title: Attitudes toward self-sampling for cervical cancer screening among primary care attendees living on the US-Mexico border.
abstract: BACKGROUND
  Hispanic women living along the US border with Mexico have one of the highest cervical cancer mortality rates in the nation, owing in part to lower rates of screening. The barriers to screening in this population include lack of access to care and fear of and embarrassment about the pelvic examination. Screening for oncogenic or high-risk human papillomavirus during cervical cytology has been added to screening recommendations. A novel method for human papillomavirus testing is self-sampling, in which women collect their own cervicovaginal samples. There is lack of information about the acceptability of self-sampling as an alternative to cytology for cervical cancer screening in women living along the US-Mexico border.
  
  
  METHODS
  We conducted five focus groups with women between the ages of 30 and 65 who were primary care patients of clinics along the US-Mexico border. We used constructs from different health behavioral theories as a framework for the interview guide.
  
  
  RESULTS
  A total of 21 women participated in the focus groups, 80% of whom were Hispanic; mean age was 53.4 (standard deviation 7.9). More than one-third (38%) of the participants had not undergone a Papanicolaou test in the last 3 years. Women identified the perceived benefits of self-sampling as ease, convenience, practicability, less embarrassment, and need for child care as compared with a Papanicolaou test. The main barrier to self-sampling was concern about not performing the test correctly.
  
  
  CONCLUSIONS
  In this qualitative study, we found positive attitudes toward self-sampling among women living along the US border with Mexico. Further research is needed to evaluate interventions that address women's low levels of self-efficacy to perform the test and to evaluate the effectiveness of self-sampling in increasing cervical cancer screening rates.
authors.affiliation: From the Department of Family and Community Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso.
authors.forename: Eribeth
authors.initials: E
authors.lastname: Penaranda
authors.affiliation: From the Department of Family and Community Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Molokwu
authors.affiliation: From the Department of Family and Community Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Hernandez
authors.affiliation: From the Department of Family and Community Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso.
authors.forename: Rebekah
authors.initials: R
authors.lastname: Salaiz
authors.affiliation: From the Department of Family and Community Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso.
authors.forename: Norma
authors.initials: N
authors.lastname: Nguyen
authors.affiliation: From the Department of Family and Community Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso.
authors.forename: Theresa
authors.initials: T
authors.lastname: Byrd
authors.affiliation: From the Department of Family and Community Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso.
authors.forename: Navkiran
authors.initials: N
authors.lastname: Shokar
mesh_terms: D000328:Adult; D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006630:Hispanic or Latino; D006801:Humans; D008800:Mexico / Q000208:ethnology; D008875:Middle Aged; D065006:Papanicolaou Test / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000523:psychology; D011320:Primary Health Care; D011582:Psychological Theory; D036301:Qualitative Research; D012648:Self Care / Q000379:methods / Q000523:psychology*; D020377:Self Efficacy; D013048:Specimen Handling / Q000379:methods / Q000523:psychology*; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000208:ethnology; D014626:Vaginal Smears / Q000379:methods / Q000523:psychology*