Interim Process Evaluation Report for WAC Health Service - Implementation Strategies for Self-Collection & Cervical Screening

Executive Summary

• Wathaurong Health Service and University of Melbourne have been collaborating together to co-develop implementation strategies to increase cervical screening participation and improve the experience of cervical screening for Aboriginal women
• The following implementation strategies were developed and evaluated using a process approach:

1. Data strategies

A quality improvement activity was conducted to update cervical screening histories and integrate the National Cancer Screening Register into Best Practice

• The cervical screening rate of Indigenous women aged 24 – 75 years who are up-to-date with cervical screening is currently 75%
• In May 2023, the range of actual cervical screening participation lies between 65% and 79% of the total active population.

2. Service Strategies

Service CST Protocol: The overall awareness and understanding of the service protocol varied between staff. There was a notion that non-GP staff would have liked to be more involved in the development of the protocol. There was a perceived need for additional training and education about the protocol and more clarity around whether home-based self-collection is feasible. Pathology processes, especially when there is no GP available to sign pathology forms off, was a perceived barrier to implementation.

VACCHO/ACPCC kits: There was high acceptability of the pouches from staff and that the pouches were well received by the community with WAC health service having significant uptake during the early stages of implementation. There was a perception that the return rate of swabs when the pouches were used isn’t monitored and that ensuring pathology processes are completed i.e., enclosing or completing a pathology form and labelled tube, to ensure swabs are processed accurately is needed.

3. Health promotion strategies

Two activities have been conducted to inform the content of GoShare and the recall letter:

• A short survey was conducted with Aboriginal and Torres Strait Islander women (n = 30) at the Sistas’ self-care day was held on May 7^th were self-collection health promotion materials from the National Cervical Screening Program were available to women attending.
• Focus group discussions were conducted with Aboriginal (n = 11) and non-Indigenous women(n = 3) who work at WAC health service.

Overall, women found both the reminder letter and GoShare strategies acceptable to increase the awareness of self-collection availability to women in the community. Aligning the two strategies together was suggested as a way for women to do further research. Women mentioned making the strategies more accessible to people with differing literacy, accessibility to a mobile or who are gender-diverse. Women also wanted to know that self-collection was accurate, easy and quick to complete, what results would mean, and they can access it from their trusted health professional. Women preferred Message option 2 and 1, in both the FGDs and survey responses.

Recommendations for the future implementation of these strategies are outlined within the report and are subject to amendment based on consultation with WAC health service stakeholders.