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Williams, Denitza; Davies, Myfanwy; Fiander, Alison Nina; Farewell, Daniel; Hillier, Sharon; Brain, Katherine Emma (2017)
Publisher: Wiley-Blackwell
Journal: Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
Languages: English
Types: Article
Subjects: Original Research Paper, self‐sampling, RG, attitudes, human papillomavirus, cervical screening, intentions, Original Research Papers, HPV, R1
Background: Testing for human papillomavirus (HPV) is being incorporated into the cervical\ud screening programme, with the probable future introduction of HPV as a primary test\ud and a possibility of HPV self-sampling.\ud In anticipation of this development, we sought to\ud inform future policy and practice by identifying potential barriers to HPV self-sampling.\ud Methods: A cross-sectional\ud survey of 194 women aged 20-64\ud years was conducted.\ud Logistic regression analysis was used to identify determinants of self-sampling\ud intentions.\ud A purposive subsample of 19 women who reported low self-sampling\ud intentions\ud were interviewed. Interviews were framework-analysed.\ud Results: Most survey participants (N=133, 69.3%) intended to HPV self-sample.\ud Lower\ud intention was associated with lower self-efficacy\ud (OR=24.96, P≤.001), lower education\ud (OR=6.06, P≤.05) and lower perceived importance of HPV as a cause of cervical\ud cancer (OR=2.33, P≤.05). Interviews revealed personal and system-related\ud barriers.\ud Personal barriers included a lack of knowledge about HPV self-sampling,\ud women’s low\ud confidence in their ability to self-sample\ud correctly and low confidence in the subsequent\ud results. System-related\ud factors included a lack of confidence in the rationale for\ud modifying the current cervical screening programme, and concerns about sample\ud contamination\ud and identity theft.\ud Conclusions: Insights gained from this research can be used to guide further enquiry\ud into the possibility of HPV self-sampling\ud and to help inform future policy and practice.\ud Personal and system-related\ud barriers including low confidence in the reasons for\ud changing current cervical screening provision need to be addressed, should HPV self-sampling\ud be incorporated into the cervical screening programme.