Adopting the PREVENTABLE Model

The Cervical Cancer Prevention in El Salvador (CAPE) program completed a series of human papillomavirus (HPV)-based screening demonstration projects that resulted in modification of screening guidelines and set the stage for national implementation of HPV primary screening. This chapter outlines the elements that contributed to the success of CAPE within a process of change model called PREVENTABLE. The model rests on two pillars, political will and evidence, which feed and complement one another. Recognizing political windows of opportunity and obtaining government commitment are crucial to support innovative programs and effect significant transformations. Simultaneously, convincing evidence motivates and channels political will. Thus, primary drivers of the model are research and evaluation of outcomes that reinforce the main pillars; secondary drivers are context dependent, including education, advocacy, negotiation, the legal framework, and budgetary constraints. The experiences from CAPE and PREVENTABLE provide possible blueprints to renovate existing paradigms of cancer control programs.