Lucy Kivuti-Bitok

Barriers and Opportunities for HPV Self-Sampling in Underserved Rural Communities: Insights from a Mixed Methods Study

Cervical cancer is the leading cause of cancer-related deaths among women in sub-Saharan Africa, especially in rural areas with limited access to screening. This study explored factors influencing rural Kenyan women’s willingness to self-collect samples for HPV-DNA testing. Data were drawn from a mixed methods study in two Kenyan rural counties, including surveys with 174 women and interviews with 21 participants. The mean age of the survey sample was 45.2 (SD = 13.2) years. Only 6.4% had ever been screened, yet 76.9% expressed willingness to self-collect samples for testing. Increased willingness was associated with cervical cancer awareness (OR = 3.49, 95% CI = 1.50–8.11), relying on health workers as primary sources of health information (OR = 1.88, CI = 1.23–2.86), or the news media (OR = 2.63, CI = 1.27–5.48). High cervical cancer stigma (OR = 0.71, CI = 0.57–0.88) and longer travel times of 30–120 min to a health facility (OR = 0.44, CI = 0.20–0.93) were linked to reduced willingness. Integration of the findings showed that comprehensive health promotion—through education, health worker endorsement, and mass media campaigns—may improve HPV self-sampling uptake and reduce the cervical cancer burden in rural Kenya.

The effect of school-based educational session on knowledge, attitudes, and beliefs of cervical cancer among adolescents in mixed day high schools in Embu County: a quasi-experimental study.

School-based interventions have proven effective in enhancing knowledge and altering attitudes toward cervical cancer among adolescents. This study aimed to evaluate the effect of a school-based educational intervention on the attitudes, beliefs, and knowledge of cervical cancer among adolescents in mixed-day high schools in Embu County. This study used a single-group, repeated cross-sectional design to assess the effect of a structured health education session on cervical cancer among adolescent boys and girls in mixed-gender secondary schools. A self-administered anonymous questionnaire was administered before and immediately after the post-intervention. The education session lasted 30-45 min, and the study population included teenage boys and girls in selected mixed-day secondary schools in Embu County. Schools were conveniently sampled, and students in Form One and Form Two were purposively selected. Data were analyzed using R version 4.2.2 Descriptive statistics included means, standard deviations, counts, and percentages. Welch's two-sample t-test to compare pre and post- intervention groups scores. Effect sizes were estimated using Cohen's d with 95% confidence intervals. Statistical significance was set at α = 0.05. Our findings revealed that the respondents had low knowledge of cervical cancer and the HPV vaccine before the health education session. The overall knowledge score increased from a pretest mean of 105.23 to a posttest mean 131.8, respectively, which was a statistically significant change (t (567.66) = 6.89, p < 0.001) with a 95% confidence interval for the mean difference of 19.02 to 34.18. The magnitude of the difference corresponded to a moderate effect size (Cohen's d = 0.58, 95% CI: 0.41-0.74). Many adolescents indicated a willingness to engage in discussions about cervical cancer, with several expressing intent to talk with friends, with 40.99% strongly agreeing to talk to parents about the topic. Approximately 73% of the students expressed a desire to share information with their parents and friends, whereas 70.22% indicated that they would ask their guardians to take them for the HPV vaccine. The majority (70%) of the students agreed that the lecture delivery method was good. However, 48% of the students felt that the lecture was complicated. The single session educational intervention on cervical cancer was associated with improved knowledge of cervical cancer among adolescents. Majority of the respondents expressed willingness to discuss the topic with peers and parents, suggesting potential for information dissemination within their communities.