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Primary Healthcare Services01:30

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Implementing changes to cervical screening: A qualitative study with health professionals.

Rachael H Dodd1, Helena M Obermair1,2, Kirsten J McCaffery1

  • 1Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.

The Australian & New Zealand Journal of Obstetrics & Gynaecology
|June 9, 2020
PubMed
Summary

Australian health professionals support cervical screening changes but face implementation challenges. Practical issues and communication gaps impact program effectiveness, requiring adjustments for future success.

Keywords:
Australiaattitudecommunicationprimary health careuterine cervical neoplasms/prevention & control

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Area of Science:

  • Public Health
  • Gynecologic Oncology
  • Health Services Research

Background:

  • The Australian National Cervical Screening Program underwent significant changes in December 2017.
  • These modifications included reduced screening frequency and the introduction of a new cervical screening test.

Purpose of the Study:

  • To investigate the perspectives and experiences of Australian healthcare professionals regarding the updated cervical screening program.
  • To identify challenges and benefits encountered during the implementation of new cervical screening guidelines.

Main Methods:

  • Conducted 31 semi-structured interviews with diverse healthcare professionals across Australia.
  • Included general practitioners, obstetricians, gynaecologists, pathologists, and nurses involved in cervical screening.
  • Utilized Framework Analysis for comprehensive data interpretation.

Main Results:

  • Healthcare professionals generally held positive attitudes towards the program changes.
  • Identified key challenges: practical system issues (e.g., colposcopy referrals, registry access, self-collection), communication/education deficits, and workarounds.
  • Observed unintended consequences like reduced opportunistic screening and concerns about underscreening in vulnerable populations.

Conclusions:

  • The study highlights practical and downstream challenges in implementing renewed screening programs.
  • Addressing these issues is crucial for streamlining future program execution and ensuring optimal cervical cancer prevention.
  • Findings offer valuable insights for program adaptation and healthcare professional support.