Self-Sampling for Human Papillomavirus (HPV) Testing in African American Women - Mississippi Delta

Cervical Cancer

self-sampling for HPV testing

The purpose of this study is to examine the efficacy and costs of this patient-centered approach (Choice between two cervical cancer screening modalities) in adherence to cervical cancer screening as compared to the current standard of care within the public health system in Mississippi (Pap test at the local department -Pap) among un/under-screened African American women in the Mississippi Delta using a theory-based, culturally relevant intervention implemented by Peer Health Educators (PHEs).

OBJECTIVE: Our objective is to examine the efficacy and costs of a patient-centered approach (Choice between self-sampling and Pap test) in adherence to cervical cancer screening as compared to Pap test at the local health department (Pap) among un/under-screened African American women in the Mississippi Delta. HYPOTHESES: Women in the Choice arm will have a higher cervical cancer screening adherence as well as higher satisfaction than women assigned to the Pap arm; (2) Within the Choice arm, more women will choose and complete self-sampling than Pap test; and (3) The Choice intervention will be on average less costly and more cost-effective than the Pap intervention. SPECIFIC AIMS: (1) To compare the impact of these two intervention approaches, Choice versus Pap, on cervical cancer screening adherence through a group randomized controlled trial; (2) To compare patient satisfaction between the two intervention approaches; and (3) To compare the costs and cost-effectiveness of these two intervention approaches, Choice versus Pap. STUDY DESIGN: 12 towns will be randomized to either Choice or Pap (180 women/arm). Peer Health Educators (PHEs) will identify African American women who report not having undergone cervical cancer screening in the past three years and deliver a brief theory-based, cultural relevant educational session on cervical cancer and screening using a door-to-door approach. Women randomized to the Pap arm will be provided with information on how to schedule an appointment at the local health department. Women randomized to the Choice arm will be given the choice of attending the health department for a Pap test or self-collecting their own sample at home to be sent for HPV testing. PHEs will follow-up with women in either arm who have a positive test in order to assure diagnostic evaluation and care.

United States