Overcoming Barriers to Cervical Screening Among Pacific Women: A Narrative Review

Abstract

Purpose: This narrative review explores the barriers and facilitators for Pacific women accessing the cervical screening pathway. Despite organized cervical screening in New Zealand, Pacific women still face significant health disparities in regard to cervical cancer incidence and mortality and access to colposcopy services. Providing a narrative synthesis of the available literature examining Pacific women and the barriers and facilitators to the cervical screening pathway may provide some insight into the provision of primary and secondary health services for Pacific women.Methods: Four electronic databases were searched for articles published between January 1990 and June 2017 and included bibliographies of key journal articles and gray material. A narrative review and synthesis were undertaken of qualitative, quantitative, and mixed methods research.Results: The literature is focused on the cervical screening aspect of the cervical screening pathway. There was a paucity of literature that examines the barriers and facilitators Pacific women experience accessing colposcopy services. Barriers to cervical screening for Pacific women are multifaceted and interrelated. Factors such as culture, fear, practical issues, health care experiences, and knowledge/education influence screening practices. Facilitators to cervical screening are also multifaceted and included knowledge, health care experience, culture, and practical issues. Culturally tailored approaches improve access to cervical screening for Pacific women.Conclusion: Understanding Pacific women's experiences, facilitators, and barriers to the cervical screening pathway is essential in assisting health care professionals, policy makers, and funders provide culturally appropriate services. Further research is required to examine Pacific women's experiences of navigating colposcopy services and the interface between primary and secondary care services.

He Tapu Te Whare Tangata (sacred house of humanity): Under‐screened Māori women talk about HPV self‐testing cervical screening clinical pathways

“…Women deserve to be nurtured throughout the entire pathway and be informed so they are not put off this new screening pathway (and technology). As asserted by previous research, culturally appropriate health promotion campaigns are vital to provide the public with information about changes to cervical screening pathways 5,28,29,36 …”

“…As asserted by previous research, culturally appropriate health promotion campaigns are vital to provide the public with information about changes to cervical screening pathways. 5,28,29,36 Attending colposcopy was often stressful or uncomfortable for these women. Emotional and material support to help them attend were considered important, as was being treated sensitively by colposcopy teams.…”

Human Papillomavirus (HPV) Self-Sampling among Never-and Under-Screened Indigenous Māori, Pacific and Asian Women in Aotearoa New Zealand: A Feasibility Study

“…Of those who made an appointment, nearly a third did not attend the primary care practice setting. There are known barriers to primary care access in Aotearoa, New Zealand [34][35][36][37]. The focus groups led to the highest uptake of self-sampling, and in discussions about their experience of the current screening programme, some Pacific women indicated that they would prefer to discuss and attend a screening in a group setting.…”

Feasibility and acceptability of telehealth and contactless delivery of human papillomavirus (HPV) self-testing for cervical screening with Māori and Pacific women in a COVID-19 outbreak in Aotearoa New Zealand

“…4 Self-testing reduces a range of barriers to screening. [5][6][7] Our research and other local studies have demonstrated that self-testing is acceptable, improves participation in screening and will improve equity if well implemented. [8][9][10] We have shown that very overdue and never-screened Māori, Pacific and Asian women were more likely to accept offer of a mailed self-test kit than the same offer in a clinic and, further, that these groups of women have a strong preference for a mailed self-test method of delivery.…”