ASPO Abstracts
Barriers and facilitators to follow-up for women who tested positive for high-risk HPV using a self- sample kit during the COVID-19 pandemic
Category: Behavioral Science & Health Communication
Conference Year: 2023
Abstract Body:
Purpose: At-home self-sample human papillomavirus (HPV) tests are an alternative screening strategy for individuals underscreened for cervical cancer, but barriers and facilitators to follow-up among those who test positive for high-risk (HR-) HPV are relatively unknown. Methods: Data were collected as part of the PRESTIS (Prospective Evaluation of Self-Testing to Increase Screening) trial. Trial participants are women enrolled in a public safety net health system, ages 30-65 years, and underscreened for cervical cancer. We conducted semi-structured telephone interviews of 10 English-speaking participants who received positive HPV results after completing at-home self-sampling. We coded interview transcripts and analyzed them using a grounded theory approach. Results: Participants either attended their follow-up (n=6), scheduled their follow-up (n=3), or didn't attend their follow-up (n=1). Participants reported COVID-related barriers to follow-up, including delayed appointments due to COVID-19 infection and fear of acquiring COVID-19 when attending for follow-up. Lack of time constraints was a commonly reported facilitator among those who attended for follow-up. Additionally, self-motivation driven by fear of developing cancer and taking responsibility for personal health was an internal factor that influenced a participant's decision to attend their follow-up. Conclusion: COVID-19 was an important barrier to follow-up among women who received a positive self-sample HPV test. Despite being previously under screened for cervical cancer, participants were highly motivated to attend their clinical follow up due to internal and external factors. Further research is needed to better understand these barriers and facilitators to follow-up for future implementation of HPV self-sample kits.
Keywords: Human Papillomavirus, Self-Sampling Kits, (Factors Influencing) Follow Up, COVID-19, Qualitative Analysis