Novel decision support intervention to support choice in cervical screening modality: SUCCEED or In-clinic or self-sampling for HPV: Supporting person-centred choice for cervical screening

Problem

Cervical cancer is the second most diagnosed cancer in women under 45 years old in the UK. Cervical screening using Human Papillomavirus (HPV) testing is routinely offered to individuals with a cervix between 25 and 64 years old in the UK via NHS cancer screening programmes, mostly through primary care. The cervical screening eligible population could for the first time have a choice of cervical screening modality; in-clinic or self-sampling. This may overcome some barriers of attending cervical screening. Removing some sampling from healthcare services could reduce pressures on primary care, though the impact of this choice would need to be explored. NICE guidelines recommend shared decision making in everyday care including the use of quality-assured patient decision aids. To date, no intervention has integrated behaviour change techniques with decision support principles to support equitable participation in cervical screening, whilst also promoting informed person-centred screening modality choice. This project aims to:• Identify optimal methods of communicating cervical screening programme changes.• Understand the needs of individuals eligible for cervical screening regarding a decision support tool when presented with a choice of cervical screening method.

Approach

A qualitative co-production approach will be used. Up to 30 semi-structured interviews with a diverse sample of cervical-screening eligible participants, focusing on underserved populations, will be asked about communication preferences and decision support needs. Stakeholders (up to 20) including GPs and practice nurses, will be interviewed for their perceptions of the implications of choice and implementation of interventions to support choice on the service journey.Interviews will be recorded and transcribed verbatim. Thematic analysis during data collection will enable the use of ‘information power’ so that data collection will stop when no significant new themes are identified. Regular team meetings, including with public involvement partners, will review coding and analysis development.A novel theory-informed Logic Model of the active components required for an intervention for preference-based decision support about screening modality will be developed.

Findings

Cervical-screening eligible participants are currently being recruited, with data collection due to start in March 2023. Data collection progress and early interview findings will be presented.

Consequences

Outputs will identify key ingredients for the development of a novel behaviour change and decision support tool for supporting choice in cervical screening method. Findings will build the platform for future research by identifying a logic model, communication strategy and stakeholder consortium for the subsequent development of novel integrated behaviour change and decision support interventions within a new screening programme provision. Ultimately this would aim to support equitable uptake and person-centred choice for screening modality in cervical screening across demographic groups. This can serve to lower cancer inequalities.