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Identifying ways to maximise cervical screening uptake: a qualitative study of GPs' and practice nurses' cervical cancer screening-related behaviours

O'Connor, M., McSherry, L. A., Dombrowski, S. U. , Francis, J. J. ORCID: 0000-0001-5784-8895, Martin, C. M., O'Leary, J. J. & Sharp, L. (2021). Identifying ways to maximise cervical screening uptake: a qualitative study of GPs' and practice nurses' cervical cancer screening-related behaviours. HRB Open Research, 4, 44. doi: 10.12688/hrbopenres.13246.1


Background:  Cervical screening uptake is declining in several countries. Primary care practitioners could play a greater role in maximising uptake, but better understanding is needed of practitioners' cervical screening-related behaviours. Among general practitioners (GPs) and practice nurses, we aimed to identify cervical screening-related clinical behaviours; clarify practitioners' roles/responsibilities; and determine factors likely to influence clinical behaviours.

Methods: Telephone interviews were conducted with GPs and practice nurses in Ireland. Interview transcripts were analysed using the Theoretical Domains Framework (TDF), a comprehensive psychological framework of factors influencing clinical behaviour.

Results: 14 GPs and 19 practice nurses participated. Key clinical behaviours identified were offering smears and encouraging women to attend for smears. Smeartaking responsibility was considered a predominantly female role. Of 12 possible theoretical domains, 11 were identified in relation to these behaviours. Those judged to be the most important were beliefs about capabilities; environmental context and resources; social influences; and behavioural regulation. Difficulties in obtaining smears from certain subgroups of women and inexperience of some GPs in smeartaking arose in relation to beliefs about capabilities. The need for public health education and reluctance of male practitioners to discuss cervical screening with female patients emerged in relation to social influences.

Conclusions: We identified - for the first time - primary care practitioners' cervical-screening related clinical behaviours, their perceived roles and responsibilities, and factors likely to influence behaviours. The results could inform initiatives to enable practitioners to encourage women to have smear tests which in turn, may help increase cervical screening uptake.

Publication Type: Article
Additional Information: © 2021 Ali S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Publisher Keywords: cervical screening; clinical behaviours; primary care practitioners; the Theoretical Domains Framework; women
Subjects: R Medicine > RC Internal medicine
R Medicine > RG Gynecology and obstetrics
R Medicine > RT Nursing
Departments: School of Health & Psychological Sciences
Text - Accepted Version
Available under License Creative Commons: Attribution International Public License 4.0.

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