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“So, if she wasn’t aware of it, then how would everybody else out there be aware of it?”—Key Stakeholder Perspectives on the Initial Implementation of Self-Collection in Australia’s Cervical Screening Program: A Qualitative Study

Background: In December 2017, the Australian National Cervical Screening Program transitioned from 2-yearly cytology-based to 5-yearly human papillomavirus (HPV)-based cervical screening, including a vaginal self-collection option. Until July 2022, this option was restricted to under- or never-scree...

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Autores principales: Zammit, Claire M., Creagh, Nicola S., McDermott, Tracey, Smith, Megan A., Machalek, Dorothy A., Jennett, Chloe J., Prang, Khic-Houy, Sultana, Farhana, Nightingale, Claire E., Rankin, Nicole M., Kelaher, Margaret, Brotherton, Julia M. L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9739016/
https://www.ncbi.nlm.nih.gov/pubmed/36497850
http://dx.doi.org/10.3390/ijerph192315776
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author Zammit, Claire M.
Creagh, Nicola S.
McDermott, Tracey
Smith, Megan A.
Machalek, Dorothy A.
Jennett, Chloe J.
Prang, Khic-Houy
Sultana, Farhana
Nightingale, Claire E.
Rankin, Nicole M.
Kelaher, Margaret
Brotherton, Julia M. L.
author_facet Zammit, Claire M.
Creagh, Nicola S.
McDermott, Tracey
Smith, Megan A.
Machalek, Dorothy A.
Jennett, Chloe J.
Prang, Khic-Houy
Sultana, Farhana
Nightingale, Claire E.
Rankin, Nicole M.
Kelaher, Margaret
Brotherton, Julia M. L.
author_sort Zammit, Claire M.
collection PubMed
description Background: In December 2017, the Australian National Cervical Screening Program transitioned from 2-yearly cytology-based to 5-yearly human papillomavirus (HPV)-based cervical screening, including a vaginal self-collection option. Until July 2022, this option was restricted to under- or never-screened people aged 30 years and older who refused a speculum exam. We investigated the perspectives and experiences of stakeholders involved in, or affected by, the initial implementation of the restricted self-collection pathway. Methods: Semi-structured interviews were conducted with 49 stakeholders as part of the STakeholder Opinions of Renewal Implementation and Experiences Study. All interviews were audio recorded and transcribed. Data were thematically analysed and coded to the Conceptual Framework for Implementation Outcomes. Results: Stakeholders viewed the introduction of self-collection as an exciting opportunity to provide under-screened people with an alternative to a speculum examination. Adoption in clinical practice, however, was impacted by a lack of clear communication and promotion to providers, and the limited number of laboratories accredited to process self-collected samples. Primary care providers tasked with communicating and offering self-collection described confusion about the availability, participant eligibility, pathology processes, and clinical management processes for self-collection. Regulatory delay in developing an agreed protocol to approve laboratory processing of self-collected swabs, and consequently initially having one laboratory nationally accredited to process samples, led to missed opportunities and misinformation regarding the pathway’s availability. Conclusions: Whilst the introduction of self-collection was welcomed, clear communication from Government regarding setbacks in implementation and how to overcome these in practice were needed. As Australia moves to a policy of providing everyone eligible for screening the choice of self-collection, wider promotion to providers and eligible people, clarity around pathology processes and the scaling up of test availability, as well as timely education and communication of clinical management practice guidelines, are needed to ensure smoother program delivery in the future. Other countries implementing self-collection policies can learn from the implementation challenges faced by Australia.
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spelling pubmed-97390162022-12-11 “So, if she wasn’t aware of it, then how would everybody else out there be aware of it?”—Key Stakeholder Perspectives on the Initial Implementation of Self-Collection in Australia’s Cervical Screening Program: A Qualitative Study Zammit, Claire M. Creagh, Nicola S. McDermott, Tracey Smith, Megan A. Machalek, Dorothy A. Jennett, Chloe J. Prang, Khic-Houy Sultana, Farhana Nightingale, Claire E. Rankin, Nicole M. Kelaher, Margaret Brotherton, Julia M. L. Int J Environ Res Public Health Article Background: In December 2017, the Australian National Cervical Screening Program transitioned from 2-yearly cytology-based to 5-yearly human papillomavirus (HPV)-based cervical screening, including a vaginal self-collection option. Until July 2022, this option was restricted to under- or never-screened people aged 30 years and older who refused a speculum exam. We investigated the perspectives and experiences of stakeholders involved in, or affected by, the initial implementation of the restricted self-collection pathway. Methods: Semi-structured interviews were conducted with 49 stakeholders as part of the STakeholder Opinions of Renewal Implementation and Experiences Study. All interviews were audio recorded and transcribed. Data were thematically analysed and coded to the Conceptual Framework for Implementation Outcomes. Results: Stakeholders viewed the introduction of self-collection as an exciting opportunity to provide under-screened people with an alternative to a speculum examination. Adoption in clinical practice, however, was impacted by a lack of clear communication and promotion to providers, and the limited number of laboratories accredited to process self-collected samples. Primary care providers tasked with communicating and offering self-collection described confusion about the availability, participant eligibility, pathology processes, and clinical management processes for self-collection. Regulatory delay in developing an agreed protocol to approve laboratory processing of self-collected swabs, and consequently initially having one laboratory nationally accredited to process samples, led to missed opportunities and misinformation regarding the pathway’s availability. Conclusions: Whilst the introduction of self-collection was welcomed, clear communication from Government regarding setbacks in implementation and how to overcome these in practice were needed. As Australia moves to a policy of providing everyone eligible for screening the choice of self-collection, wider promotion to providers and eligible people, clarity around pathology processes and the scaling up of test availability, as well as timely education and communication of clinical management practice guidelines, are needed to ensure smoother program delivery in the future. Other countries implementing self-collection policies can learn from the implementation challenges faced by Australia. MDPI 2022-11-27 /pmc/articles/PMC9739016/ /pubmed/36497850 http://dx.doi.org/10.3390/ijerph192315776 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Zammit, Claire M.
Creagh, Nicola S.
McDermott, Tracey
Smith, Megan A.
Machalek, Dorothy A.
Jennett, Chloe J.
Prang, Khic-Houy
Sultana, Farhana
Nightingale, Claire E.
Rankin, Nicole M.
Kelaher, Margaret
Brotherton, Julia M. L.
“So, if she wasn’t aware of it, then how would everybody else out there be aware of it?”—Key Stakeholder Perspectives on the Initial Implementation of Self-Collection in Australia’s Cervical Screening Program: A Qualitative Study
title “So, if she wasn’t aware of it, then how would everybody else out there be aware of it?”—Key Stakeholder Perspectives on the Initial Implementation of Self-Collection in Australia’s Cervical Screening Program: A Qualitative Study
title_full “So, if she wasn’t aware of it, then how would everybody else out there be aware of it?”—Key Stakeholder Perspectives on the Initial Implementation of Self-Collection in Australia’s Cervical Screening Program: A Qualitative Study
title_fullStr “So, if she wasn’t aware of it, then how would everybody else out there be aware of it?”—Key Stakeholder Perspectives on the Initial Implementation of Self-Collection in Australia’s Cervical Screening Program: A Qualitative Study
title_full_unstemmed “So, if she wasn’t aware of it, then how would everybody else out there be aware of it?”—Key Stakeholder Perspectives on the Initial Implementation of Self-Collection in Australia’s Cervical Screening Program: A Qualitative Study
title_short “So, if she wasn’t aware of it, then how would everybody else out there be aware of it?”—Key Stakeholder Perspectives on the Initial Implementation of Self-Collection in Australia’s Cervical Screening Program: A Qualitative Study
title_sort “so, if she wasn’t aware of it, then how would everybody else out there be aware of it?”—key stakeholder perspectives on the initial implementation of self-collection in australia’s cervical screening program: a qualitative study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9739016/
https://www.ncbi.nlm.nih.gov/pubmed/36497850
http://dx.doi.org/10.3390/ijerph192315776
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