Determinants of Routine Cervical Screening Participation in Underserved Women: A Qualitative Systematic Review

Wearn, Angela and Shepherd, Lee (2022) Determinants of Routine Cervical Screening Participation in Underserved Women: A Qualitative Systematic Review. Psychology & Health. pp. 1-26. ISSN 0887-0446 (In Press)

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Objective: Routine, population-wide cervical screening programmes reduce cervical cancer incidence and mortality. However, socioeconomically deprived communities and ethnic minority groups typically have lower uptake in comparison to the general population and thus are described as ‘underserved’. A systematic qualitative literature review was conducted to identify relevant determinants of participation for these groups.

Methods: Online databases were searched for relevant literature from countries with well-established, call-recall screening programmes. Overall, articles were eligible for inclusion. Data was synthesized via Framework synthesis. Dahlgren & Whitehead’s (1) social model of health was used as a broad a priori coding framework.

Results: Participation was influenced by determinants at multiple levels. Overall, patient-provider relationships and peer support facilitated engagement. Cultural disparities, past healthcare experience and practical barriers hindered service access and exacerbatednegative thoughts, feelings and attitudes towards participation. Complex interrelationships between determinants suggest barriers have a cumulative effect on screening participation.

Conclusions: These findings present a framework of psychosocial determinants of cervical screening uptake in underserved women and emphasise the role of policy makers and practitioners in reducing structural barriers to screening services. Additional work, exploring the experience of those living within socioeconomically disadvantaged areas, is needed to strengthen understanding in this area.

Item Type: Article
Additional Information: Funding information: This study was supported by Northumbria University’s Research Development Fund as part of a doctoral studentship.
Uncontrolled Keywords: Cervical screening, underserved, qualitative, evidence synthesis
Subjects: C800 Psychology
Department: Faculties > Health and Life Sciences > Psychology
Depositing User: John Coen
Date Deposited: 03 Mar 2022 14:20
Last Modified: 16 Mar 2023 03:31

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