Acceptability of HPV self-sampling tests: Talanoa with women and health workers in Samoa

Cervical cancer is recognised as a leading cause of mortality amongst women in the Pacific Region. Samoa does not have a national cervical cancer screening programme and currently performs any screening opportunistically. Human papilloma virus (HPV) Deoxyribose Nucleic Acid (DNA) self-sampling is a promising intervention to decrease the burden of cervical cancer. To better inform a decision around a potential cervical cancer prevention programme, this research aimed to examine the acceptability of self-sampling HPV DNA tests amongst health workers and women in Samoa and explore their views of a cervical cancer prevention programme. It also aims to explore the use of the Talanoa methodology as a tool for engaging in health research in Samoa. The study interviewed six health workers, ten urban women and nine rural women. Interviews and focus group discussions were recorded, transcribed and analysed using thematic analysis to identify common themes. Seven key themes identified were the importance of education, the significance of cultural beliefs and values, the value of benefits, the concerns with literacy and health literacy, the need for options, the different challenges that they face and empowerment. These were similar across the two aims looking at the self-sampling HPV DNA test. The Talanoa methodology was important in helping the researcher engage with participants to identify these themes. In the context of Samoa, it is the Feso’otaiga, journeying through to Fa’amasaniga, Fa’atulima, Va Fealoa’i and Reciprocity encompassed in spirituality that can bridge the Talanoa to Fa’afaletui making for a more meaningful discussion. In conclusion, participants in this study found HPV self-sampling test acceptable and the level and depth of engagement by participants suggests Samoa is in a good position to develop a potential cervical cancer prevention programme that is likely to be met with enthusiasm by stakeholders of such a programme