Results of a Pilot Study of a Mail-Based Human Papillomavirus Self-Testing Program for Underscreened Women from Appalachian Ohio

Paul L. Reiter, Abigail B. Shoben, Deborah McDonough, Mack Ruffin, Martin Steinau, Elizabeth R. Unger, Electra D. Paskett, Mira L. Katz

Research output: Contribution to journalArticle

Abstract

Human papillomavirus (HPV) self-testing is an emerging cervical cancer screening strategy, yet few mail-based HPV self-testing programs have been implemented in the United States. We report the results of a pilot study of a mail-based program, the Health Outcomes through Motivation and Education Project. Methods In 2015 to 2016, we recruited 103 women from Appalachian Ohio who were aged 30 to 65 years and had not received a Papanicolaou (Pap) test in at least 3 years. Women were mailed an HPV self-test and randomized to receive either (a) self-test instructions developed by the device manufacturer and a standard information brochure about cervical cancer (control group) or (b) self-test instructions developed by the Health Outcomes through Motivation and Education Project and a photo story information brochure about cervical cancer (intervention group). Logistic regression compared study arms on HPV self-test return and receipt of a Pap test. Results Overall, 80 (78%) women returned their HPV self-test. Return was similar among the intervention and control groups (78% vs. 77%; odds ratio, 1.09; 95% confidence interval, 0.43-2.76). Among returners, 26% had an oncogenic HPV type detected in their sample. Women who returned their self-test reported high levels of satisfaction and positive experiences with the self-testing process. Few women overall received a Pap test (11%), and Pap testing was similar among the intervention and control groups (14% vs. 8%; odds ratio, 1.91; 95% confidence interval, 0.52-6.97). Conclusions Mail-based HPV self-testing programs are a potentially promising strategy for reaching underscreened women in Appalachia. Efforts are needed to better understand how to optimize the success of such programs.

Original languageEnglish (US)
Pages (from-to)185-190
Number of pages6
JournalSexually transmitted diseases
Volume46
Issue number3
DOIs
StatePublished - Mar 1 2019

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Postal Service
Papanicolaou Test
Uterine Cervical Neoplasms
Pamphlets
Control Groups
Motivation
Appalachian Region
Odds Ratio
Confidence Intervals
Education
Health
Early Detection of Cancer
Logistic Models
Equipment and Supplies

All Science Journal Classification (ASJC) codes

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Reiter, Paul L. ; Shoben, Abigail B. ; McDonough, Deborah ; Ruffin, Mack ; Steinau, Martin ; Unger, Elizabeth R. ; Paskett, Electra D. ; Katz, Mira L. / Results of a Pilot Study of a Mail-Based Human Papillomavirus Self-Testing Program for Underscreened Women from Appalachian Ohio. In: Sexually transmitted diseases. 2019 ; Vol. 46, No. 3. pp. 185-190.
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abstract = "Human papillomavirus (HPV) self-testing is an emerging cervical cancer screening strategy, yet few mail-based HPV self-testing programs have been implemented in the United States. We report the results of a pilot study of a mail-based program, the Health Outcomes through Motivation and Education Project. Methods In 2015 to 2016, we recruited 103 women from Appalachian Ohio who were aged 30 to 65 years and had not received a Papanicolaou (Pap) test in at least 3 years. Women were mailed an HPV self-test and randomized to receive either (a) self-test instructions developed by the device manufacturer and a standard information brochure about cervical cancer (control group) or (b) self-test instructions developed by the Health Outcomes through Motivation and Education Project and a photo story information brochure about cervical cancer (intervention group). Logistic regression compared study arms on HPV self-test return and receipt of a Pap test. Results Overall, 80 (78{\%}) women returned their HPV self-test. Return was similar among the intervention and control groups (78{\%} vs. 77{\%}; odds ratio, 1.09; 95{\%} confidence interval, 0.43-2.76). Among returners, 26{\%} had an oncogenic HPV type detected in their sample. Women who returned their self-test reported high levels of satisfaction and positive experiences with the self-testing process. Few women overall received a Pap test (11{\%}), and Pap testing was similar among the intervention and control groups (14{\%} vs. 8{\%}; odds ratio, 1.91; 95{\%} confidence interval, 0.52-6.97). Conclusions Mail-based HPV self-testing programs are a potentially promising strategy for reaching underscreened women in Appalachia. Efforts are needed to better understand how to optimize the success of such programs.",
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Results of a Pilot Study of a Mail-Based Human Papillomavirus Self-Testing Program for Underscreened Women from Appalachian Ohio. / Reiter, Paul L.; Shoben, Abigail B.; McDonough, Deborah; Ruffin, Mack; Steinau, Martin; Unger, Elizabeth R.; Paskett, Electra D.; Katz, Mira L.

In: Sexually transmitted diseases, Vol. 46, No. 3, 01.03.2019, p. 185-190.

Research output: Contribution to journalArticle

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N2 - Human papillomavirus (HPV) self-testing is an emerging cervical cancer screening strategy, yet few mail-based HPV self-testing programs have been implemented in the United States. We report the results of a pilot study of a mail-based program, the Health Outcomes through Motivation and Education Project. Methods In 2015 to 2016, we recruited 103 women from Appalachian Ohio who were aged 30 to 65 years and had not received a Papanicolaou (Pap) test in at least 3 years. Women were mailed an HPV self-test and randomized to receive either (a) self-test instructions developed by the device manufacturer and a standard information brochure about cervical cancer (control group) or (b) self-test instructions developed by the Health Outcomes through Motivation and Education Project and a photo story information brochure about cervical cancer (intervention group). Logistic regression compared study arms on HPV self-test return and receipt of a Pap test. Results Overall, 80 (78%) women returned their HPV self-test. Return was similar among the intervention and control groups (78% vs. 77%; odds ratio, 1.09; 95% confidence interval, 0.43-2.76). Among returners, 26% had an oncogenic HPV type detected in their sample. Women who returned their self-test reported high levels of satisfaction and positive experiences with the self-testing process. Few women overall received a Pap test (11%), and Pap testing was similar among the intervention and control groups (14% vs. 8%; odds ratio, 1.91; 95% confidence interval, 0.52-6.97). Conclusions Mail-based HPV self-testing programs are a potentially promising strategy for reaching underscreened women in Appalachia. Efforts are needed to better understand how to optimize the success of such programs.

AB - Human papillomavirus (HPV) self-testing is an emerging cervical cancer screening strategy, yet few mail-based HPV self-testing programs have been implemented in the United States. We report the results of a pilot study of a mail-based program, the Health Outcomes through Motivation and Education Project. Methods In 2015 to 2016, we recruited 103 women from Appalachian Ohio who were aged 30 to 65 years and had not received a Papanicolaou (Pap) test in at least 3 years. Women were mailed an HPV self-test and randomized to receive either (a) self-test instructions developed by the device manufacturer and a standard information brochure about cervical cancer (control group) or (b) self-test instructions developed by the Health Outcomes through Motivation and Education Project and a photo story information brochure about cervical cancer (intervention group). Logistic regression compared study arms on HPV self-test return and receipt of a Pap test. Results Overall, 80 (78%) women returned their HPV self-test. Return was similar among the intervention and control groups (78% vs. 77%; odds ratio, 1.09; 95% confidence interval, 0.43-2.76). Among returners, 26% had an oncogenic HPV type detected in their sample. Women who returned their self-test reported high levels of satisfaction and positive experiences with the self-testing process. Few women overall received a Pap test (11%), and Pap testing was similar among the intervention and control groups (14% vs. 8%; odds ratio, 1.91; 95% confidence interval, 0.52-6.97). Conclusions Mail-based HPV self-testing programs are a potentially promising strategy for reaching underscreened women in Appalachia. Efforts are needed to better understand how to optimize the success of such programs.

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