Analysis of Notable Facilitators
Many studies discussed facilitators and interventions that encouraged young women to undergo cervical cancer screening. Increased knowledge and awareness were noted in twelve studies.24,26,28,30,33,34,36,39,42,44-46 Specific points of knowledge included severity of disease,24,30as well as the understanding that the test could allow successful prevention and treatment of cancer.28 High self-efficacy and perceived control/empowerment about health was a facilitator in three studies.43,47,48
Trusting and longitudinal relationships with their healthcare providers were noted as facilitators in four studies,25,32,39,42as was choice of healthcare provider specifically25 or testing by a female physician.32 Hobbs et al39 specifically noted that physicians who were able to communicate well and put patients at ease acted as a facilitator. Alternative methods of screening such as self-sampling were noted as a facilitator of cervical cancer screening to avoid perceived invasiveness.34,49
Social norms and public perceptions, including if friends and family members received testing, was noted as a facilitator.20,29,33,37,46,48 A diagnosis of cervical cancer in the family was noted as a motivation for undergoing screening,33 as well as support or encouragement from one’s mother specifically.37 Media coverage was noted to encourage participation in cervical cancer screening, particularly if involving celebrities or public figures.26,34
Facilitators to improve the logistical barriers of cervical cancer were analyzed. Five studies noted either telephone or written reminders would be helpful for patients.25,32,39,42,43 To address the time constraints of patients, Black et al32 and Blomberg et al25 noted that cervical screening could be linked with appointments for prescription renewals or other examinations. In addition, Blomberg et al25 suggested flexibility in time and location of screening, including options such as screening available on college campuses. Shorter wait-times, expanded clinic hours, and having someone pick up the phone when patients book appointments were noted as practical options by Hobbs et al39. Cost-free services, provision of babysitting services, and arranged transportation were also suggested.25,35,39