PDF(Pubmed)
Abstract：
With recent shifts in guideline-recommended cervical cancer screening in the U.S., it is important to accurately measure screening behavior. Previous studies have indicated the U.S. National Health Interview Survey (NHIS), a resource for measuring self-reported screening adherence, has lower validity among non-White racial/ethnic groups and non-English speakers. Further, measuring diverse population groups\' comprehension of items and attitudes toward HPV self-sampling merits investigation as it is a modality likely to be recommended in the U.S. soon. This study cognitively tested NHIS items assessing recency of and reasons for receiving cervical cancer screening and attitudes toward HPV self-sampling. We conducted cognitive interviews between April 2021 - April 2022 in English and Spanish with individuals screened in the past two years by either a medical center in metropolitan Seattle, Washington or a safety-net healthcare system in Dallas, Texas. Interviews probed understanding of reasons for screening, experiences with abnormal results, and interest in HPV self-sampling. We completed 32 interviews in Seattle and 42 interviews in Dallas. A majority of participants were unaware that two different tests for cervical cancer screening exist (Pap and HPV). Many did not know which type(s) of test they received. Dallas participants had more limited and inaccurate knowledge of HPV compared to Seattle participants, and fewer responded favorably toward HPV self-sampling (32% vs. 55%). To improve comprehension and accurate reporting of cervical cancer screening, we suggest specific refinements to currently used survey questions. Attitudes toward self-sampling should be explored further as differences may exist by region and/or sociodemographic factors.
摘要：
随着美国最近指南推荐的宫颈癌筛查的变化，准确测量筛查行为很重要。先前的研究表明，美国国家健康访谈调查(NHIS)用于测量自我报告的筛查依从性的资源，在非白人种族/族裔群体和非英语使用者中的有效性较低。Further,测量不同人群对HPV自我抽样项目和态度的理解值得进行调查，因为这是一种可能很快在美国推荐的方式。这项研究对NHIS项目进行了认知测试，评估了接受宫颈癌筛查的新近度和原因以及对HPV自我采样的态度。我们在2021年4月至2022年4月之间以英语和西班牙语进行了认知访谈，这些访谈在过去两年中由西雅图大都会的医疗中心进行了筛查。华盛顿或达拉斯的安全网医疗系统，德克萨斯州。访谈探讨了对筛选原因的理解，有异常结果的经验，以及对HPV自我取样的兴趣。我们在西雅图完成了32次采访，在达拉斯完成了42次采访。大多数参与者不知道存在两种不同的宫颈癌筛查测试（Pap和HPV）。许多人不知道他们接受了哪种类型的测试。与西雅图参与者相比，达拉斯参与者对HPV的了解更有限和不准确。对HPV自我取样的反应较少(32%与55%）。提高对宫颈癌筛查的理解和准确报告，我们建议对当前使用的调查问题进行具体改进。由于地区和/或社会人口统计学因素可能存在差异，因此应进一步探讨对自我采样的态度。
