Self-Collection for Primary HPV Testing: Perspectives on Implementation From Federally Qualified Health Centers

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Le, Amanda ; Rohweder, Catherine ; Wheeler, Stephanie B. ; Lafata, Jennifer Elston ; Teal, Randall ; Giannone, Kara ; Zaffino, MaryShell ; Smith, Jennifer S.
• Description:
  Introduction
  
  Primary testing for high-risk human papillomavirus (HPV) by self-collection could result in higher rates of cervical cancer screening. Federally qualified health centers (FQHCs) in the US serve a large proportion of women who have low income and no health insurance and are medically underserved — risk factors for being insufficiently screened for cervical cancer. Although the implementation of self-collection for HPV testing is not yet widespread, health care entities need to prepare for its eventual approval by the US Food and Drug Administration. We conducted focus groups and interviews among clinical and administrative staff and leadership to gather data on key logistical concerns that must be addressed before implementing self-collection for HPV testing in FQHCs.
  
  Methods
  
  We identified focus group and interview participants from 6 FQHCs in North Carolina. We conducted focus groups with clinical and administrative staff (N = 45) and semistructured interviews with chief executive officers, senior-level administrators, chief medical officers, and clinical data managers (N = 24). Transcripts were coded by using codebooks derived from research questions and notes taken during data collection. Themes emerged on implementation of self-collection for HPV testing. We applied the constructs from the Consolidated Framework for Implementation Research (CFIR) to themes to identify domains of potential barriers and facilitators to implementation.
  
  Results
  
  Clinical personnel reported that offering self-collection for HPV testing is acceptable and feasible and can increase cervical cancer screening rates. Uncertainties emerged about accuracy of results, workflow disruptions, financial implications, and effects on clinic quality measures.
  
  Conclusion
  
  Implementing self-collection for HPV testing was considered feasible and acceptable by participants. However, important health service delivery considerations, including financial implications, must be addressed before integrating self-collection for HPV testing into the standard of care.
  
  
• Subjects:
  Delivery Of Health Care Early Detection Of Cancer Female Humans Mass Screening Papillomavirus Infections Uterine Cervical Neoplasms
• Source:
  Prev Chronic Dis. 2023; 20
• DOI:
  http://dx.doi.org/10.5888/pcd20.230056
• ISSN:
  1545-1151
• Pubmed ID:
  37857461
• Pubmed Central ID:
  PMC10599328
• Document Type:
  Journal Article
• Funding:
  P30 CA016086/CA/NCI NIH HHSUnited States/ ; P30 DK056350/DK/NIDDK NIH HHSUnited States/ ; UH2 CA202663/CA/NCI NIH HHSUnited States/ ; UH3 CA202663/CA/NCI NIH HHSUnited States/
• Place as Subject:
  North Carolina
• Volume:
  20
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:71082a0c6c69442d23d382bf6845dd58623a314ff0f750279ddce0bc46ed9fc88073920c7743518b2ceca30bdefc14be5d795ba9eb7979fffa09274d1c5eb311
• Download URL:
  https://stacks.cdc.gov/view/cdc/151122/cdc_151122_DS1.pdf
• File Type:
  [PDF - 540.47 KB ]