Integrating HPV self-collect into primary care to address cervical cancer screening disparities.
Integrating HPV self-collect into primary care to address cervical cancer screening disparities.
复制标题
将 HPV 自我收集纳入初级保健，以解决宫颈癌筛查差异。
DOI：
10.1016/j.pmedr.2024.102599
复制
发表时间：
2024-02
影响因子：
2.8
通讯作者：
Winer, Rachel L.
中科院分区：
文献类型：
--
作者：
Pratt, Rebekah;Barsness, Christina Bliss;Lin, John;Desai, Jay;Fordyce, Kristi;Ghebre, Rahel;Hassan, Faiza;Ibrahim, Anisa;Ramer, Tim;Szpiro, Adam;Weiner, Bryan J.;Xiong, Serena;Yohe, Sophia;Winer, Rachel L.
关键词：
人乳头瘤病毒(HPV)自我收集显示，在筛查不足的人群中，如索马里患者，有望提高宫颈癌筛查率，但人们对如何将这种方法整合到初级保健中知之甚少。在这项研究中，向索马里妇女提供初级保健服务的初级保健提供者和工作人员被问及他们对将HPV自我收集纳入常规保健以解决宫颈癌筛查差距的看法。30名初级保健提供者和工作人员参加了半结构化访谈，探讨他们对HPV自我收集的看法，以及他们在诊所普遍实施这一方法的预期需求或障碍，以及与索马里妇女等特定患者群体的访谈。使用建构主义版本的扎根理论进行了主题分析。提供者和工作人员希望患者对HPV自我收集的选择有积极的反应，并对对索马里患者和所有患者使用这种方法感兴趣。HPV Self-Collect被认为可以直接整合到现有的临床工作流程中。提供者在很大程度上缺乏对支持初步HPV检测和HPV自我收集的证据的认识，分享了对自我收集的有效性和缺乏体检的担忧。提供者认为，要成功实施，需要全诊所的工作人员教育和患者教育，以及解决差异的战略，如文化和语言定制。将HPV自我收集作为初级保健临床就诊中宫颈癌筛查过程中的一种选择，提供了相当大的机会来解决健康差距，并可能使所有患者受益。
Human papillomavirus (HPV) self-collect shows promise to increase cervical cancer screening rates in underscreened populations, such as Somali patients, but little is known about how to integrate such an approach in primary care. In this study, primary care providers and staff who provide primary care services to Somali women were asked for their views on integrating HPV self-collect into routine care to address cervical cancer screening disparities. Thirty primary care providers and staff participated in semi-structured interviews exploring their views on HPV self-collect and their anticipated needs or barriers to implementing this approach into the clinic generally and with specific patient populations, such as Somali women. A thematic analysis using the constructivist version of grounded theory was undertaken. Providers and staff anticipate positive patient reaction to the option of HPV self-collect, and were interested in using this approach both for Somali patients and for all patients in general. HPV self-collect was viewed as straightforward to integrate into existing clinic workflows. Providers largely lacked awareness of the evidence supporting primary HPV testing and HPV self-collect specifically, sharing concerns about effectiveness of self-collect and the lack of a physical exam. Providers felt clinic-wide staff education and patient education, along with strategies to address disparities, such as cultural and linguistic tailoring would be needed for successful implementation. Integrating HPV self-collect as an option in the cervical cancer screening process in a primary care clinical encounter offers considerable opportunity to address health disparities and may benefit all patients.
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