Understanding the effect of new U.S. cervical cancer screening guidelines and modalities on patients' comprehension and reporting of their cervical cancer screening behavior.
Understanding the effect of new U.S. cervical cancer screening guidelines and modalities on patients' comprehension and reporting of their cervical cancer screening behavior.
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DOI：
10.1016/j.pmedr.2023.102169
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发表时间：
2023-04
影响因子：
2.8
通讯作者：
Kessler, Larry G.
中科院分区：
文献类型：
--
作者：
Higashi, Robin T.;Tiro, Jasmin A.;Winer, Rachel L.;Ornelas, India J.;Bravo, Perla;Quirk, Lisa;Kessler, Larry G.
关键词：
认知访谈有助于评估不同人群的理解能力。“宫颈癌筛查”一词使许多少数群体参与者感到困惑。许多参与者不知道子宫颈检查的两种方式。关于HPV自我采样的不同信念可能反映了社会人口因素。我们对推荐的美国调查项目进行了改进，以增强理解。随着最近美国指南推荐的宫颈癌筛查的转变，精确测量筛选行为是重要的。以前的研究表明，美国国家健康访谈调查（NHIS）是一种用于测量自我报告的筛查依从性的资源，在非白人种族/民族群体和非英语人群中的有效性较低。此外，测量不同人群对项目的理解和对HPV自我采样的态度值得调查，因为这是一种可能很快在美国推荐的方式。本研究以认知方式测试NHIS项目，评估接受子宫颈癌筛检的近因与原因，以及对HPV自我取样的态度。我们在2021年4月至2022年4月期间用英语和西班牙语对过去两年中由华盛顿大都市西雅图的医疗中心或德克萨斯州达拉斯的安全网医疗保健系统筛选的个人进行了认知访谈。访谈探讨了对筛查原因的理解，异常结果的经验以及对HPV自我采样的兴趣。我们在西雅图完成了32次采访，在达拉斯完成了42次采访。大多数参与者不知道存在两种不同的宫颈癌筛查测试（Pap和HPV）。许多人不知道他们接受的是哪种类型的测试。与西雅图的参与者相比，达拉斯的参与者对HPV的了解更加有限和不准确，对HPV自我采样的反应更少（32%对55%）。为了提高对宫颈癌筛查的理解和准确报告，我们建议对目前使用的调查问题进行具体改进。应进一步探讨对自我采样的态度，因为区域和/或社会人口因素可能存在差异。
Cognitive interviews are useful to assess comprehension in diverse populations. The term “cervical cancer screening” confused many minoritized participants. Many participants were unaware of the two modalities for cervical screening. Different beliefs about HPV self-sampling may reflect sociodemographic factors. We offer refinements to recommended U.S. survey items to enhance comprehension. With recent shifts in guideline-recommended cervical cancer screening in the U.S., it is important to accurately measure screening behavior. Previous studies have indicated the U.S. National Health Interview Survey (NHIS), a resource for measuring self-reported screening adherence, has lower validity among non-White racial/ethnic groups and non-English speakers. Further, measuring diverse population groups’ comprehension of items and attitudes toward HPV self-sampling merits investigation as it is a modality likely to be recommended in the U.S. soon. This study cognitively tested NHIS items assessing recency of and reasons for receiving cervical cancer screening and attitudes toward HPV self-sampling. We conducted cognitive interviews between April 2021 - April 2022 in English and Spanish with individuals screened in the past two years by either a medical center in metropolitan Seattle, Washington or a safety-net healthcare system in Dallas, Texas. Interviews probed understanding of reasons for screening, experiences with abnormal results, and interest in HPV self-sampling. We completed 32 interviews in Seattle and 42 interviews in Dallas. A majority of participants were unaware that two different tests for cervical cancer screening exist (Pap and HPV). Many did not know which type(s) of test they received. Dallas participants had more limited and inaccurate knowledge of HPV compared to Seattle participants, and fewer responded favorably toward HPV self-sampling (32% vs. 55%). To improve comprehension and accurate reporting of cervical cancer screening, we suggest specific refinements to currently used survey questions. Attitudes toward self-sampling should be explored further as differences may exist by region and/or sociodemographic factors.
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