Preferences for interventions designed to increase cervical screening uptake in non‐attending young women: How findings from a discrete choice experiment compare with observed behaviours in a trial

Abstract

Background: Young women's attendance at cervical screening in the UK is continuing to fall, and the incidence of invasive cervical cancer is rising. Objectives:We assessed the preferences of non-attending young women for alternative ways of delivering cervical screening.Design: Postal discrete choice experiment (DCE) conducted during the STRATEGIC study of interventions for increasing cervical screening uptake. Attributes included action required to arrange a test, location of the test, availability of a nurse navigator and cost to the National Health Service.Setting and participants: Non-attending young women in two UK regions. Main outcome measures:Responses were analysed using a mixed multinomial logit model. A predictive analysis identified the most preferable strategy compared to current screening. Preferences from the DCE were compared with observed behaviours during the STRATEGIC trial. Results:The DCE response rate was 5.5% (222/4000), and 94% of respondents agreed screening is important. Preference heterogeneity existed around attributes with strong evidence for test location. Relative to current screening, unsolicited selfsampling kits for home use appeared most preferable. The STRATEGIC trial showed this same intervention to be most effective although many women who received it and were screened, attended for conventional cytology instead. Conclusions:The DCE and trial identified the unsolicited self-sampling kit as the most preferred/effective intervention. The DCE suggested that the decision of some | 203 CAMPBELL Et AL.

Lack of Awareness, Body Confidence and Connotations of Sex: An Interpretative Phenomenological Analysis of Barriers Affecting the Decision to Attend Initial Cervical Cancer Screening

“…CCS has sexual connotations which contribute to embarrassment, 17,22,23 concerns over partner opinions 3,4 and may trigger traumatic memories. 44 The findings of the current study extend and bolster the case for a move towards self-sampling at home, 3,59 which may circumvent these potential barriers, alongside traditional barriers such as time and location.…”

Accounting for Preference Heterogeneity in Discrete-Choice Experiments: An ISPOR Special Interest Group Report

“…Studies that reported using continuous distributions for the random parameters (eg, RPL, GMNL) most commonly specified a normal distribution (n = 110), although there were examples of lognormal (n = 15) and triangular distributions (n = 2). 29,30 A handful of studies [31][32][33] reported using an RPL model with correlated parameters, but reporting on the assumed covariance matrix of random parameters was generally limited.…”

How do young women approaching screening age interpret the NHS cervical screening leaflet? A mixed methods study of identifying interpretation difficulties, barriers, facilitators, and leaflet interpretation, engagement and future screening behaviour

“…Digital educational initiatives are suggested to address identified barriers, counter low cancer risk beliefs, and amplify the perceived importance of screening (Chorley et al, 2017 ; Vorsters et al, 2017 ). Additionally, implementing at-home screening test kits, supported by previous research (Campbell et al, 2020 ), shows promise in overcoming emotional barriers such as embarrassment and anxiety, thereby addressing critical factors hindering young women from attending screening appointments.…”