sanctioned and/or extralegal production and exploitation of group-differentiated vulnerability to premature death,” as stated by Ruth Gilmore in her 2007 book Golden Gulag . Despite solid evidence for the prevalence and potential effects of racism, few studies provide data to guide the development, implementation, and evaluation of antiracism interventions in diverse settings (e.g., community, health care), activities that we refer to in this review as practice. A central focus of PHCRP is to guide evidence-based action to disrupt racism; therefore, the framework may be useful in guiding antiracism practice. However, evidence for its use for practice has not been established. To encourage the development, implementation, and evaluation of antiracism solutions, this review examines the evidence applying PHCRP to practice-focused research. The findings provide a baseline assessment to guide future evidence-based antiracism mitigation efforts. We offer recommendations to support future practice-focused work.

BackgroundCervical cancer is a leading cause of cancer deaths among women in Nigeria, yet awareness is low. Historically, art has served as a medium for processing emotions and sharing experiences, which can be effective in promoting health and behavior change. ObjectiveThis study aimed to examine art submissions and social media engagement from a Nigerian crowdsourcing open call to inform co-designed strategies for cervical cancer prevention among women. MethodsThis study reported following the SRQR (Standard Reporting for Qualitative Research) guideline. From October to November 2023, we launched an open call for art on social media, inviting adult women to submit artwork that raises awareness about cervical cancer prevention. Participants’ submissions were anonymized and reviewed by an independent panel of judges. A total of 6 finalists were selected to participate in a social media contest during Cervical Cancer Elimination Week, and 3 winners were identified based on total social media likes and comments, as well as grading rubric scores. We analyzed participants’ art entries through thematic analysis in six steps: (1) familiarization, (2) creating categories, (3) identifying themes, (4) reviewing themes, (5) defining themes, and (6) discussing findings. The emerging themes included using art to express emotions, to convey health-related content, and to use art as a form of self-regulation, which were further analyzed using the Relationships and Expectations domain of the PEN-3 (perceptions, enablers, and nurturers) cultural model. ResultsA total of 43 entries from participants aged 18-27 (mean 22.2, SD 2.6) years were analyzed. The entries included visuals (n=14), audiovisual (n=14), text (n=14), and audio (n=1). Most entries (42/43, 97.6%) focused on cervical cancer and human papillomavirus, covering definitions, risk factors, treatment, and prevention. Using the PEN-3 cultural model’s Relationships and Expectations domain for analysis, 62.8% (27/43) addressed “perceptions” of art as a means of mental and emotional expression, reflecting feelings such as humor, sadness, hope, faith, unity, and fear related to cervical cancer prevention. A majority (34/43, 79.1%) aimed to promote human papillomavirus screening and vaccination and were categorized as “enablers,” viewing art as a tool for health awareness, including educational resources. Additionally, 7% (3/43) included “nurturers,” representing self-regulation addressing stresses linked to having relatives with cervical cancer. Six finalist entries were shared on social media to promote cervical cancer awareness, reaching 8685 individual Instagram accounts and generating 2727 likes and 782 comments. ConclusionsThis study used art to increase awareness about cervical cancer on social media. Art can serve as a tool for promoting health by incorporating visual, emotional, and contextual messages to influence the target audience’s behavior.

The aim of this study is to assess the level of knowledge, intent to vaccinate, and hesitancy among young girls and caregivers in Nigeria. Cervical cancer is the second most prevalent cancer among women in Nigeria, with more than 7,000 deaths annually. The HPV vaccine is highly effective in protecting young girls and women from this preventable disease. Despite the national rollout and introduction into the routine immunization schedule, low vaccine uptake has been recorded in some regions due to vaccine hesitancy and misinformation. In July 2024, we conducted a cross-sectional study in Lagos, Nigeria, after the national rollout among daughters (9–14 years) and caregivers. Guided by the PEN-3 Cultural model, we developed a quantitative questionnaire to assess perceptions of the HPV vaccine and willingness to take the vaccine among caregivers and daughters. Descriptive data analysis was conducted, and the results are presented in tables. Among the young girls surveyed, a total of 41 responses were collected. Of these girls, 51.2% were in primary school and the remainder in secondary school. Only 20.5% had heard of the HPV vaccine, while 15.9% were confident they had been vaccinated. Nevertheless, 40.9% believed that girls aged 9-14 should receive the HPV vaccine to prevent cervical cancer, and 24.4% felt they were healthy enough to forgo vaccination. Additionally, 44 adult caregivers participated in the survey, with 56.8% being female and 43.2% male. About 61.4% had completed tertiary education, while 31.8% had only reached secondary education. Most caregivers were employed full-time (43.2%), with 38.6% self- employed and 11.4% unemployed. Notably, 56.8% had never heard of the HPV vaccine. Only 15.9% had vaccinated their daughters, primarily between ages 9–14. Regarding intentions to vaccinate, 47.7% expressed that they were likely to approve the HPV vaccine for their daughters. In terms of vaccine hesitancy, only 25% believed the vaccine was safe, 34.1% believed it was effective against cervical cancer, and 34.1% felt the benefits outweighed the risks of side effects. Our study highlights low HPV vaccine uptake among young adolescent girls, with many caregivers unaware of the vaccine. Less than half were willing to vaccinate their daughters, primarily due to concerns about safety and efficacy. Increasing awareness and addressing hesitancy is essential to improve vaccine acceptance among caregivers. Oluwakorede J. Adedeji, Olufunto A. Olusanya, Peter Kalulu, Nkiruka Obodoechina, Maria Afadapa, Priscilla A. Kabutey, Caven N. Ngoe, Sonam Shah, Temitope Ojo, Abideen Salako, Joseph Ogbeh, Folahanmi T. Akinsolu, Ucheoma Nwaozuru, Dawit Alemu, Olaitan H. Olayiwola, Idris A. Oladosu, Collins O. Airhihenbuwa, Joseph D. Tucker, Oliver C. Ezechi, Juliet Iwelunmor. Increasing HPV Vaccine Uptake: Assessing Knowledge, Intent, and Hesitancy Among Young Girls and Caregivers in Nigeria [abstract]. In: Proceedings of the 13th Annual Symposium on Global Cancer Research; 2025 Sep 16. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(12_Suppl):Abstract nr 53.

Sustaining evidence-based interventions in resource-limited settings is critical to optimizing gains in health outcomes. In 2015, we published a review of the sustainability of health interventions in African countries, highlighting gaps in the measurement and conceptualization of sustainability in the region. This review updates and expands upon the original review to account for developments in the past decade and recommendations for promoting sustainability. First, we searched five databases (PubMed, SCOPUS, Web of Science, Global Health, and Cumulated Index to Nursing and Allied Health Literature (CINAHL)) for studies published between 2015 and 2022. We repeated the search in 2023 and 2024. The review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Studies were included if they reported on the sustainability of health interventions implemented in African countries. Study findings were summarized using descriptive statistics and narrative synthesis, and sustainability strategies were categorized based on the Expert Recommendations for Implementing Change (ERIC) strategies. Thirty-four publications with 22 distinct interventions were included in the review. Twelve African countries were represented in this review, with Nigeria (n = 6) having the most representation of available studies examining sustainability. Compared to the 2016 review, a similar proportion of studies clearly defined sustainability (52

Human papillomavirus (HPV) vaccination can prevent cancer in low- and middle-income countries (LMICs), but its uptake remains low, especially in Nigeria. Understanding participatory approaches can help identify local strategies to increase, build capacity for, and sustain vaccine uptake. This study evaluated the effectiveness of an innovation bootcamp in enhancing the knowledge and skills of youth implementers about HPV and cervical cancer as a strategy to increase vaccine uptake among Nigerian girls aged 9–14 years. An innovation bootcamp is an intensive training program that engages end users to build capacity and skills. This was a five-week hybrid bootcamp guided by Youth Participatory Action Research (YPAR) and the PEN-3 cultural model at the Nigerian Institute of Medical Research in Lagos, Nigeria. Data were collected using pre- and post-training surveys to assess sociodemographic characteristics, participant preparation, motivations, support needs, baseline learning barriers, the bootcamp process, and knowledge and implementation science research skills (using 9-item and 22-item self-reported scales, respectively). We conducted descriptive analyses of quantitative data and thematic analysis for qualitative, open-ended responses, and we estimated changes in knowledge and skills using the Wilcoxon Signed-Rank test. Five teams comprised of 16 participants attended the bootcamp, and 13 completed the post-survey. Of the 16 participants, most were female (81

BACKGROUND:In Nigeria, cardiovascular diseases, especially hypertension, are on the rise. This increase in hypertension correlates with more strokes, significantly impacting mortality. Since hypertension often persists into adulthood, early interventions are crucial to prevent its complications. Non-invasive methods, such as music and creative activities, can effectively improve blood pressure and reduce stroke risk. This study aims to improve intergenerational awareness of hypertension and promote sustainable preventive practices by involving youth and caregivers within families and communities. METHODS:We employed a participatory, observational design, incorporating a five-month crowdsourcing open call followed by a designathon event. Participatory social and health innovations were combined and implemented as part of a larger study titled "Innovative Tool to Expand Music-Inspired Strategies for Blood Pressure and Stroke Prevention" (I-TEST BP/Stroke). Our study targeted youths aged 14 to 24, a critical period for shaping health behaviors and attitudes toward diseases. The 20 finalist textual entries were categorized into themes using the PEN-3 cultural model. The PLAN framework analyzed the effectiveness of participants' entries in conveying public health messages. RESULTS:The crowdsourced open call for musical ideas received 85 submissions between October 2023 and March 2024. More males (74.3%) than females, mainly aged 22-24, and mostly undergraduates (44.3%), participated in the open call, with 88.65% having heard of hypertension. Qualitative analysis with PEN-3 highlighted themes regarding Perceptions and Enablers, such as monitoring blood pressure, engaging in physical activity, and avoiding alcohol and smoking. The use of Pidgin English and Nigerian languages in songs represents Positive Cultural Empowerment. The Negative Cultural Empowerment domain addresses misconceptions about hypertension, including the belief that hypertension is a curse. Utilizing the PLAN framework, the submissions demonstrated an effective blend of catchy, memorable tunes with health education messages. CONCLUSION:The designathon produced various music genres, including afrobeats, rap, and R&B, with lyrics deemed feasible and socio-culturally appropriate. This suggests that music interventions tailored to Nigeria could enhance public awareness of hypertension and stroke prevention if scaled up.

Adolescents and young adults (AYAs) participatory approaches for HIV control have increased across LMICs, but there are few trials to evaluate effectiveness. We assessed a crowdsourced HIV self-testing (HIVST) intervention among a cohort of AYA in Nigeria. METHODS:We conducted a pragmatic stepped-wedge cluster randomized control trial recruiting participants (aged 14-24 years) from 32 local government areas across four geo-political zones in Nigeria. Eligible AYA were HIV negative or unknown HIV status, residing in study sites, spoke English, and consented. Areas were randomly assigned to one of four steps and AYA were followed for 24 months. AYA research facilitators implemented a 4YBY crowdsourced HIV prevention bundle. The primary outcome was self-reported HIVST uptake. We compared the probability of HIVST between the control and intervention periods using a generalized linear mixed model. We examined the fixed cost and per capita cost of the intervention. The protocol was registered with Clinical Trials.gov on January 15, 2021, under registration NCT04710784. RESULTS:2652 AYA were screened, and 1500 were enrolled in the study (March 10, 2021- August 31, 2023). 1333/1500 (89 %) were followed up at 24 months. The mean age of AYA was 20 ± 2.65 years old, most were students (1155/1500, 77 %), and unemployed (915/1500, 61 %). The intervention led to a 9.96-fold increase in HIV self-testing uptake compared to the control period (95 % CI: 8.36-11.85, p < 0.0001). The annual fixed cost of the intervention was estimated at US$42,237, with a per capita testing cost of US$14.8. No significant adverse events were reported. CONCLUSION:A crowdsourced HIV prevention intervention increased HIVST uptake among Nigerian AYA. Greater participation of AYA in the design and implementation of clinical trials is needed to achieve UNAIDS targets.

We organized an Innovation Bootcamp for young people in Nigeria to develop strategies promoting the uptake of the hepatitis B birth dose vaccine among newborns, which remains low, with an estimated coverage of 52%. This event was a collaborative, cross-disciplinary capacity-building platform to generate creative solutions addressing barriers to Hepatitis B vaccine uptake. The purpose of this study was to describe the bootcamp activities that address this gap and evaluate the impact of an Innovation Bootcamp designed to build research capacity among young Nigerians. The bootcamp was informed by Participatory Action Research focused at engaging young people as co-researchers to investigate and address issues affecting their respective communities using the PEN-3 cultural model. Qualitative data from the community needs assessment were analyzed using a thematic analysis framework to identify and synthesize emerging themes. Socio-demographic characteristics of the participants were collected, and a pre- and post-survey was administered. The participants' knowledge of hepatitis B and research skills were compared using the Wilcoxon test. Our results included five teams composed of fifteen participants with a mean age of 25.5 years, originating from the Southern regions of Nigeria. The post-survey showed significant improvements in participants' knowledge and research skills, with knowledge increasing by 21.6% (mean score: 39.7 to 48.3, p = 0.010) and research skills by 36.4% (mean score: 56.1 to 76.5, p < 0.001). Each team co-designed implementation strategies, including referral pathways from traditional birth attendants to formal health centers, comprehensive training workshops, and trusted community leaders as vaccination ambassadors. In conclusion, the bootcamp demonstrated its effectiveness in strengthening capacity and increasing knowledge (although in a small sample size), which contributed to informing the development of implementation strategies. Findings from the pilot studies will ultimately inform future research focused on promoting and sustaining youth-derived vaccination service delivery strategies in Nigeria.

Background:Expanding HIV research capacity among the global majority (individuals identifying as Black/African American, American Indian and Alaska Native, Asian, Native Hawaiian and Other Pacific Islander, Multiracial, and Hispanic/Latino) is important. However, achieving national goals to increase the pool of implementation science and HIV early-stage investigators from underrepresented backgrounds remains elusive, largely due to limited investment in training and mentoring these individuals. To address this issue, we launched the Stimulating Training and Access to HIV Research Experiences (STAR) program, a partnership led by Saint Louis University and the University of North Carolina at Chapel Hill in collaboration with Georgia State University and Texas A&M University. The STAR program aims to establish a pathway for Underrepresented minority (UREM) students to engage in HIV and implementation science research. Methods:We launched a crowdsourcing open call from November 30, 2022, to January 22, 2023, to identify potential trainees at the four participating institutions (Prompt: "How might we promote HIV prevention among youth aged 13-24 years in your community?"). The finalists from the crowdsourcing call participated in a 2-day designathon, which included didactic introductory lectures on HIV, dissemination and implementation science. The finalists participated in a 6-week innovation bootcamp, including modules on HIV research, implementation science, research ethics, and fieldwork experience with community partners. We assessed the acceptability of the STAR program through participant self-reported surveys on their experience and evaluation of the lectures. Findings:Twenty-four individuals applied to the STAR program by completing the crowdsourcing open call, 12 were selected for the designathon, and 10 completed the fellowship. The first cohort of STAR trainees (10 students-6 undergraduate and 4 graduate students) successfully completed the STAR innovation bootcamp. The innovation bootcamp culminated in seven proposals that the trainees implemented and evaluated over 12 months, with support from the research team, mentors, and participatory learning community. The implementation strategies proposed by the trainees include the use of peer engagement, storytelling, digital engagement tools, and artificial intelligence to promote awareness of HIV and increase the uptake of HIV testing. All the participants were satisfied with the STAR program (90% very satisfied and 10% satisfied) and indicated enthusiasm for pursuing academic and research careers in HIV and/or implementation science. Conclusion:Building a pathway for UREM investigators is crucial to ending the HIV epidemic. The STAR program may enhance interest, build research capacity, and increase the UREM talent pool retained in this field.

Expanding human papillomavirus (HPV) vaccination for girls and HPV self-collection for women can reduce the global burden of cervical cancer. However, HPV vaccination and self-collection services are rarely implemented simultaneously in mother-daughter dyads, leaving a critical gap in cervical cancer prevention. From 2023 to 2024, a community-engaged model for combined HPV vaccination and screening was co-designed using crowdsourcing open calls and designathons with mother-daughter teams and pilot-tested by trained research facilitators. This study explores the impact of this crowdsourced, community-engaged mother-daughter campaign and implementation strategy bundle on HPV vaccination among girls and HPV screening among their mothers in Nigeria over 6 months in 18 Nigerian local government areas (LGAs). A hybrid effectiveness-implementation type II pragmatic stepped-wedge cluster randomized control trial has been employed to the effectiveness of an implementation strategy bundle; a crowdsourced, tailored, community-engaged, mother-daughter HPV campaign on increasing uptake of HPV vaccination among girls aged 9–14 and HPV screening uptake among women aged 30–49 in Nigeria. The mother-daughter campaign will be tailored to local sites and conducted among 612 mother-daughter dyads (1,224 participants) recruited from 18 LGAs in six geopolitical zones of Nigeria. Trained community health workers will collect baseline data and implement a mother-daughter campaign that will provide education on cervical cancer control and access to onsite services for HPV vaccination and screening in a private area while engaging mothers and daughters simultaneously to increase uptake of the services. A mixed-methods evaluative and iterative assessment will be conducted using Proctor’s Implementation Outcomes Framework and the PEN- 3 cultural model. The primary outcomes are the uptake of HPV preventive measures—HPV vaccination (one dose) among girls (ascertained by onsite clinical records of vaccine uptake) and HPV self-collection completion among mothers (ascertained by laboratory receipt of self-collected specimens) within six months of trial enrollment. Pre-post effectiveness and cost of study components are embedded in the implementation and sustainment phases, compared to pre-implementation data assessed for each LGA. This study is a unique dyadic intervention focused on both girls and their mothers or female caregivers to drive cervical cancer control in Africa. Findings have the potential to inform local and global policies aimed at reducing the cervical cancer burden in African countries like Nigeria, eliminating missed opportunities by closing the research-to-translation gap. The protocol was registered with clinicaltrials.gov under registration NCT06728085.

BACKGROUND:Cervical cancer is one of the leading causes of death among women in Africa, but stigma often delays cervical cancer prevention. We explore the perceptions, enablers and nurturers through the lens of intersectional stigma in the uptake of cervical cancer prevention services in Nigeria. METHOD:Indepth interviews and focus group discussions were conducted among women aged 30-65 years and girls aged 9-26 years in Lagos, Nigeria. Data were analysed thematically. Using the relationships and expectation domain of the PEN-3 cultural model, we identified perceptions, enablers and nurturers related to the uptake of primary and secondary cervical cancer prevention services in Nigeria. We also explored how social identities may intersect with health-related stigmas and affect the uptake of these services. RESULT:We interviewed 31 women and 31 girls. 61% of the participants were Christians and 39% were Muslims and were from the three major ethnic groups in Nigeria: Igbo (34%), Hausa (38%) and Yoruba (28%). Themes emerging from the data: (1) positive perceptions (self-efficacy): many women understood the importance of protecting themselves and their daughters from cervical cancer and strongly believed that they could educate their partners/husbands and would not let other people's experiences with the vaccine influence them negatively. (2) Negative perceptions (anticipated stigma): some women expressed that because the human papillomavirus that causes cervical cancer is mainly sexually transmitted, they were concerned that they may be perceived as being promiscuous if they decide to commence routine cervical cancer screening. (3) Enablers (social support): nearly all women wanted the support of their spouses before receiving cervical cancer screening. (4) Nurturers (resilience): many clearly understood the complex social and economic realities faced by Nigerians that negatively affect their access to healthcare. CONCLUSION:These findings offer intersectional insights into advancing public health and culturally anchored interventions to preventing cervical cancer-related stigma in Nigeria.

This study aims to assess the effectiveness of a Mega-Designathon Bootcamp in enhancing HPV-related knowledge and research skills to improve HPV vaccination rates among girls in Nigeria. Evidence shows that human papillomavirus (HPV) vaccines are available to prevent cancer in low- and middle-income countries. However, the uptake and continuation of these vaccines among end users remain low in Nigeria. Understanding various participatory implementation approaches can help identify locally sourced strategies and build knowledge and skills to promote sustained uptake. We utilized crowdsourced open calls to gather tailored strategies among youth for enhancing HPV vaccination uptake and sustainability. Submissions were initially screened for Artificial Intelligence use, and expert judges subsequently shortlisted the top ten teams from 365 submissions to advance to the designathon, where they refined their ideas with expert guidance. Five teams (n = 16) were rigorously selected, advancing to the mega bootcamp phase for further training. The PEN-3 cultural model informed our analysis, and we performed pre- and post-analysis of the bootcamp training survey responses. The five teams involved 16 participants, mostly female (81%), with an average age of 22 years. Qualitative results indicated that participants were motivated to participate in the mega bootcamp by their desire to learn, network, and make a positive impact on their community’s health. Key training resources identified included access to the internet, mentorship, and honesty throughout the training. Following the bootcamp, median (IQR) knowledge scores improved from 33 (30.8–35.3) to 36 (34.0–40.0); (p = 0.043), while research skills scores increased from 55 (46.8–60.3) to 81 (73.5–93.5); (p < 0.001). The mega bootcamp helped participants learn more about HPV and cervical cancer while improving their implementation science research skills. The bootcamp demonstrated that structured and participatory approaches can promote engagement and learning. Empowering youth with the right resources and mentorship can drive sustainable HPV vaccination initiatives in Nigeria. This study highlights the importance of community-driven strategies in addressing public health challenges and promoting greater uptake and sustainability of evidence-based interventions like HPV vaccination. Peter Kalulu, Olufunto A. Olusanya, Nkiruka Obodoechina, Maria Afadapa, Abideen Salako, Joseph Ogbeh, Priscilla A. Kabutey, Caven N. Ngoe, Emily Miller, Temitope Ojo, Folahanmi T. Akinsolu, Ucheoma Nwaozuru, Olaywola Olaitan, Idris A. Oladosu, Collins O. Airhihenbuwa, Joseph D. Tucker, Juliet Iwelunmor. Participatory Implementation Science to Enhance Knowledge and Build Capacity for Increasing the Uptake and Sustainability of HPV Vaccination Among Girls in Nigeria [abstract]. In: Proceedings of the 13th Annual Symposium on Global Cancer Research; 2025 Sep 16. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(12_Suppl):Abstract nr 50.

This study aims to identify barriers and enablers to hepatitis B birth dose vaccine (HBV-BD) uptake in Nigeria and propose community-informed solutions using a Participatory Action Research (PAR) approach. Hepatitis B, a major public health issue and the leading cause of liver cancer affects 8.1% of Nigerian adults. Timely administration of the HBV-BD within 24 hours of birth, followed by three doses, reduces the risk of infection and liver cancer by up to 100%. However, despite its inclusion in Nigeria’s Immunization Schedule, only 20–33% of newborns receive the vaccine within 24 hours. Using PAR, an open call was launched to crowdsource ideas from Nigerian youth on improving HBV-BD uptake. Five teams advanced to a Bootcamp, where they received training in research ethics, community engagement, and intervention design. Over five weeks, participants developed study proposals and piloted projects in their communities using the PEN-3 model to identify barriers and design culturally appropriate strategies to improve vaccine uptake. Quantitatively, the 15 participants (14 females, 1 male; mean age 25) demonstrated a 21.66% increase in HBV knowledge and a 36.37% improvement in research skills post-Bootcamp. Qualitatively, teams identified key barriers to HBV-BD uptake, including limited knowledge of hepatitis B, low vaccine awareness, cultural myths, mistrust of foreign medical interventions, healthcare worker attitudes, vaccine inaccessibility, and preference for home births. Proposed strategies included (a) culturally tailored health education through workshops, (b) outreach campaigns to raise awareness, (c) media-based information dissemination, and (d) community engagement with leaders, healthcare workers, and traditional birth attendants. These strategies leveraged perceptions, enablers, and relationships within communities to address gaps. Despite existing HBV-BD policies, uptake in Nigeria remains low, emphasizing the need for community-driven interventions. Crowdsourcing through the Mega-Designathon empowered communities to co-develop innovative, cost-effective strategies that address sustainability and implementation challenges. Scaling HBV-BD coverage to 90% by 2030 could prevent 32% of averted deaths in Africa. These findings could inform vaccination programs in other low- and middle-income countries. Maria Augustina Afadapa, Olufunto Olusanya, Peter Kalulu, Nkiruka Obodoechina, Priscilla A. Kabutey, Caven N. Ngoe, Sonam Shah, Temitope Ojo, Abideen Salako, Joseph Ogbeh, Folahanmi T. Akinsolu, Ucheoma Nwaozuru, Dawit Alemu, Olaitan H. Olayiwola, Idris A. Oladosu, Collins Airhihenbuwa, Joseph Tucker, Oliver Ezechi, Juliet Iwelunmor. Improving Training on Hepatitis B in Nigeria: Findings from an Innovation Bootcamp to Strengthen Capacity [abstract]. In: Proceedings of the 13th Annual Symposium on Global Cancer Research; 2025 Sep 16. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(12_Suppl):Abstract nr 28.

Community-Engaged Research (CER) arose as a means of increasing the democratic participation of communities that study outcomes directly impact. CER has been identified as a recommended approach for conducting biomedical and behavioral health research with Black communities, a population that has been excluded from and exploited by academic health research for centuries. However, solely increasing community participation without identifying and redressing racialized power imbalances within community-academic partnerships involving Black populations can stall progress towards racial health equity. The purpose of this study was to explore how power can be redistributed equitably in community-academic health research partnerships involving Black populations. Utilizing the qualitative methodological approach of critical narrative inquiry, counter-stories from 12 Black individuals who have served as community partners on U.S.-based academic health research teams were collected via in-depth semi-structured narrative interviews. A reflexive thematic analysis approach was utilized to identify and analyze strategies expressed by study participants for increasing community agency, efficacy, and solidarity in health research. By centering the voices of Black community members who have directly engaged with academic health research institutions, this study sought to amplify the desires and aspirations of Black communities regarding shifting power in health research processes and outcomes.

Key PointsAfrican American patients have unique insights on hemodialysis adherence and use of motivational interviewing to promote adherence.Key themes were mental health issues; historical mistrust; social determinants of health; and importance of provider cultural competence.Themes led to a novel conceptual model, which will inform the design of a motivational interviewing-based protocol to improve adherence.BackgroundCompared with White patients, African American (AA) patients have a four-fold higher prevalence of kidney failure and higher hemodialysis nonadherence. Adherence behaviors are influenced by psychosocial factors, including personal meaning of a behavior and self-confidence to enact it. We assessed perspectives of AA hemodialysis patients on unique factors affecting dialysis adherence, and use of motivational interviewing (MI), an evidence-based intervention, to improve these factors, dialysis adherence, and outcomes in AAs.MethodsSelf-identified AA hemodialysis patients (N=22) watched a brief video describing MI and then completed a semistructured interview or focus group session. Interview questions explored unique barriers and facilitators of hemodialysis adherence in AAs and perceived utility of MI to address these obstacles. Verbatim transcripts and an iterative inductive/deductive approach were used to develop a hierarchical coding system. Three experienced coders independently coded the same two transcripts. Coding was compared, and discrepancies were reconciled by a fourth coder or consensus. Transcripts, quotations, and codes were managed using Microsoft Excel 2016 and SPSS version 28.0.ResultsThemes and subthemes emerged and culminated in a novel conceptual model informed by three theoretical models of behavior change: Theory of Self-Care Management for Vulnerable Populations; Social Cognitive Theory; and Self Determination Theory. This conceptual model will inform the design of a culturally tailored, MI-based intervention to improve dialysis adherence in AAs.ConclusionsIntegrating AA hemodialysis patient perspectives is critical for enhancing dialysis care delivery and the design of effective interventions such as MI to improve dialysis adherence in AA and promote kidney health equity. AA hemodialysis patients view MI as a tool to clarify patient priorities, build trust, and promote patient-provider therapeutic alliance. Cultural tailoring of MI to address unique barriers of AAs with kidney failure will improve adherence and health outcomes in these vulnerable patients.