Health care provider perspectives on cervical screening for Aboriginal and Torres Strait Islander women: a qualitative study

Abstract

Objective: To investigate perspectives of primary health care providers (HCPs) on providing cervical screening for Aboriginal and Torres Strait Islander women, who experience a higher burden of cervical cancer than other Australian women. Methods: Semi‐structured interviews with 13 HCPs from four Australian Indigenous primary health care centres (PHCCs). Transcripts were thematically analysed. Results: HCPs discussed the need to approach cervical screening with sensitivity to women's emotional and cultural needs and sustaining relationships built on trust and respect. HCPs reported challenges in promoting screening to Aboriginal and Torres Strait Islander women due to cumbersome systems, competing clinical priorities, workforce capacity limitations and specific challenges associated with implementing the renewed National Cervical Screening Program. Conclusions: In practice, HCPs experience several challenges to delivering cervical screening. Understanding HCPs’ perspectives on their approach to cervical screening delivery, and the systems in which this occurs, can help to ensure that they receive adequate support and resources to deliver cervical screening to Aboriginal and Torres Strait Islander women. Implications for public health: It is important that HCPs adopt a multi‐faceted, person‐centred approach to cervical screening that is responsive to women's needs and that works synchronously with supportive PHCC services and systems and the National Cancer Screening Register.

Aboriginal and Torres Strait Islander women's views of cervical screening by self‐collection: a qualitative study

“…46 Evidence suggests that healthcare professionals consider self-collection as a valuable option, particularly for under-and never-screened women, but they remain uncertain and hesitant about its efficacy and continue to view clinician-collected samples as the gold standard. 25,[46][47][48] Despite it being highly anticipated, there were delays to the introduction of selfcollection. This was largely due to the need for laboratories to conduct and have approved their own in-house validation to process self-collected samples; only one laboratory had done so in Australia when self-collection was introduced.…”

“…It highlights the need to ensure that clinicians are aware of self‐collection and are confident in recommending it to their clientele 46 . Evidence suggests that healthcare professionals consider self‐collection as a valuable option, particularly for under‐ and never‐screened women, but they remain uncertain and hesitant about its efficacy and continue to view clinician‐collected samples as the gold standard 25,46-48 …”

“…The methods and study design have been described in detail elsewhere. 7,26 In brief, the study was conceptualised, led and conducted by Aboriginal and Torres Strait Islander women (Author 1, Author 2, Author 5). We included both screened and under-or never-screened women who were recruited from five Aboriginal and Torres Strait Islander Primary Health Care Centres (PHCC) across three Australian states/territories.…”

“…The data reported here are from a larger study entitled Screening Matters: Aboriginal and Torres Strait Islander women's attitudes and perspectives on participation in cervical screening. The methods and study design have been described in detail elsewhere 7,26 . In brief, the study was conceptualised, led and conducted by Aboriginal and Torres Strait Islander women (Author 1, Author 2, Author 5).…”

Health care provider's experience and perspective of cervical cancer screening in Singapore: A qualitative study

“…We identified the downside of not having an organized screening program with a call and recall capacity, challenges for expanding CCS under current clinical settings and patient preference for screening settings. In particular, a lower acceptance to screening was observed in primary care settings compared to tertiary care settings, which has not been reported in studies from other high-income countries ( 22 – 24 ) This may be driven by preferences for specialist care among women, as well as the primary care physicians' lack of time to discuss CCS in light of other health priorities. Unlike previous research in Singapore ( 14 ), we also explored perspectives on recent CCS innovations, such as self-sampling and HPV genotyping, and their role in clinical practice.…”