title: Bolivian health providers' attitudes toward alternative technologies for cervical cancer prevention: a focus on visual inspection with acetic acid and cryotherapy.
abstract: BACKGROUND
  Little is known about health providers' attitudes toward visual inspection with acetic acid (VIA) and cryotherapy in the prevention of cervical cancer, as most research in Latin America and the Caribbean (LAC) has examined attitudes of the general population. This study describes attitudes of Bolivian health professionals toward new technologies for cervical cancer prevention, focusing on VIA and cryotherapy.
  
  
  METHODS
  Between February 2011 and March 2012, we surveyed 7 nurses and 35 physicians who participated in 5-day workshops on VIA and cryotherapy conducted in Bolivia. Multiple choice and open-ended questions were used to assess participants' acceptability of these procedures and the feasibility of their implementation in the context of perceived barriers for the early detection of cervical cancer in this country.
  
  
  RESULTS
  Most believed that cultural factors represent the main barrier for the early detection of cervical cancer (70%), although all stated that VIA and cryotherapy would be accepted by women, citing the advantages of VIA over cytology for this belief. Most also believed their colleagues would accept VIA and cryotherapy (71%) and that VIA should replace Pap testing (61%), reiterating the advantages of VIA for these beliefs. Those who believed the contrary expressed a general resistance to change associated with an already existing cytology program and national norms prioritizing Pap testing.
  
  
  CONCLUSIONS
  Most participants had favorable attitudes toward VIA and cryotherapy; however, a sizable minority cited challenges to their adoption by colleagues and believed VIA should not replace cytology. This report can inform the development of strategies to expand the use of alternative cervical cancer screening methods in LAC and Bolivia.
authors: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. uxr6@cdc.gov
authors: Analía Romina
authors: AR
authors: Stormo
authors: Victor Conde
authors: VC
authors: Altamirano
authors: Macarena
authors: M
authors: Pérez-Castells
authors: David
authors: D
authors: Espey
authors: Haydee
authors: H
authors: Padilla
authors: Karen
authors: K
authors: Panameño
authors: Milton
authors: M
authors: Soria
authors: Carlos
authors: C
authors: Santos
authors: Mona
authors: M
authors: Saraiya
authors: Silvana
authors: S
authors: Luciani
mesh_terms: D019342:Acetic Acid; D000328:Adult; D001838:Bolivia; D002983:Clinical Competence; D017679:Cryotherapy; D054521:Cultural Competency / Q000523:psychology; D004059:Diffusion of Innovation; D055088:Early Detection of Cancer / Q000379:methods* / Q000523:psychology; D005240:Feasibility Studies; D005260:Female; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007202:Indicators and Reagents; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D010820:Physicians / Q000523:psychology*; D011369:Professional-Patient Relations; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy; D014626:Vaginal Smears / Q000706:statistics & numerical data
chemical_list: D007202:Indicators and Reagents; D019342:Acetic Acid