Table 5.
Motivators and barriers to cervical screening
| Factor | Motivator | Participant Quote |
|---|---|---|
| Intrinsic | Having good awareness and knowledgef, including through communications and information | “If we're four times more likely to die, why don't we have a specific ad for us?”—Lapsed screener, metropolitan |
| Perceiving screening to be | “You could be silently dying and not know it…I think it's good to have that | |
| important | peace of mind” – Never screened, metropolitan | |
| Situational | A past positive screening | “The nurse gave a lot of detail that was great, it makes you at ease knowing |
| experience | what's going on” – Regularly screened, regional | |
| Key influencers / support | “We go get it done together, we are each other's support person…I'm the older | |
| provided | cousin and she's very shy so I go be there with her because she doesn't like | |
| doing things on her own” – Regularly screened, regional | ||
| Structural | Having ease of access to | “I go to [the Aboriginal Medical Service] because of the transport” – Regularly |
| healthcare services (and | screened, regional | |
| childcare to facilitate this | ||
| access) | ||
| Attending a proactive and | “Once you've had your first pap test you get a reminder…they chase you up, | |
| culturally appropriate | that's a good thing” – Regularly screened, regional | |
| healthcare service (eg: where | ||
| opportunistic screening and | ||
| trauma informed care are | ||
| offered) | ||
| Having the option of where | “[The Aboriginal Community Controlled Health Service] is more comfortable, | |
| to be screened and by whom | you can just walk in. You don't need to make an appointment” - Lapsed | |
| (particularly in a private and | screener, metropolitan | |
| female focussed | ||
| environment) | ||
| Factor | Barrier | Participant Quote |
| Intrinsic | The prevalence of negative | “I was abused as a child so that's why I don't like the pap smear” – Never |
| emotions and attitudes | screened, metropolitan | |
| associated with the topic | ||
| Not prioritising preventative | “The last time I saw a doctor was 12 months ago…there's no time to get sick | |
| health measures | when you have kids, we're just so busy” – Lapsed screener, regional | |
| Situational | Past negative experiences | “They just don't care…I refuse to go…I'd rather lay down and die” - Lapsed |
| (including medical | screener, remote | |
| conditions enhancing the | ||
| pain and lack of culturally | ||
| safe approaches) | ||
| Lack of positive role | “I asked my sister about it and she said they put the claws into your vagina…I | |
| modelling | don't know if I want to get it done now” – Never screened, metropolitan | |
| Unsupportive and / or | “Partners may not let them go because of jealousy” – Lapsed screener, regional | |
| abusive partners | ||
| Structural | Not having access to medical | “Transport is a big thing for a lot of people especially in this town, if you don't |
| services (eg: childcare and | have a car you can't get anywhere” – Never screened, regional | |
| transport) | ||
| Not receiving reminders or | “I don't own a phone” – Lapsed screener, regional | |
| being prompted |
f
ORIMA's Aboriginal and Torres Strait Islander community interviewers, as well as community organisations who assisted with recruitment, reported back to ORIMA consultants following the research in most locations to indicate the positive impact that exposure to information and discussion on the topic had on participants, including improvements in their awareness and understanding, as well as more positive attitudes, the continuation of discussions in community, increased intention to undergo cervical screening and / or follow up on their own or their children's HPV vaccination.