"We didn’t do [it] a lot…now that it's something that we can all do.” - Development of a clinical service protocol for non-general practitioner staff to offer self-collection cervical screening in an Aboriginal community-controlled health setting: an iterative implementation study.

Objective/Purpose:

Developing implementation models for self-collection (SC) cervical screening within Aboriginal community-controlled health service (ACCHO) settings is necessary to translate self-collection’s potential into a meaningful increase in screening participation for Aboriginal women. This research demonstrates the co-design, development, and refinement of a novel non-general practitioner (GP)-led model of self-collection within a Victorian metropolitan ACCHO.  

Method/Project Description:

Utilising principles of codesign with Aboriginal communities, the need for broader promotion of self-collection by other staff was identified as a service priority. A clinical service protocol outlining how self-collection could be supported and offered by nurses, Aboriginal health workers and practitioners was co-developed by staff and the research team. Pre-, midline- and end-point implementation was assessed through semi-structured interviews with service staff in conjunction with staff training (2 sessions) and continuous protocol development, alongside other tailored implementation strategies.  

Results/Outcomes:

21 interviews were conducted in 2023 with service staff with different implementation roles. Perceived acceptability and effectiveness of the protocol was high, however, awareness differed vastly across staff who were prime implementers. Initially, there was a need for greater guidance around details regarding SC results, follow-up and escalation, and GP support when required. This was needed to build implementation confidence and “diffusion” across the service. The need to have GP sign off on the SC pathology request form was viewed as a significant implementation barrier in a busy, primary care setting. Co-implementation of the protocol with other implementation strategies was suggested as well as involvement of other service staff e.g., Koori maternity service midwives and health workers. Endline interviews are scheduled to be conducted by the end of 2023 with finalised data to be analysed and presented by April 24.  We will also present data describing the uptake of self-collection cervical screening at the service through the implementation period