TY - JOUR
T1 - Understanding Patients' Perspectives and Information Needs Following a Positive Home Human Papillomavirus Self-Sampling Kit Result
AU - Tiro, Jasmin A.
AU - Betts, Andrea C.
AU - Kimbel, Kilian
AU - Buist, Diana S.M.
AU - Mao, Constance
AU - Gao, Hongyuan
AU - Shulman, Lisa
AU - Malone, Colin
AU - Beatty, Tara
AU - Lin, John
AU - Thayer, Chris
AU - Miglioretti, Diana L.
AU - Winer, Rachel L.
N1 - Funding Information:
We greatly appreciate the dedicated work of Mary Shea at Kaiser Permanente Washington Health Research Institute for her significant contributions to the qualitative interviews processes. This work was supported by the National Cancer Institute of the National Institutes of Health (grant no. R01CA168598-01A1). A.C.B. was also supported by NCI/-NIH (grant no. R25CA57712). The National Cancer Institute was not involved in the study design; the collection, analysis, or interpretation of data; the writing of this report; or the decision to submit this report for publication.
Publisher Copyright:
© 2019 Mary Ann Liebert, Inc.
PY - 2019/3
Y1 - 2019/3
N2 - Objective: We explored patient perspectives after a positive human papillomavirus (HPV) self-sampling result to describe experiences and information needs for this home-based screening modality. Materials and Methods: We recruited women who tested high-risk (hr) HPV positive during a pragmatic trial evaluating mailed hrHPV self-sampling kits as an outreach strategy for women overdue for Pap screening in a U.S. integrated health care system. Telephone interviews were conducted from 2014 to 2017. Five independent coders analyzed transcripts using iterative content analysis. Results: Forty-six women (61% of invited; median age 55.5 years) completed a semistructured interview. Six themes emerged: (1) convenience of home-based screening, (2) intense feelings and emotions after receiving positive kit results, (3) importance of seeing provider and discussing kit results, (4) information seeking from various sources, (5) confusion about purpose and meaning of HPV versus Pap tests, and (6) concern that HPV self-sampling is inaccurate when the subsequent Pap test is normal. Conclusions: Although women liked the kit's convenience, discussion about discordant home HPV and in-clinic Pap results led them to question the accuracy of HPV self-sampling. Patient-provider communication around home HPV kits is more complex than for reflex or cotesting because clinician-collected Pap results are unknown at the time of the positive kit result. Patients need education about differences between HPV and Pap tests and how they are used for screening and follow-up. To reassure patients and keep them interested in self-sampling, education should be provided at multiple time points during the screening process.
AB - Objective: We explored patient perspectives after a positive human papillomavirus (HPV) self-sampling result to describe experiences and information needs for this home-based screening modality. Materials and Methods: We recruited women who tested high-risk (hr) HPV positive during a pragmatic trial evaluating mailed hrHPV self-sampling kits as an outreach strategy for women overdue for Pap screening in a U.S. integrated health care system. Telephone interviews were conducted from 2014 to 2017. Five independent coders analyzed transcripts using iterative content analysis. Results: Forty-six women (61% of invited; median age 55.5 years) completed a semistructured interview. Six themes emerged: (1) convenience of home-based screening, (2) intense feelings and emotions after receiving positive kit results, (3) importance of seeing provider and discussing kit results, (4) information seeking from various sources, (5) confusion about purpose and meaning of HPV versus Pap tests, and (6) concern that HPV self-sampling is inaccurate when the subsequent Pap test is normal. Conclusions: Although women liked the kit's convenience, discussion about discordant home HPV and in-clinic Pap results led them to question the accuracy of HPV self-sampling. Patient-provider communication around home HPV kits is more complex than for reflex or cotesting because clinician-collected Pap results are unknown at the time of the positive kit result. Patients need education about differences between HPV and Pap tests and how they are used for screening and follow-up. To reassure patients and keep them interested in self-sampling, education should be provided at multiple time points during the screening process.
KW - Human papillomavirus DNA tests
KW - early detection of cancer
KW - mass screening
KW - qualitative research
KW - uterine cervical neoplasms
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U2 - 10.1089/jwh.2018.7070
DO - 10.1089/jwh.2018.7070
M3 - Article
C2 - 30481121
AN - SCOPUS:85062958489
SN - 1540-9996
VL - 28
SP - 384
EP - 392
JO - Journal of Women's Health
JF - Journal of Women's Health
IS - 3
ER -