Patient attitudes toward HPV self-sampling and community health worker-delivered cervical cancer screening services in an underserved area

Abstract

Introduction: In Indiana, Black women had 12% higher cervical cancer incidence, and 21% higher mortality compared to White women during the years 2008-2017. Human Papillomavirus (HPV) self-sampling delivered by community health workers (CHW) has demonstrated potential to increase cervical cancer screening rates among at-risk populations. This study aims to understand patient attitudes toward HPV self-sampling and CHW-delivered screening. Methods: We conducted a cross-sectional online survey among patients from three Planned Parenthood clinics in Lake County, IN, which has one of the highest cervical cancer mortality rates in Indiana. Patients' willingness to self-sample and to receive health education and services related to cervical cancer screening from CHWs was analyzed using logistic regression. Results: In the final sample (N = 140), the largest proportions of respondents were below age 30 (54.3%), aware of cervical cancer (78.6%), up to date on cervical cancer screening (84.3%), had no prior self-sampling experience (53.6%) and were aware of CHWs (52.1%). Multivariable logistic regression analyses showed Black patients had higher odds of being willing to: self-sample at home (aOR = 3.749, 95% CI = 1.619-8.681), receive health education from CHWs (aOR = 4.952, 95% CI = 2.124-11.548), and receive health services from CHWs (aOR = 3.305, 95% CI = 1.479-7.388) compared to White patients. Conclusion: Our results showed Black patients had higher willingness for HPV self-sampling and CHW delivery of cervical cancer screening services. Study findings can be used to inform future CHW-led interventions for outreach, education, and delivery of self-sampling interventions to increase cervical cancer screening rates among Black women in underserved areas.