Self-administered versus provider-directed sampling in the Anishinaabek Cervical Cancer Screening Study (ACCSS): a qualitative investigation with Canadian First Nations women
Background While (Pap)anicolaou screening has helped to decrease cervical cancer incidence in Canada, First Nations women continue to have a higher burden and mortality relative to mainstream populations. Many First Nations women may feel uncomfortable with the invasiveness of this test, contributin...
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crjcrbmj:10.1136/bmjopen-2017-017384 2024-06-23T07:45:35+00:00 Self-administered versus provider-directed sampling in the Anishinaabek Cervical Cancer Screening Study (ACCSS): a qualitative investigation with Canadian First Nations women Zehbe, Ingeborg Wakewich, Pamela King, Amy-Dee Morrisseau, Kyla Tuck, Candace Institute of Aboriginal Peoples Health 2017 http://dx.doi.org/10.1136/bmjopen-2017-017384 https://syndication.highwire.org/content/doi/10.1136/bmjopen-2017-017384 en eng BMJ BMJ Open volume 7, issue 8, page e017384 ISSN 2044-6055 2044-6055 journal-article 2017 crjcrbmj https://doi.org/10.1136/bmjopen-2017-017384 2024-05-30T08:18:56Z Background While (Pap)anicolaou screening has helped to decrease cervical cancer incidence in Canada, First Nations women continue to have a higher burden and mortality relative to mainstream populations. Many First Nations women may feel uncomfortable with the invasiveness of this test, contributing to this statistic. Implemented from 2009 to 2015 in 10 Northwest Ontario First Nations communities, the Anishinaabek Cervical Cancer Screening Study (ACCSS) uniquely addressed this Indigenous health inequity through a mixed methods approach. Objective Our goal was to offer an alternative test which the women could do themselves: human papillomavirus (HPV) testing based on self-sampling. We investigated whether First Nations women preferred HPV self-sampling over healthcare provider (HCP)-administered Pap screening. Methods Participatory action researchinformed by the ethical space concept has guided all stages of the ACCSS. We conducted qualitative interviews with 16 HCPs and 8 focus group discussions with 69 female community members followed by a cluster-randomised controlled trial (RCT). Here, we draw on the qualitative field data and an end-of-study community update gathering to disseminate and contextualise research findings. Informant data were evaluated using thematic analysis. Results We discuss factors influencing participants’ strong preference for HPV self-sampling over physician-conducted Pap screening. Key arguments included enhanced accessibility and more personal control, less physical and emotional discomfort and fewer concerns regarding privacy of test results. For future implementation of HPV self-sampling, study participants emphasised the need for more culturally sensitive education addressed to community members of all genders, starting at school, clarifying that HPV causes cervical cancer. Further, HPV infection should be de-stigmatised by accentuating that it affects men and women alike. Conclusion Here we show that self-sampling in conjunction with community engagement and culturally sensitive ... Article in Journal/Newspaper anishina* First Nations The BMJ Canada BMJ Open 7 8 e017384 |
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English |
description |
Background While (Pap)anicolaou screening has helped to decrease cervical cancer incidence in Canada, First Nations women continue to have a higher burden and mortality relative to mainstream populations. Many First Nations women may feel uncomfortable with the invasiveness of this test, contributing to this statistic. Implemented from 2009 to 2015 in 10 Northwest Ontario First Nations communities, the Anishinaabek Cervical Cancer Screening Study (ACCSS) uniquely addressed this Indigenous health inequity through a mixed methods approach. Objective Our goal was to offer an alternative test which the women could do themselves: human papillomavirus (HPV) testing based on self-sampling. We investigated whether First Nations women preferred HPV self-sampling over healthcare provider (HCP)-administered Pap screening. Methods Participatory action researchinformed by the ethical space concept has guided all stages of the ACCSS. We conducted qualitative interviews with 16 HCPs and 8 focus group discussions with 69 female community members followed by a cluster-randomised controlled trial (RCT). Here, we draw on the qualitative field data and an end-of-study community update gathering to disseminate and contextualise research findings. Informant data were evaluated using thematic analysis. Results We discuss factors influencing participants’ strong preference for HPV self-sampling over physician-conducted Pap screening. Key arguments included enhanced accessibility and more personal control, less physical and emotional discomfort and fewer concerns regarding privacy of test results. For future implementation of HPV self-sampling, study participants emphasised the need for more culturally sensitive education addressed to community members of all genders, starting at school, clarifying that HPV causes cervical cancer. Further, HPV infection should be de-stigmatised by accentuating that it affects men and women alike. Conclusion Here we show that self-sampling in conjunction with community engagement and culturally sensitive ... |
author2 |
Institute of Aboriginal Peoples Health |
format |
Article in Journal/Newspaper |
author |
Zehbe, Ingeborg Wakewich, Pamela King, Amy-Dee Morrisseau, Kyla Tuck, Candace |
spellingShingle |
Zehbe, Ingeborg Wakewich, Pamela King, Amy-Dee Morrisseau, Kyla Tuck, Candace Self-administered versus provider-directed sampling in the Anishinaabek Cervical Cancer Screening Study (ACCSS): a qualitative investigation with Canadian First Nations women |
author_facet |
Zehbe, Ingeborg Wakewich, Pamela King, Amy-Dee Morrisseau, Kyla Tuck, Candace |
author_sort |
Zehbe, Ingeborg |
title |
Self-administered versus provider-directed sampling in the Anishinaabek Cervical Cancer Screening Study (ACCSS): a qualitative investigation with Canadian First Nations women |
title_short |
Self-administered versus provider-directed sampling in the Anishinaabek Cervical Cancer Screening Study (ACCSS): a qualitative investigation with Canadian First Nations women |
title_full |
Self-administered versus provider-directed sampling in the Anishinaabek Cervical Cancer Screening Study (ACCSS): a qualitative investigation with Canadian First Nations women |
title_fullStr |
Self-administered versus provider-directed sampling in the Anishinaabek Cervical Cancer Screening Study (ACCSS): a qualitative investigation with Canadian First Nations women |
title_full_unstemmed |
Self-administered versus provider-directed sampling in the Anishinaabek Cervical Cancer Screening Study (ACCSS): a qualitative investigation with Canadian First Nations women |
title_sort |
self-administered versus provider-directed sampling in the anishinaabek cervical cancer screening study (accss): a qualitative investigation with canadian first nations women |
publisher |
BMJ |
publishDate |
2017 |
url |
http://dx.doi.org/10.1136/bmjopen-2017-017384 https://syndication.highwire.org/content/doi/10.1136/bmjopen-2017-017384 |
geographic |
Canada |
geographic_facet |
Canada |
genre |
anishina* First Nations |
genre_facet |
anishina* First Nations |
op_source |
BMJ Open volume 7, issue 8, page e017384 ISSN 2044-6055 2044-6055 |
op_doi |
https://doi.org/10.1136/bmjopen-2017-017384 |
container_title |
BMJ Open |
container_volume |
7 |
container_issue |
8 |
container_start_page |
e017384 |
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1802641321711632384 |