title: Cervical cancer screening in a sexually transmitted disease clinic: screening adoption experiences from a midwestern clinic.
abstract: OBJECTIVE
  We examined whether a sexually transmitted disease (STD) clinic could reach women who had not received a Papanicolau (Pap) test in the past 3 years. We also explored staff attitudes and implementation of cervical cancer screening.
  
  
  METHODS
  Women (n = 123) aged 30 to 50 years were offered cervical cancer screening in an Indiana STD clinic. We measured effectiveness by the patients' self-reported last Pap test. We explored adoption of screening through focus groups with 34 staff members by documenting their attitudes about cervical cancer screening and screening strategy adaptation. We also documented recruitment and screening implementation.
  
  
  RESULTS
  Almost half (47.9%) of participants reported a last Pap test 3 or more years previously; 30% had reported a last Pap more than 5 years ago, and 11.4% had a high-risk test outcome that required referral to colposcopy. Staff supported screening because of mission alignment and perceived patient benefit. Screening adaptations included eligibility, results provision, and follow-up.
  
  
  CONCLUSIONS
  Cervical cancer screening was possible and potentially beneficial in STD clinics. Future effectiveness-implementation studies should expand to include all female patients, and should examine the degree to which adaptation of selected adoption frameworks is feasible.
authors.affiliation: Beth E. Meyerson is with the Indiana University School of Public Health-Bloomington. M. Aaron Sayegh and Alissa Davis are with Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington. Janet N. Arno is with the Marion County Health and Hospital Corporation, Bell Flower Clinic, Indianapolis, IN. Gregory D. Zimet is with the Center for HPV Research, School of Medicine, Indiana University, Indianapolis. Ann M. LeMonte and James A. Williams are with the Infectious Disease Laboratory, Indiana University, Indianapolis. Lynn Barclay is with the American Sexual Health Association, Research Triangle Park, NC. Barbara Van Der Pol is with the University of Alabama, Birmingham.
authors.forename: Beth E
authors.initials: BE
authors.lastname: Meyerson
authors.forename: M Aaron
authors.initials: MA
authors.lastname: Sayegh
authors.forename: Alissa
authors.initials: A
authors.lastname: Davis
authors.forename: Janet N
authors.initials: JN
authors.lastname: Arno
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Zimet
authors.forename: Ann M
authors.initials: AM
authors.lastname: LeMonte
authors.forename: James A
authors.initials: JA
authors.lastname: Williams
authors.forename: Lynn
authors.initials: L
authors.lastname: Barclay
authors.forename: Barbara
authors.initials: B
authors.lastname: Van Der Pol
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D017144:Focus Groups; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D007196:Indiana; D008403:Mass Screening; D008875:Middle Aged; D065006:Papanicolaou Test; D012749:Sexually Transmitted Diseases / Q000175:diagnosis*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*