Understanding Patients' Perspectives and Information Needs Following a Positive Home Human Papillomavirus Self-Sampling Kit Result

Jasmin A. Tiro, Andrea C. Betts, Kilian Kimbel, Diana S.M. Buist, Constance Mao, Hongyuan Gao, Lisa Shulman, Colin Malone, Tara Beatty, John Lin, Chris Thayer, Diana L Miglioretti, Rachel L. Winer

Research output: Contribution to journalArticle

Abstract

Objective: We explored patient perspectives after a positive human papillomavirus (HPV) self-sampling result to describe experiences and information needs for this home-based screening modality. Materials and Methods: We recruited women who tested high-risk (hr) HPV positive during a pragmatic trial evaluating mailed hrHPV self-sampling kits as an outreach strategy for women overdue for Pap screening in a U.S. integrated health care system. Telephone interviews were conducted from 2014 to 2017. Five independent coders analyzed transcripts using iterative content analysis. Results: Forty-six women (61% of invited; median age 55.5 years) completed a semistructured interview. Six themes emerged: (1) convenience of home-based screening, (2) intense feelings and emotions after receiving positive kit results, (3) importance of seeing provider and discussing kit results, (4) information seeking from various sources, (5) confusion about purpose and meaning of HPV versus Pap tests, and (6) concern that HPV self-sampling is inaccurate when the subsequent Pap test is normal. Conclusions: Although women liked the kit's convenience, discussion about discordant home HPV and in-clinic Pap results led them to question the accuracy of HPV self-sampling. Patient-provider communication around home HPV kits is more complex than for reflex or cotesting because clinician-collected Pap results are unknown at the time of the positive kit result. Patients need education about differences between HPV and Pap tests and how they are used for screening and follow-up. To reassure patients and keep them interested in self-sampling, education should be provided at multiple time points during the screening process.

Original languageEnglish (US)
Pages (from-to)384-392
Number of pages9
JournalJournal of Women's Health
Volume28
Issue number3
DOIs
StatePublished - Mar 1 2019

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Papanicolaou Test
Emotions
Pragmatic Clinical Trials
Integrated Delivery of Health Care
Interviews
Human papillomavirus 6
Patient Education
Reflex
Communication
Education

Keywords

  • early detection of cancer
  • Human papillomavirus DNA tests
  • mass screening
  • qualitative research
  • uterine cervical neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Understanding Patients' Perspectives and Information Needs Following a Positive Home Human Papillomavirus Self-Sampling Kit Result. / Tiro, Jasmin A.; Betts, Andrea C.; Kimbel, Kilian; Buist, Diana S.M.; Mao, Constance; Gao, Hongyuan; Shulman, Lisa; Malone, Colin; Beatty, Tara; Lin, John; Thayer, Chris; Miglioretti, Diana L; Winer, Rachel L.

In: Journal of Women's Health, Vol. 28, No. 3, 01.03.2019, p. 384-392.

Research output: Contribution to journalArticle

Tiro, JA, Betts, AC, Kimbel, K, Buist, DSM, Mao, C, Gao, H, Shulman, L, Malone, C, Beatty, T, Lin, J, Thayer, C, Miglioretti, DL & Winer, RL 2019, 'Understanding Patients' Perspectives and Information Needs Following a Positive Home Human Papillomavirus Self-Sampling Kit Result', Journal of Women's Health, vol. 28, no. 3, pp. 384-392. https://doi.org/10.1089/jwh.2018.7070
Tiro, Jasmin A. ; Betts, Andrea C. ; Kimbel, Kilian ; Buist, Diana S.M. ; Mao, Constance ; Gao, Hongyuan ; Shulman, Lisa ; Malone, Colin ; Beatty, Tara ; Lin, John ; Thayer, Chris ; Miglioretti, Diana L ; Winer, Rachel L. / Understanding Patients' Perspectives and Information Needs Following a Positive Home Human Papillomavirus Self-Sampling Kit Result. In: Journal of Women's Health. 2019 ; Vol. 28, No. 3. pp. 384-392.
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