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297 Novel decision support for choice in cervical screening modality
  1. Elly Clarke1,
  2. Kate Lifford1,
  3. Kate Brain1,
  4. Adrian Edwards1,
  5. Fiona Wood1,
  6. Natalie Joseph-Williams1,
  7. Andrew Carson-Stevens1,
  8. Jo Waller2,
  9. Rhiannon Phillips3,
  10. Lindsay Haywood4,
  11. Caroline Evans4,
  12. Sally Killian4,
  13. Gareth Powell5,
  14. Katie Walbeoff5,
  15. Ardiana Gjini6,
  16. Katie Musialowski7,
  17. Denitza Williams1
  1. 1Division of Population Medicine and PRIME Centre Wales, School of Medicine, Cardiff University
  2. 2Wolfson institute of Population Health, Queen Mary University of London
  3. 3Cardiff School of Sport and Health Science, Cardiff Metropolitan University
  4. 4Public Partner
  5. 5Public Health UK
  6. 6Hywl Dda University Health Board
  7. 7Jo’s Cervical Cancer Trust, UK

Abstract

Introduction Cervical cancer is the fourth most common cancer in individuals with a cervix globally, despite being largely preventable by vaccination and screening. In the UK, uptake of free, routine cervical screening using human papillomavirus (HPV) testing is suboptimal. Offering a choice of in- clinic or self-sampling for HPV could improve participation. We aim to develop a combined behaviour change and shared decision making (SDM) logic model to inform the development of tools to support equitable and person-centered cervical screening.

Methods Individuals eligible for cervical screening from diverse backgrounds (N=30), and stakeholders (screening leads, health professionals, charities) (N=20), were interviewed to explore need and feasibility of a combined behaviour change and SDM intervention. Findings informed a theory-informed (I-SAM and IMPLEMENT-SDM) logic model of the active components required for a preference-based decision support tool. Theories guided the interview schedule and thematic analysis.

Results Six main themes emerged: attitudes to choice, need for SDM, misunderstanding of current screening, and offer of choice, decision support and launch preferences. Participants felt that a clear preparation phase for offer of choice, simple comparison of options, a range of intervention formats and hierarchy of information available from a trusted source were important. Stakeholder interviews are ongoing. A logic model to inform the development of a combined behaviour change and decision support tool will be presented at ISDM.

Discussion Cervical screening uptake is below recommended levels, knowledge about cervical screening is low and the need for behaviour change and decision support is high. There is a clear need for the development of integrated theories to ensure equitable and preference based screening.

Conclusion Given the radical change in cervical screening modalities now imminent, screening participants need novel resources to support both decision-making and behavioural implementation of those choices.

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