None listed
Conditions
Brief summary
Prior to the introduction of HPV primary screening and the option for HPV self-testing in September 2023, we began a broad research programme to investigate the implementation of non-standard strategies to improve uptake of HPV self-testing in three pathways (observational study): 1) in general practice via opportunistic offers, 2) mailed at-home testing via text message invite to people enrolled with the study primary health organisation (PHO), and 3) offering on-site and/or take-home testing at various community settings. The second pathway invited all eligible people enrolled with the study PHO (over 25,000 eligible people); of these, 6,067 consented to receive a test kit, but the proportion of participants who returned their sample was low (around 12%). We sought to test the offer of an incentive to increase sample return in the priority groups with the lowest return rates (Maori and Pacific) who had consented as part of the second pathway and received our full schedule of text message and call attempt reminders, but did not return their sample. While there is currently no published evidence for the use of participant incentives towards cervical screening in New Zealand, for wahine Maori and Pacific women, providing an incentive after a healthcare appointment is akin to the cultural concepts of manaakitanga and reciprocity, respectively; small gifts or koha may be considered as an acknowledgement of their decision to be screened. In New Zealand, incentives were a component of smoking cessation programmes during pregnancy and the COVID-19 vaccination programme. The objective of this nested randomised controlled study was to investigate the effect of offering an incentive upon sample return compared with no offer of an incentive alongside a repeat mailed test kit on the sample return rate in eligible Maori and Pacific who had previously consented, but who had not returned their sample. The control group of Maori and Pacific were mailed a test kit but were not an incentive.
Interventions
The study intervention was the offer of an incentive to complete a mailed at-home HPV self-test. The incentive was a $50 supermarket voucher.
The offer was made in a letter, which was mailed to eligible participants with an HPV self-test kit.
The test kit contained:
1) a study brochure that explained the importance of cervical screening and the purpose of the study, and instructions on how to self-sample and return it for testing;
2) a swab and pre-labelled collection tube;
3) a pre-labelled l
The study intervention was the offer of an incentive to complete a mailed at-home HPV self-test. The incentive was a $50 supermarket voucher. The offer was made in a letter, which was mailed to eligible participants with an HPV self-test kit. The test kit contained: 1) a study brochure that explained the importance of cervical screening and the purpose of the study, and instructions on how to self-sample and return it for testing; 2) a swab and pre-labelled collection tube; 3) a pre-labelled laboratory test form; 4) a pre-paid courier bag with which to return the sample for testing. Although the study was conducted prior to the introduction of HPV self-testing to the national screening programme on 12 September 2023, the swab used in the study (BD Onclarity) is one of the options available in the programme. The duration of the intervention was approximately four months.
Sponsors
Health New Zealand | Te Whatu Ora, Waitemata District
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
30 Years to 69 Years
Healthy volunteers
Yes
Inclusion criteria
1. Maori and Pacific people aged 30-69 years 2. Enrolled with the study Primary Health Organisation (PHO) 3. Meeting the National Cervical Screening Programme (NCSP) Clinical Practice Guidelines as eligible for HPV self-testing (i.e. people with a cervix and due for cervical screening) 4. Provided consent to participate in the study 5. The full schedule of reminder text messages and call attempts were completed and at least 77 days had passed since the last reminder 6. No HPV test result was received prior to 22/04/2024
Exclusion criteria
1. Total hysterectomy 2. History of cervical cancer 3. No longer residing in Auckland or enrolled with the study PHO 4. Previous high-grade lesion and no test of cure 5. Symptomatic (e.g. abnormal bleeding or discharge) 6. Never been sexually active 7. Were sent more than one previous self-test kit
Outcome results
None listed