Improving Attitudes and Beliefs of Cervical Cancer Screening Guidelines Through an Evidence-based Quality Improvement Project

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Introduction/Purpose: Cervical cancer is highly preventable, in part, due to its long pre-invasive stage and the availability of screening with the Papanicolaou (Pap) test and high-risk human papillomavirus (hrHPV) testing (cotest). The purpose of this project was to identify and improve healthcare provider (HCP) attitudes, beliefs, and knowledge of the most updated screening guidelines. Methods: Data were collected from six HCPs using an online pre- and post-intervention cross-sectional survey. The participants were surveyed before an educational session that detailed the most recent United States Preventive Services Task Force (USPSTF) cervical cancer screening guidelines, and again two months postintervention. Results: When the survey was scored pre- and post-intervention, the majority (two-thirds) of the participants improved their score. Sixty-seven percent of HCPs reported use of cotesting for screening and recommended a greater than three-year screening interval in women with normal cotest results (unchanged after intervention). HCPs perceived greater encouragement for cotesting and extending the screening interval from national-level sources than from their practice administration (pre- and post-intervention). An important barrier (67%) to extending the interval included concerns about patients losing contact with the medical system (50% at baseline). Conclusion: Improvements in the majority of HCP survey scores from pre- to post-intervention underscores the clinical significance of this project. Breakdown of the item specific results may reflect a perceived lack of support from administration and patients. Further education of HCPs, staff, and patients regarding the implications of hrHPV testing, as well as increased administrative support will be an important component in 5 the clinic-wide implementation of national guidelines.

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cervical cancer screening, HPV test, protocols/practice guidelines, HCP attitudes/beliefs/perceptions
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