The project

The Department of Public Health Programmes is located at Randers Regional Hospital and is responsible for planning, administration and quality development of cancer screening, including cervical cancer screening, in the Central Denmark region which covers 22% of the Danish population. The department is thus responsible for providing invitations to women in the target population in the region and has a close and important collaboration with the pathology department responsible for analyses of cervical samples and with gynaecological departments providing follow-up services in terms of colposcopy and cervical biopsies.

Previous experience relevant to the Tasks:

Our research group has substantial experience in many aspects of cancer screening programmes, covering meta analysis, active involvement of citizens and patients in development of new strategies for increasing screening participation, and initiatives to reduce social inequality in cancer screening. 

Berit Andersen is an experienced leader of daily operation of cancer screening programmes, and of research projects and research teams. She has a deep insight into a wide range of screening research methodologies (interventions, health services research, epidemiology, register-based studies, laboratory research, qualitative research etc.). 

She is elected member in several national committees of trust which includes membership of the Danish Council on Ethics and chair of the National Steering Group for Cervical Cancer Screening. 

Pia Kirkegaard has substantial experience in exploring lay peoples’ perceptions and beliefs about health, risk, and cancer screening, using ethnographic methods such as semi-structured interviews, focus groups, and participant observation. She has in-depth knowledge about user/stakeholder involvement in research, including action research, in a Danish context, and hands-on experience with vulnerable groups including how to contact and include them in order to make tailored interventions to increase awareness about screening participation. Mette Tranberg has substantial experience in providing HPV

self-sampling offers to women and has an excellent overview of the literature regarding cervical cancer screening and especially self-sampling. Owing to her clinical background as a biomedical laboratory scientist, she has valuable knowledge of how to organise the laboratory set-up when providing self-sampling.

Team:

• Berit Andersen (MD, PhD) Clinical Professor in screening behaviour and organization of screening programmes at Aarhus University and Head of Department of Public Health Programmes, Randers Regional Hospital, Central Denmark Region.
• Pia Kirkegaard (MA in Social Anthropology and PhD) Senior researcher at the Department of Public Health Programmes, Randers Regional Hospital, Central Denmark Region.
• Mette Tranberg (biomedical laboratory scientist, Master in Health Science, PhD) Post doc researcher at the Department of Public Health Programmes, Randers Regional Hospital, Central Denmark Region.

The London School of Hygiene & Tropical Medicine is renowned for its research, postgraduate studies and continuing education in public and global health. The School has an international presence and collaborative ethos, and is uniquely placed to help shape health policy and translate research findings into tangible impact.

We have 3,000 staff based all around the world with core hubs in London and at the MRC Units in The Gambia and Uganda, which joined LSHTM in February 2018. Our outstanding, diverse and committed staff make an impact where it is most needed – deploying research in real time in response to crises, developing innovative programmes for major health threats, or training the next generations of public and global health leaders and researchers.

Previous experience relevant to the Tasks:

Our group has significant experience of conceptualising, developing and obtaining data to populate cost effectiveness models of both HPV and HIV. We also have extensive experience in conducting qualitative research, working with marginalised and vulnerable communities, and performing systematic reviews. We also have experience of collecting costing data alongside intervention studies in different settings. 

Finally we have significant experience of estimating cost-effectiveness results from models and running appropriate uncertainty and sensitivity analyses.

Team:

• Dr Anna Foss (MMath, PhD), Associate Professor in Public Health Education and Mathematical Epidemiology at LSHTM.
• Dr Rosa Legood (DPhil), Associate Professor in Health Economics at LSHTM.
• Dr Sadie Bell (PhD), Assistant Professor in Public Health Evaluation at LSHTM.
• Professor Martin McKee (CBE MD DSc MSc FRCP FRCPE FRCPI FFPH MAE FMedSci), Professor of European Public Health at LSHTM

The Local Health Authority (AUSL) of Reggio Emilia is the institution that administers the National Health Service in the Reggio Emilia province. It provides directly in-patients, out-patients, primary and preventive care; it also buys from other private and public hospitals and clinics for all the citizens residents in the province. It works for the protection and the improvement of public health, health promotion and the reduction of health inequalities and access to services.

The strategic mission is to respond to the needs and expectations of health among citizens, ensuring effective, timely interventions for health promotion, prevention and care that are accessible without barriers of culture, language and socio-economic conditions, in respect of the person and in a safe condition using efficiently the available resources.

Furthermore it researches and encourages forms of integration, participation and collaboration with the broader social context of the locally distributed expertise to enrich the community capital. It favours the capacity of differentiation and specialization of the responses to improve the quality of life and citizens’ health opportunities.

Previous experience relevant to the Tasks:

Paolo Giorgi Rossi, the director of the Epidemiology Unit of the AUSL-IRCCS conducted several studies on screening participation: PI HTA of the methods to increase screening participation (funded by the Italian Ministry of Health); PI of the first Italian trial of self-sampling (funded by the ASR Abruzzo) and investigator in the second Italian trial on Self-sampling (Funded by the Regione Abruzzo Health Authority); investigator in the trial for

increasing participation in colorectal cancer screening (funded by the Italian Ministry of Health); investigator in the trial on methods to increase compliance to colonoscopy in subjects with positive faecal occult blood test in colorectal cancer screening (funded by the Italian Ministry of Health). He was part of European Guidelines development group on cervical cancer screening updated in 2015. https://www.gisci.it/documenti/news/

EW0115451ENN_002.pdf. He is also member of the Guidelines Development Group for the European Commission Initiative on Breast Cancer screening co-editor of the diagnosis chapter. During this four year long experience he achieved expertise in GRADE methodology to develop recommendations.

Luciana Ballini is expert in Health Technology Assessment and has been Partner Coordinator for the participation of the Emilia Romagna Region to the European Network in Health Technology Assessment (EUnetHTA) Joint Action 1, Joint Action 2 and Joint Action 3 funded by the European Commission. She has been author or co-author of European Joint Relative Effectiveness Assessment of medical devices and screening technologies, and

participates in the scientific consultation with medical devices and medicines developers on the development plan of their products.

The Unit has conducted several systematic reviews on screening methods and in particular on screening participation.

Team: 

• Paolo Giorgi Rossi, PhD director of Reggio Emilia Epidemiology unit at AUSL-IRCCS.
• Pamela Mancuso, Statistician working in Reggio Emilia AUSL Epidemiology Unit since 2013.
• Massimo Vicentini, Biologist, specialised in Medical Statistics. Coordinator of Reggio Emilia Population Diabetes Register and vice-manager of the Reggio Emilia Cancer Registry.
• Luciana Ballini, B.Sc. M.Sc. at AUSL-IRCCS .Leading the regional Health Technology Assessment programme of Emilia-Romagna, Italy for the evaluation, adoption, diffusion and appropriate clinical use of innovative health technologies and interventions.
• Francesco Venturelli, Medical Doctor, specialised in Hygiene and Preventive medicine, working at the Epidemiology unit of the Azienda USL-IRCCS of Reggio Emilia.
• Marta Ottone, Statistician working in the Reggio Emilia AUSL Epidemiology.
• Laura Bonvicini, Statistician working in the Reggio Emilia AUSL Epidemiology unit since 2010.

The University of Porto Institute of Public Health (ISPUP) aims to create and disseminate high quality information and knowledge in the broad field of Public Health as well as to provide related services such as a pioneering Occupational health clinic in the University of Porto. 

ISPUP hosts several postgraduate programmes in cooperation with different units within and outside the University of Porto, which result in approximately 50 Master and 10 PhD graduates each year. ISPUP promotes strong interactions among highly experienced researchers from complementary fields, such as Epidemiology, Biostatistics, Environment, Nutrition, Behavioural Sciences, Social Sciences and Preventive Medicine. Researchers at ISPUP are involved in a large number of national and international projects with competitive funding obtained from national and international sources. 

ISPUP hosts scientists at several career levels (64 PhD graduates), who publish over 200 scientific papers in peer-reviewed journals annually, placing the Institute among the most productive and competitive Portuguese institutions in health sciences research. 

ISPUP fosters cooperation between agents within the University of Porto as well as with

other regional, national and international academic and health institutions. It maintains several collaborations with European, South American and African partners, ensuring a global and dynamic exchange of clinical and population-based scientific information, training and research skills. 

ISPUP enhances the cooperation between agents of the University of Porto and its link to regional, national and international institutions. It maintains several

collaborations with European, South American and African partners, ensuring a global and dynamic exchange of clinical and population-based scientific information.

Previous experience relevant to the Tasks:

We have a large experience in epidemiological research, through the design and implementation of cross-sectional, case-control, cohort and experimental studies, as well as in the use of qualitative and mixed-methods approaches to research in different areas of public health.

Regarding cancer screening we recently published the results of a trial testing the effectiveness of a stepwise intervention with an increasing level of complexity and cost to increase adherence to organised cervical cancer screening; the tested intervention was a 3-step invitation to screening, based on automated text messages/phone calls (step 1), manual phone calls (step 2) and face-to-face interviews (step 3), applied sequentially to non-adherent women after each step.

Team: 

• Nuno Lunet (PharmD, MPH, PhD – Public Health), Professor of Epidemiology at the Faculty of Medicine of the University of Porto, and Member of the Board of Directors of the University of Porto Institute of Public Health (ISPUP). No funding is requested for his implication in the project.
• Firmino Machado (MD – Public Health, MsC – Statistics), Professor of Epidemiology (Invited Assistant) at the Faculty of Medicine of the University of Porto. Researcher at the Institute of Public Health of the University of Porto (ISPUP). No funding is requested for his implication in the project.

University of Tartu (founded in 1632) is the oldest, largest and the only classical university in Estonia with more than 16000 students and 1800 academic staff members. 

UTARTU includes nine faculties, four colleges and several regional development units. As Estonia’s national university, UTARTU stresses the importance of international cooperation and partnerships with reputable research universities all over the world. To support and develop the professional competence of its students and academic staff, the university has entered into bilateral cooperation agreements with 69 partner institutions in 26 countries. UTARTU is Estonia’s leading centre of research and training. Research at UTARTU focuses on subjects as diverse as medicine and philosophy, genetics and computer science. More than half of the PhD theses written in Estonia are defended in UTARTU. More than half of the country’s research publications are authored by UTARTU academics, and the university manages work-intensive research projects and topics in every important research area. The University of Tartu currently ranks among the top 1.2 percent of the world’s best universities (QS World University Rankings, 2018/2019) and belongs to the top 1% of the world’s most-cited universities and research institutions in the fields of Clinical Medicine, Chemistry, Environment/Ecology, Plant and Animal Science, Social Sciences (general), Molecular Biology and Genetics (ISI Web of Science). The University of Tartu has a well-established and active Ethics Review Committee on Human Research.

Previous experience relevant to the Tasks:

Our research team has surveillance and public health expertise related to infectious and chronic diseases; international research collaboration, and an extensive record of research based on the use of administrative health data, data from population-based surveys and state registries including.

Team:

• Anneli Uusküla (MD, PhD) is a professor of epidemiology at the University of Tartu.
• Anna Tisler-Sala holds BSc (Gen Technology), MPH (Public Health) is a research fellow at UTARTU.

Universitatea Babeș-Bolyai (UBB) is a multicultural university, with teaching programmes in Romanian, Hungarian, German, and English (BA, MA/MSc and PhD). UBB has 21 faculties, more than 45,000 students, and an experienced teaching and research staff of over 1,700. The Department of Psychology was founded in 1919 and occupies the first position in Romanian academic ratings, based on its high quality academic achievements and prodigious research activity. UBB is the only Romanian university present in the top 5% world universities listed in the Academic Ranking of World Universities/ARWU. 

UBB holds the EC ‘HR Excellence in Research’ award (2018) in recognition of its commitment to delivering fair recruitment practices and a supportive and stimulating working environment for researchers. UBB intends to develop and consolidate the innovation character and facilitate the technological and cognitive transfer of resources managed through its Office of Management and Creative Cognitive Transfer (OMCCT) that awaits certification as a Technological Transfer Center, aimed to stimulate innovation and technological transfer in order to transpose research outputs into economy. 

UBB also launched its research platform that recognises 58 Research-Development-Innovation Units that provide access to their research platforms for doctoral students and researchers.

Previous experience relevant to the Tasks:

Involved as team in projects focused on cervical screening, and HPV vaccination in Romania, developing and conducting qualitative research methods (interviews, focus groups, Delphi group, action-research), increasing adherence to treatment and preventive behaviours; Adriana Baban works as consultant for developing methodology for cervical screening programme in Republic of Moldova (project funded by UNFPA).

Team:

• Prof. Adriana Baban, PhD, Professor of Health Psychology at UBB.
• Diana Taut, PhD, is currently a lecturer at the department of Psychology, UBB.
• Marcela Penta, PhD, is a research associate at the Department of Psychology, UBB.

Oncology Institute Cluj Napoca was established in 1929 as an Institute for Cancer Prevention and Research.

IOCN has become a comprehensive cancer centre, with a modern multi-modal structure, member and accredited by European Organization of Cancer Institutes (OECI). Over one million BP performed tests existed in the Institute’s archives in 1996, when we first performed an evaluation and report, together with thousands of colposcopy evaluations, treatments and surveillance of found lesions.

The historical expertise and capability of IOCN has facilitated the organization of screening programmes since the 90’s, providing an indispensable infrastructure, through the existence in the Institute of a multidisciplinary group of epidemiologists trained in the surveillance of non-communicable diseases, cytologists and anatomopathologists, breast specialists – mammography radiologists, oncological gynaecological surgeons specialised in colposcopy, Mammary Tumour Centre, multidisciplinary commissions for gynaecological cancers, data managers, technicians, physicians, specifically trained registrars, etc. along with physicians with specialised training in the management of cancer registries and cancer prevention.

Previous experience relevant to the Tasks:

Project CEDICROM on Norway Funds self-sampling study:

CEDICROM used 3 mobile units, performing 175 visits in rural and suburban communities

2073 “door to door “ with health mediators :1249 roma, 444 rusians Danube Delta, 200 ukrainean, 80 slovak, 100 romanian, 368 HPV tests= 17,8% , 47 HPV+ = prevalence 12,8%

• Group A – assisted prelevation on mobile unit 182 women from 1037 invited = 17,6% , 16 HPV + =8,79%
• Group B – self-sampling, 117 from 1036 invited = 11,3% , 22 HPV + = 18,8 % Mobile units tests intake was higher, 237 from 368 women tested= 64,4%, but significant percentage of self samplings (over 35%) prove HPV self-sampling value in low resource settings and for BP screening resistant women.

Team:

• Florian Alexandru Nicula, MD, PhD, Senior Researcher Grade I, Head of Prevention and Cancer Control Department at The Oncology Institute in Cluj-Napoca.
• Patriciu Andrei Achimaș-Cadariu, MD, PhD, Prof., Gynaecologic Oncology and Surgical Oncology, Oncology Institute “Prof.Dr. Ion Chiricuţă ” Cluj-Napoca.
• Bianca Maria Nicula, HPV/BP Principal clinical HPV lab technician at The Oncology Institute of Cluj-Napoca.
• Catalin Ioan Vlad, MD, PhD, General Manager IOCN and oncological surgeon with teaching and research duties at IOCN.
• Anca Meda Burca, Research in economics and Financial Director IOCN.

Established in 1996, the European Institute of Women’s Health (EIWH) is a nongovernmental organisation, promoting gender equity in public health, research and social policies across Europe. The EIWH promotes gender-specific bio-medical and socioeconomic research that addresses sex (biological and physiological) and genderbased differences to ensure access to quality treatment and care for women across the lifespan.

The EIWH aims to reduce inequalities in health, in particular due to gender, age and socioeconomic status, ethnicity etc by highlighting that gender/sex is an important determinant of health and our understanding how vulnerability to, onset and progression of specific diseases vary in men and women must be improved. 

The EIWH uses evidence-based arguments in position papers, policy briefs and reports to influence the policy environment.

The EIWH actively supports policies and programmes that promote healthy and safe pregnancies, including EUROmediCAT. The EIWH five-year strategic plan includes safe pregnancy and maternal health as a key priority.

EIWH has worked closely with the European Commission, Member States and the World Health Organisation to place gender and women’s health on the health and research agenda. EIWH is a member of the committee that represents patients and consumers with the European Medicines Agency (EMA). The EIWH is a Board member of the European Public Health Alliance (EPHA) and is a member of the European Centre for Disease Control and prevention formal advisory group representing patients (observer status).

Previous experience relevant to the Tasks:

Communications lead of the MyHealth migrant project; Carried out two roundtable meetings in the European Parliament one on on cervical cancer; Stakeholders in CanCon-JA, EPAAC-JA, CHRODIS-JA, ASSET project, Stakeholder in EU Joint Action for Vaccination. EIWH organised Meeting in EU Parliament_”Healthy Women Healthy Europe”.

Team:

• Rebecca Moore, Senior Researcher at EIWH.
• Vanessa Moore, Senior Researcher at EIWH.
• Peggy Maguire, Director General of the EIWH.

The HPRC conducts research on the relationship between psychological, social and cultural factors and health for youth and adults – on a national level and as a part of international collaborations. 

It was established in 2000 as an independent research institution and has been spearheading the development of health psychology research and education, as well as catalysing health promotion in Bulgaria. HPRC specialises on the topics of health equity and prevention, cultural aspects of health, qualitative and mixed research methods. 

Among the key aims of HPRC is also the development of culturally sensitive health promotion programmes related to the psychosocial aspects of health. It promotes excellence in scholarship, stimulates international collaborations and develops research and applied projects which enhance wellbeing and reduce injustices and inequalities for individuals and communities. 

Its work has been funded by the Bulgarian Ministry of Science and Education, WHO, The Gates Foundation, Jacobs Foundation, EU Framework 7 Programme, UNICEF, UNESCO.

Previous experience relevant to the Tasks:

HPRC has conducted multiple studies in psychosocial aspects of health, including in the areas of health education, preventing mental health problems and promoting youth physical and mental health, and addressing the school environment. We have extensive experience in the tasks relevant to this proposal including research on cervical cancer prevention (screening and vaccination) and in qualitative methodologies and action research, more

specifically communication with stakeholders, data collection and analysis, dissemination of research findings, and developing health promotion recommendations.

• HBSC: Health and Behaviour in School Aged Children: An international WHO affiliated study. 2005-2008; 2013-2015
• PREDI-NU: Preventing Depression and Improving Awareness through Networking in the EU – EHealth project: EU Executive Agency for Health and Consumers, 10 country team. Developed the self-management E-tool for depression iFightDepression.
• ORCAB: Improving quality and safety in the hospital: The link between organizational culture, burnout and quality of care. European Commission Seventh Framework Programme, 10 country international team.

Team:

• Irina Todorova, PhD, is Director of the Health Psychology Research Center 
• Yulia Panayotova, PhD in Social Medicine from the Medical University, Sofia. Panayotova is employed as Director of Projects at the Health Psychology Research Center; she will be working in the position of postdoc for this project and project manager, bearing the personnel costs for her role for this project.

ECL is a pan-European umbrella organisation of national and regional cancer leagues. Established in 1980, ECL has been providing a unique and important platform for cancer societies in the extended Europe, from Iceland to Turkey. ECL’s 30 member leagues provide advice, support, and other services in cancer control in 25 countries (as of 2020), to more than 500 million citizens.

The major fields of activity for ECL’s members includes cancer prevention; public information and awareness campaigns; services for patients and their families and relatives; and direct support for research to defeat cancer.

Since 2015, ECL has been the primary organisation responsible for disseminating the European Code Against Cancer, which is an initiative of the European Commission to inform people about actions they can take for themselves or their families to reduce their risk of cancer.

Previous experience relevant to the Tasks:

The ECL secretariat can provide substantial experience in public communication across all aspects of cancer control accrued during the 40 years of the association’s existence. The ECL secretariat can take advantage of its coordination role to activate the current membership of the Association of European Cancer Leagues (currently 30 cancer societies in 25 European countries) in dissemination actions, including relations with national mass media.

ECL director Dr Wendy Yared has over 25 years’ experience in public health at international level, including active participation in relevant EU projects and initiatives, such as the CANCON, EPAAC and iPAAC joint actions, the relaunch of the annual European Week Against Cancer, and validating the public communication of the 4th edition of the European Code Against Cancer.

Team: 

• Arianna Khatchadourian, EU Projects Officer.
• Wendy TSE YARED, Director of the Association of European Cancer Leagues (ECL).