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“I would never have gone for screening if it hadn't arrived, this home kit”. Motivation, Capacity and Opportunities for Cervical Cancer Home-based Vaginal Self-sampling in Reunion Island: a qualitative study
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Edité par CCSD -
International audience. Abstract Background: In 2022, RESISTE conducted a cluster-randomised trial to assess the feasibility and effectiveness of home delivery of HPV vaginal self-sampling kits. The trial targeted women living in deprived areas who were not up to date with their screening. This article presents the results of the post-intervention qualitative study conducted in Reunion Island. The study explores women's motivation and capacity to conduct home-based vaginal self-sampling and analyses the influence of providing a financial incentive (voucher upon return) and of returning the kit by post or to a health professional. Method: A total of 35 semi-structured interviews were conducted with women respondents who returned the kit (16), non-respondents (13) and health professionals contacted by women during the trial (6). Results: After receiving the kit, several women underwent screening either by self-sampling or by visiting a health professional. Ease of use, convenience and privacy were key factors in self-sampling uptake. Receiving the kit at home creates a sense of being targeted which reinforces the perceived relevance of screening and further encourages uptake. Relatives generally had a facilitating effect, encouraging self-sampling and follow-up. Amongst women respondents, a HPV positive result, was a strong motivator to undergo a follow-up smear test. Nevertheless, a lack of prior knowledge of vaginal self-sampling, led to a lack of trust in the programme amongst women sometimes likened by women to a scam. This and the perceived complexity of the procedure were the main demotivating factors. The financial incentive did not reverse this trend. On the contrary, it contributed to doubts regarding authenticity. In addition, the health professionals contacted rarely encouraged women to self-sample. Conclusions : Women appreciated receiving an HPV vaginal self-sampling kit at home. Motivation and capacity could however be improved by increasing prior communication – to both women and health professionals - on self-sampling in general, and more specifically on reliability, sample preservation and ease of use. User-friendliness could also be improved by providing HPV tests results more quickly. Providing the option of collecting and returning the kit to a health professional of women’s choice helps ensure they receive adapted information and support. Trial Registration: 6 February 2020 - "Sud-Ouest et Outre-Mer II" ethics committee - Version 04 dated 29 July 2023 is currently in force - ID-RCB no.: 2020-A0002237 (File 2-20-006 id6698) 2°HPs.
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