Adebola Adegboyega

HPV Self-Sampling Promotion Among African American (AA) and Sub-Saharan African (SAI) Immigrant Women: Adaptation and Usability Testing

Background: Cervical cancer (CC) rates have declined nationally but rates remain high in Black women with most cases occurring among unscreened and under-screened women. This paper describes the adaptation, acceptability, and useability of an education intervention, “Health is Wealth: A Cervical Health Intervention”, to promote cervical screening and reduce perceived barriers to CC screening among two subgroups of Black women: African American (AA) and sub-Saharan African immigrant (SAI) women. Methods: In this paper, we describe the process of adapting the Health is Wealth intervention using the Barrera and Castro adaptation framework. The iterative adaptation process included formative focus groups (n = 30 participants) to gather information, expert feedback (n = 4), and usability testing (n = 7). Results: The systematic process resulted in the modification of educational intervention components. Several aspects of the intervention were modified, and core elements of the original intervention were preserved. The usability testing findings suggest the intervention would support the objective of promoting cervical cancer screening uptake among AA and SAI women. Conclusions: Adaptation of an evidence-based intervention is necessary to ensure contextually and culturally appropriateness for target populations, particularly for minoritized populations. We demonstrated that an evidence-based intervention for Pap screening can be adapted for HPV-self-sampling promotion with target community input.

Association of Cancer Risk Perception and Patient-provider Communication with Pap Test Among African American and Sub-Saharan African-born Women

Black women bear a disproportionately higher burden of cervical cancer than any ethnic/racial group. Patient's cancer risk perceptions and patient-provider communication behavior may influence uptake of cervical cancer screening with Papanicolaou (Pap) test. We examined the association of cancer risk perceptions and patient-provider communication behavior and Pap test uptake. Black women completed a cross-sectional survey on sociodemographic, cancer perceptions, and perceived patient-centered communication behaviors. Multiple linear regression models were fitted to explore the association of perceptions and patient communication behaviors. Women (N = 116) average age was 40 ± 12.7 years and 73% had ever received a Pap test. Women who agreed with the statement that it seemed like everything causes cancer had over four times the odds of having had a Pap test (OR = 4.40, 95% CI = 1.38-13.97, p = .012) while those that responded that when they think about cancer, they automatically think of death had 73% lower odds of having had a Pap test (OR = 0.27, 95% CI = 0.08-0.95, p = .040). The odds of Pap test completion were over 4-fold among those who said their health care provider always or usually gave them the chance to ask health-related questions, compared to those who responded sometimes or never (OR = 4.11, 95% CI = 1.36-12.44; p = .012). Interventions to dispel myths and promote effective patient-provider communications are warranted to address anecdotal cancer risk perceptions and promote patient engagements.

HPV Testing Behaviors and Willingness to Use HPV Self-sampling at Home Among African American (AA) and Sub-Saharan African Immigrant (SAI) Women

HPV self-sampling is an emerging HPV testing method that offers reliable identification of cervical precancer and cancer. To determine the feasibility of HPV self-sampling in the USA, information is needed regarding women's use of HPV test and willingness to use self-sampling, especially among disparate groups such as African American (AA) and sub-Saharan African immigrant (SAI) women. The purpose of this study was to examine factors associated with having had at least one HPV test and willingness to use HPV self-sampling among AA and SAI women. AA and SAI women (n = 91) recruited from community settings completed a survey in a cross-sectional study. Data included sociodemographics, HPV and HPV testing knowledge, and willingness to use a HPV self-sampling test at home. Logistic regressions were performed to evaluate associations with having had a HPV test and willingness to use self-sampling. Respondents mean age was 38.2 years (SD = 12.6) and 65% were SAIs. The majority (84%) reported having had at least one Pap test and (36%) had at least one HPV test. Sixty-seven percent were willing to self-sample at home. Age, education, and HPV testing knowledge were associated with having had a HPV test. Being uninsured and likelihood to accept a Pap test if recommended were associated with willingness to use self-sampling at home for an HPV test. Health care providers have an important role in recommending cervical cancer screening according to current guidelines. HPV self-sampling may be a promising strategy to reach older, less educated, uninsured, and underinsured Black women.

Psychological factors among Appalachian women with abnormal Pap results

AbstractPurposeWomen who receive an abnormal Pap result may experience negative psychological factors. The purpose of this study is to assess the baseline occurrence of negative psychological factors and evaluate the relationships between psychological factors and demographic characteristics among Appalachian women who received abnormal Pap results.MethodsWe conducted a secondary analysis of data collected from Appalachia Kentucky women (N = 521) ages ≥18 enrolled in an intervention. Data included sociodemographics, Beck depression and anxiety inventories, fatalism, and personal control measures. Multiple variable logistic regression was used to investigate the association between demographics and psychological factors.FindingsParticipants were predominantly White (96.2%), with mean age 28.93 ± 11.03 years, and the majority (77%) had yearly income below $20,000. Depression was reported by 34.6% (n = 173); 10% (n = 50) experienced moderate or severe anxiety; 20.6% (n = 107) had fatalistic beliefs; and 55.1% (n = 289) believed they lacked personal control over cancer. Women with lower income had higher occurrence of depression (P = .003). Women with moderate to severe anxiety were significantly older than those with low to moderate depression (34.44 vs 28.34, P < .001). Controlling for other variables, as age increased, the odds of fatalistic beliefs increased, OR (95%) = 1.042 (1.022, 1.062). When education level increased, the odds of fatalistic beliefs decreased, OR (95%) = 0.873 (0.800, 0.952).ConclusionsGiven the high occurrence of depression, anxiety, and fatalistic beliefs among this population, health care providers should assess for underlying mental health diagnoses and psychological distress during each patient encounter and provide recommendations to address them.

Social support and cervical cancer screening among sub-Saharan African immigrant (SAI) women

Low rates of Papanicolaou (Pap) screening among sub-Saharan African immigrant (SAI) women in the US contribute to cancer diagnoses at late stages and high mortality rates. This study was conducted to examine if social support, positively associated with preventive health practices, was predictive of Pap screening in a sample of SAI women. We conducted a cross-sectional study with SAI women who recently immigrated to the US. Participants completed a survey to assess ever having had Pap screening and social support using the Medical Outcomes Study Social Support Survey. Among the 108 SAI women in our study, Pap screening uptake was 65.7%. Affectionate and positive social support were each associated with Pap screening [adjusted odds ratio (AOR) = 1.73 (1.05, 2.87) and 1.68 (1.01, 2.78), respectively]. These findings suggest that consideration should be given to strengthening certain aspects of social support to increase uptake of Pap screening among SAI women.

Men’s willingness to support HPV vaccination and cervical cancer screening in Nigeria

Summary Cervical cancer is the second most common female cancer in Nigeria, even though it can be prevented by vaccination and screening. The uptake of these preventive services is extremely low due to lack of spousal support and cost. Human papilloma virus (HPV) vaccines and cervical screening require finance as health services are mostly paid out of pocket. This study explored Nigerian men’s willingness to encourage and pay for family member to obtain HPV vaccine and cervical screening. This is a cross-sectional study of 352 men aged 18–65 years living in 12 communities in the 6-geopolitical region. We found poor perception of HPV risk, and believed their family was not susceptible to cervical cancer. However, the majority (>80%) believed HPV vaccine and cervical screenings are important. Additionally, a good number (>58%) would encourage and pay for their family member to receive HPV vaccine and cervical screening. Residency, educational level and monthly income were significantly associated with willingness to encourage their family to receive HPV vaccine and cervical screening. Also, age group, marital status, residency, educational level and monthly income were significantly associated with the willingness to pay for HPV vaccine and cervical cancer screening. Majority were willing to encourage and pay for their family member to get vaccinated and receive cervical screening. This supports the findings that lack of male involvement may be an overlooked obstacle to cervical cancer prevention in developing countries.

Group concept mapping to develop a salon-based HPV self-collection intervention

Abstract Background Black women in the US face higher cervical cancer mortality rates due to delayed diagnoses linked to lower screening rates. Contributing factors include provider bias, costs, and limited access, particularly affecting women aged 40–64. While innovative approaches like clinical and home-based HPV self-collection exist, equitable dissemination remains challenging. Distributing HPV self-collection kits in unconventional sites like hair salons may offer a solution. Using concept mapping, we gathered community insights to design a salon-based cervical cancer screening intervention. Methods We employed groupwisdom™ and REDCap platforms for community-based participatory intervention development. Participants included members of the Black Community Advisory Council of Tucson (Black CACTus), comprising hairstylists ( n  = 3), salon clients ( n  = 4), and healthcare providers( n  = 3), all identifying as Black women aged 23–53. Concept mapping included: 1) Brainstorming statements, 2) Sorting statements into thematic clusters, 3) Rating importance and feasibility, 4) Reviewing the cluster map, and 5) Evaluating a draft intervention. Results Brainstorming produced 39 statements, forming six clusters: 1) Program Promotion, 2) Insurance, Cost & Benefits, 3) Communication Considerations, 4) Information and Education, 5) Overall Logistics and Process, and 6) Sample Collection. Communication Considerations and Sample Collection were rated most important, with Communication Considerations also ranking highest for feasibility. Communication Considerations, Information and Education, and Sample Collection were the highest rated when importance and feasibility were considered together. Conclusions Engaging community perspectives is essential for adapting cancer screening from clinical settings to community spaces like hair salons. This collaborative concept mapping approach identified strategies to enhance cervical cancer screening access and uptake among Black women.