Investigator

Emma McKim Mitchell

University Of Virginia

EMMEmma McKim Mitche…
Papers(3)
A Mail-Based HPV Self…Self‐collection of sa…Predictors of cervica…
Collaborators(10)
Catherine E. ElmoreKathryn LaughonLindsay HauserMack T. RuffinMark CromoMark DignanMira L. KatzPaul L. ReiterRoger T. AndersonSarah Cooper
Institutions(5)
University Of VirginiaHershey United StatesUniversity Of KentuckyThe Ohio State Univer…The Ohio State Univer…

Papers

A Mail-Based HPV Self-Collection Program to Increase Cervical Cancer Screening in Appalachia: Results of a Group Randomized Trial

Abstract Background: Despite the promise of mail-based human papillomavirus (HPV) self-collection programs for increasing cervical cancer screening, few have been evaluated in the United States. We report the results of a mail-based HPV self-collection program for underscreened women living in Appalachia. Methods: We conducted a group randomized trial from 2021 to 2022 in the Appalachian regions of Kentucky, Ohio, Virginia, and West Virgnia. Participants were women of ages 30 to 64 years who were underscreened for cervical cancer and from a participating health system. Participants in the intervention group (n = 464) were mailed an HPV self-collection kit followed by telephone-based patient navigation (if needed), and participants in the usual care group (n = 338) were mailed a reminder letter to get a clinic-based cervical cancer screening test. Generalized linear mixed models compared cervical cancer screening between the study groups. Results: Overall, 14.9% of participants in the intervention group and 5.0% of participants in the usual care group were screened for cervical cancer. The mail-based HPV self-collection intervention increased cervical cancer screening compared with the usual care group (OR, 3.30; 95% confidence interval, 1.90–5.72; P = 0.005). One or more high-risk HPV types were detected in 10.5% of the returned HPV self-collection kits. Among the participants in the intervention group whom patient navigators attempted to contact, 44.2% were successfully reached. Conclusions: HPV self-collection increased cervical cancer screening, and future efforts are needed to determine how to optimize such programs, including the delivery of patient navigation services. Impact: Mail-based HPV self-collection programs are a viable strategy for increasing cervical cancer screening among underscreened women living in Appalachia.

Self‐collection of samples for HPV testing to increase participation in cervical cancer screening by immigrant women: An integrative review

AbstractObjectiveTo examine methods and results of studies assessing self‐collection of cervico‐vaginal samples for human papillomavirus (HPV) testing by immigrant women for insights into how future research using this method with unique subpopulations of women may improve the rates of cervical cancer screening (CCS) compared to current strategies.Data SourcesFour electronic databases were systematically searched through March 2020, with no limits applied. A manual review of reference lists was also completed.Study SelectionThe search resulted in 63 articles. After removal of duplicates, 36 were reviewed against inclusion criteria. A manual review of reference lists yielded two additional studies. The final sample included 15 relevant publications representing 13 unique empirical studies.Data ExtractionData related to study methodology and empirical results were extracted into table form.Data SynthesisThe methods of the studies were summarized and synthesized, including diversity of participants, community engagement, including collaboration with public health nurses or community health workers. In addition, methods and findings related to the educational components of the studies, and empirical findings related to various cultural groups, were described.ConclusionTo reduce health disparities in CCS, researchers should focus on diverse groups, such as immigrant women, to understand important individual and group‐specific factors that may influence screening, including whether self‐collection of samples for HPV testing along with appropriate education and support for follow‐up will address these factors.

3Papers
18Collaborators