title: Attending cervical cancer screening, opportunities and obstacles: a qualitative study on midwives' experiences telephoning non-attendees in Sweden.
abstract: OBJECTIVE
  As part of a research project aimed at increasing participation in the cervical cancer screening program (CCS), we explored midwives' unique experiences of telephoning non-attendees and offering Pap smear appointments.
  
  
  METHODS
  Twenty midwives, in four focus groups, discussed their experiences of a study investigating ways to increase participation in the CCS. The group discussions were tape-recorded and transcribed verbatim and underwent qualitative content analysis.
  
  
  RESULTS
  Speaking with more than 1000 non-attendees provided the midwives with new perspective on the CCS and they realised that improving it might address a number of reasons for not participating. These reasons were often related to logistics, such as scheduling flexibility and appointment booking. The telephone conversations revealed that some women required more individual attention, while it was discovered that others did not require screening. The midwives considered the CCS to be life-saving; participating in this screening activity gave them a sense of satisfaction and pride.
  
  
  CONCLUSIONS
  This study shows that midwives can improve access and prevent non-attendance at the cervical cancer screening program when they are aware of women's varying requirements for attending screening.
authors.affiliation: The Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden Närhälsan Primary Care, Western Health Care Region, Sweden gudrun.broberg@vgregion.se.
authors.forename: Gudrun
authors.initials: G
authors.lastname: Broberg
authors.affiliation: The Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden The Regional Cancer Centre, Western Health Care Region, Gothenburg, Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Strander
authors.affiliation: The Regional Cancer Centre, Western Health Care Region, Gothenburg, Sweden Närhälsan Primary Care, Western Health Care Region, Sweden.
authors.forename: Joy
authors.initials: J
authors.lastname: Ellis
authors.affiliation: The School of Health and Medical Sciences, Örebro University, Sweden.
authors.forename: Annsofie
authors.initials: A
authors.lastname: Adolfsson
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008875:Middle Aged; D008880:Midwifery; D011247:Pregnancy; D036301:Qualitative Research; D013548:Sweden; D013689:Telephone; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D055815:Young Adult
keywords: Cervical cancer screening; Pap smear; focus group discussions; midwife; non-attendance; qualitative study; telephone call