Communication, Culture and Cervical Self-Sampling: A Theory-Based Message Design Study for Cervical Cancer Prevention

Continued low rates of cervical screening in certain populations suggest the need to develop interventions that not only increase women’s confidence and motivation, but also address women’s documented fears and concerns about interacting with formal healthcare systems. Through the introduction of an HPV self-sampler tool, this study aimed to determine the appropriate messaging within one particular context - Jamaica - that would lead to improved levels of knowledge, beliefs and attitudes about HPV and cervical cancer and higher uptake of screening practices. The mixed methods study design included 8 focus groups, 10 interviews and a quasi-experiment in which 156 out of 163 (95.7%) study participants screened for cervical cancer using a self-sampler kit. Results from both qualitative and quantitative inquiries demonstrated high acceptability of the self-sampler among Jamaican women. Additionally, the findings suggest that messages that focus on increasing perceived susceptibility to cervical cancer could improve rates of screening. Further, interventions that utilize interpersonal and community-based social networks, including community health workers, church-based groups and other group based-education sessions may be more effective than traditional mass media. The results provide an important first step toward advancing theoretical understanding of how threat and efficacy messages are processed in a particular cultural context to increase cancer screening. These findings also make a practical contribution by demonstrating the incredible potential of cervical self-sampler tools, coupled with culturally appropriate communication, to increase uptake in an underscreened, high risk population in the English-speaking Caribbean