Table 2.

Summary of community engagement results in ACCSS.

Component of ACCSS	Outstanding findings
Qualitative work	FN women experience social, environmental, and institutional barriers to cervical screening, including poor access to healthcare, legacy of colonialism, and impoverished living conditions
	Education before trial is crucial to help women understand why cervical screening is important
Integrating randomized trial design with participatory action approach	Frequent conversations with CBRAs and CSC introduced a tailored execution of the research project in each of the communities
Incentives	Using a lottery-based incentive program, prizes of increased value offer participants the opportunity to purchase groceries or other necessities that may not be available on-reserve
Questionnaire	Trial questionnaire focused on social and environmental factors related to cervical screening preferences
	Psychosocial section will gather information about participants’ experiences and anxieties with cervical screening
	Some participating women were forthcoming with personal histories of sexual abuse and violence, and wanted to include this information in the open-ended questions
	When administering the questionnaires, CBRAs ask participants if they want these personal experiences included in the questionnaire
Recruitment approach	Educational events facilitated by the CBRAs launched the trial in each community, helping raise awareness about cervical screening and build relationships between Research Team and community
Reflection meeting before Phase 2	Building upon a PAR approach, a meeting was held between the Research Team, CBRAs, and CSC to reflect on successes and improvements following the first offer of screening in communities
	“In-person” approaches were most successful at recruiting participants in Phase 1 and were part of the Phase 2 protocol
	There is a need for more community dialog between Research Team and community members and stakeholders. Discussing ongoing progress of ACCSS with communities will ensure that project is congruent with communities’ goals
Knowledge translation	At least three representatives from FN communities are invited to formally review publications and reports generated from ACCSS
	CBRAs and CSC will help tailor strategies for disseminating research findings
Participatory action approach	Community engagement is foundation of PAR and helps widen ethical space
	Social–ecological model depicts the multiple dimensions and targets of community engagement within ACCSS