Tiro Jasmin A, Muthukrishnan Meera, Metcalfe Sadie, Hansen Kris, Lin John, Dorsey Caitlin N, Gao Hongyuan, Lacey Catherine, Anderson Melissa L, Meenan Richard T, Green Beverly B, Sparks Angela, Winer Rachel L
Department of Public Health Sciences, University of Chicago, Biological Sciences Division, Chicago, Illinois, USA.
Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
Womens Health Rep (New Rochelle). 2025 Aug 25;6(1):771-781. doi: 10.1177/26884844251371093. eCollection 2025.
Mailed human papillomavirus (HPV) self-sampling kits improve cervical cancer screening adherence. The HOME trial found information needs and anxiety among HPV-positive patients. We designed a STEP trial to test optimized intervention strategies with bolstered educational materials and a centralized nurse communicating positive results. Here, we evaluate the effect of the strategies by comparing interviews of HOME and STEP participants receiving HPV-positive results.
STEP participants were interviewed during December 2021-March 2022, and asked about their kit reaction and nurse communication, and surveyed on attitudes toward the kit. Transcripts were analyzed in two phases: (1) Coders used iterative content analysis to organize codes into node reports and identify themes and (2) coders compared node reports between the HOME and STEP trials.
Sociodemographic of 46 HOME and 28 STEP participants were similar (White, older, had prior Pap). Participants from both trials appreciated the kit's convenience, although some questioned its accuracy compared to clinician-performed screening. While many STEP participants were surprised by the positive result, most felt reassured by the nurse and understood the recommended follow-up. STEP participants expressed fewer negative emotions. More STEP than HOME participants believed the HPV result was correct (86% vs. 59%) and trusted it (90% vs. 65%). Willingness to recommend the HPV kit to a friend and use it in the future was high in both the trials.
Qualitative comparison of HOME and STEP participants' reactions suggests STEP patients received the information needed to understand HPV-positive results and complete follow-up. Findings support a centralized nurse communicating results and building trust in this new screening technology.
邮寄式人乳头瘤病毒（HPV）自我采样试剂盒可提高宫颈癌筛查的依从性。HOME试验发现HPV阳性患者存在信息需求和焦虑情绪。我们设计了一项STEP试验，以测试优化的干预策略，包括强化教育材料以及由一名集中的护士传达阳性结果。在此，我们通过比较接受HPV阳性结果的HOME和STEP参与者的访谈情况，来评估这些策略的效果。
在2021年12月至2022年3月期间对STEP参与者进行了访谈，询问他们对试剂盒的反应以及护士沟通情况，并就对试剂盒的态度进行了调查。访谈记录分两个阶段进行分析：（1）编码人员使用迭代式内容分析法将编码整理成节点报告并确定主题；（2）编码人员比较HOME和STEP试验之间的节点报告。
46名HOME参与者和28名STEP参与者的社会人口统计学特征相似（白人、年龄较大、既往有巴氏涂片检查史）。两项试验的参与者都认可试剂盒的便利性，不过一些人质疑其与临床医生进行的筛查相比的准确性。虽然许多STEP参与者对阳性结果感到惊讶，但大多数人因护士而感到安心，并理解了推荐的后续措施。STEP参与者表达的负面情绪较少。认为HPV结果正确的STEP参与者比HOME参与者更多（86%对59%），并且更信任该结果（90%对65%）。两项试验中，向朋友推荐HPV试剂盒并在未来使用它的意愿都很高。
对HOME和STEP参与者反应的定性比较表明，STEP患者获得了理解HPV阳性结果并完成后续检查所需的信息。研究结果支持由一名集中的护士传达结果并建立对这种新筛查技术的信任。
