Aisa Maleki

Barriers and facilitators of pap-smear test uptake in Asia: a systematic review

In addition to the establishment of screening procedures, it is important to identify the barriers and facilitators for promoting preventive behavior. Many studies have been conducted in the field of investigating the factors affecting Pap smear test uptake and the barriers related to it. However, a systematic approach is still needed. Therefore, this present study was conducted with the aim of systematically reviewing the barriers and facilitators of Pap smear test uptake in Asia. To collect the data, searches were performed in PubMed, WOS, ProQuest, Scopus and Cochrane databases from January 1, 2018 to January 15, 2025. Two people separately and independently evaluated the quality of the studies by Newcastle-Ottawa Scale. To conceptualize influential factors, barriers and facilitators of Pap-smear test uptake among Asian women, a theoretical thematic analysis was applied. A search yielded 4057 records, of which 44 documents discussing the determinants, barriers, and facilitators of Pap smear uptake were included in the review. There were economic, social, awareness, test and provider characteristics, and lifestyle and health behaviors dimensions in both categories of barriers and facilitators. In addition, two religious and psychological dimensions were included in the barriers category. In total, 55 components representing barriers and 51 components representing facilitators were identified. To improve Pap smear uptake, implement financial assistance and comprehensive insurance coverage. Enhance community engagement through outreach and support groups, provide counseling, and create positive messaging. Increase accessibility with mobile clinics, flexible hours, and train providers. Promote health education and offer incentives to motivate women to participate in screenings.

Using a social marketing approach to increase the pap-smear test uptake: randomized controlled trial among women residing in urban region

Social marketing intervention is a strategy to improve intention and behavior in this field. Therefore, this study was conducted with the aim of determining the impact of social marketing intervention on Pap-smear test uptake. The study conducted between June 5th 2023 and August 6th 2023. This study is registered in IRCT (code: IRCT20221126056609N1 & Registration date: 2023-04-27) The population studied were married women aged 18 to 65 living in Qazvin City. Comprehensive health service centers of Qazvin city were clustered for sampling and samples were randomly taken from each cluster and randomly divided into two control and intervention groups. Demographic, social, and economic information was collected before the intervention for both intervention and control groups. The intervention was based on four marketing mixes (product, price, place, and promotion). After three months, the pap smear test uptake was examined in both intervention and control groups. The data were analyzed by performing paired t-tests, chi-square, and odds ratio estimation in SPSS and Stata software. The findings showed that there was a significant difference in Pap smear test uptake between the intervention and control groups after the intervention. So the participant who intervened had about 12 times more chance of a test uptake and this chance in the follow-up period was 5 times more than the control group. The findings of the present study showed that the intervention based on social marketing increases awareness, perceived risk, and the demand for Pap smear tests among women. By influencing women's intention and behavior, they can be led to participate in screening. For this purpose, a multifaceted intervention should be designed based on the barriers and facilitators of test's demand. This study is registered in IRCT (code: IRCT20221126056609N1 & Registration date: 2023-04-27).