University Research Clinic for Cancer Screening, Randers Regional Hospital, Randers, Denmark
CIC-P INSERM 1432, Institut national de la santé et de la recherche médicale, Paris, France.
BMJ Open. 2024 May 17;14(5):e079921. doi: 10.1136/bmjopen-2023-079921.
The aim of this study was to map and compare stakeholders' perceptions of barriers towards cervical cancer screening for vulnerable women in seven European countries.
In Collaborative User Boards, stakeholders were invited to participate to identify barriers towards participation in cervical cancer screening.
The study is nested in the European Union-funded project CBIG-SCREEN which aims to tackle inequity in cervical cancer screening for vulnerable women (www.cbig-screen.eu). Data collection took place in Bulgaria, Denmark, Estonia, France, Italy, Portugal and Romania.
Participants represented micro-level stakeholders covering representatives of users, that is, vulnerable women, meso-level stakeholders covering healthcare professionals and social workers, and macro-level stakeholders covering programme managers and decision-makers.
Across the seven countries, 25 meetings in Collaborative User Boards with a duration of 2 hours took place between October 2021 and June 2022. The meetings were video recorded or audio recorded, transcribed and translated into English for a qualitative framework analysis.
120 participants took part in the Collaborative User Boards. Context-specific barriers were related to different healthcare systems and characteristics of vulnerable populations. In Romania and Bulgaria, the lack of a continuous screening effort and lack of ways to identify eligible women were identified as barriers for all women rather than being specific for women in vulnerable situations. The participants in Denmark, Estonia, France, Italy and Portugal identified providers' lack of cultural and social sensitivity towards vulnerable women as barriers. In all countries, vulnerable women's fear, shame and lack of priority to preventive healthcare were identified as psychological barriers.
The study provides an overview of stakeholders' perceived barriers towards vulnerable women's cervical cancer screening participation in seven European countries. The organisation of healthcare systems and the maturity of screening programmes differ between countries, while vulnerable women's psychological barriers had several similarities.
本研究旨在绘制和比较七个欧洲国家中弱势女性宫颈癌筛查障碍的利益相关者认知。
在协作用户委员会中，邀请利益相关者参与确定参与宫颈癌筛查的障碍。
该研究嵌套在欧盟资助的项目 CBIG-SCREEN 中，该项目旨在解决弱势女性宫颈癌筛查中的不公平问题（www.cbig-screen.eu）。数据收集在保加利亚、丹麦、爱沙尼亚、法国、意大利、葡萄牙和罗马尼亚进行。
参与者代表微观层面的利益相关者，涵盖用户代表，即弱势女性，中观层面的利益相关者涵盖医疗保健专业人员和社会工作者，以及宏观层面的利益相关者涵盖项目管理人员和决策者。
在七个国家中，2021 年 10 月至 2022 年 6 月期间，举行了 25 次协作用户委员会会议，每次会议持续 2 小时。会议进行了视频或音频录制，并翻译成英文进行定性框架分析。
120 名参与者参加了协作用户委员会。与不同医疗保健系统和弱势人群特征相关的特定于情境的障碍被确定为所有女性而不是弱势处境女性的障碍。罗马尼亚和保加利亚认为缺乏持续的筛查努力和识别符合条件的女性的方法是对所有女性的障碍，而不是对弱势处境女性的特定障碍。丹麦、爱沙尼亚、法国、意大利和葡萄牙的参与者认为提供者对弱势女性缺乏文化和社会敏感性是障碍。在所有国家，弱势女性对预防性医疗保健的恐惧、羞耻和缺乏优先级被确定为心理障碍。
本研究提供了对七个欧洲国家弱势女性宫颈癌筛查参与障碍的利益相关者认知的概述。国家之间的医疗保健系统组织和筛查计划的成熟度存在差异，而弱势女性的心理障碍有几个相似之处。
