Staff at the Centre for Behavioural Research in Cancer are responsible for the evaluation of PapScreen Victoria. PapScreen Victoria provides information and support for women and health professionals on Pap tests and related issues.
Literature reviews (reports in this section are covered by the other topics)
Papscreen Victoria has published two volumes of collated research and evaluation reports.
PapScreen Research and Evaluation Report Volume One [
Report: 742 KB] covering the years 1997 to 2000 can be accessed on the PapScreen Victoria website.
PapScreen Research and Evaluation Report Volume Two [ Report:warning: large file 7.57MB] covering 2001 to 2007 can also be downloaded in its entirety at the PapScreen Victoria website.
Key reports from Volume Two are summarised below with direct links to those reports. Links to more recent reports and to published papers also appear below.
Letter to the Editor: Brotherton JL, Mullins RM. Estimating coverage of the National HPV Vaccination Program: where are we at? Medical Journal of Australia 2009: 191(3): 188.
Reports:
2006: Literature Review of women's understanding of HPV: Australian research and current gaps [ Volume 2 Report: 127KB]
A literature review was conducted utilising the databases Medline and PsychInfo. The literature review was conducted to ascertain the amount of local research on women's understanding of HPV, as well as gaps in knowledge that still require research. The small amount of research conducted in Australia suggests that awareness and knowledge of HPV is minimal, highlighting an opportunity for Pap Screen to conduct educational campaigns. It was found that research was limited in Australia in comparison to the international context, presenting opportunities for future Australian research.
Contact: cbrc@cancervic.org.au
Reports:
2006: Evaluation of the nurse Pap test provider credentialing process: Brief report [ Volume 2 Report: 245 KB]
The credentialing of nurse Pap test providers is part of an ongoing commitment to the quality assurance of Pap test provision in Victoria. This report includes a summary of the evaluation of the nurse Pap test provider credentialing process. The evaluation set out to determine the impact of the credentialing process on nurses, their line managers and the Review Panel, to determine if the credentialing process is well defined and communicated clearly to nurses and their line managers; and to determine the value of the credentialing process from the perspective of nurses, line managers and the Review Panel. Recommendations for improvements to the credentialing process are also outlined.
2004: Practitioners' perceptions of service provision [ Volume 2 Report: 196 KB]
The purpose of the study was to assess practitioners' perceptions of quality Pap test provision. Various Victorian practitioners participated in the study, including general practitioners, gynaecologists and nurse Pap test providers. Participants completed a telephone survey. Over half of practitioners stated that they were "very satisfied" with the level of service they offered when administering their last Pap test. Over half of respondents also indicated they thought women were "satisfied" with the Pap test they provided. Provision of additional training for general practitioners was highlighted as an area for Improvement, doing so would allow general practitioners to feel better prepared to conduct Pap tests. Practitioners were asked to describe their process for conducting a quality Pap test and few indicated that privacy was an important component.
Contact: cbrc@cancervic.org.au
Journal Articles:
Reports:
2005: Evaluation of a strategy to increase cervical screening through the use of personalised letters. CBRC Research Paper Series No. 15. August 2005. [ Report: 956 KB] Download Abstract Only
2004: Literature review of effective reminder letter strategies used in screening programs [ Volume 2 Report: 293 KB]
A literature review was conducted to ensure the current reminder letter being sent to women is up-to-date in terms of international best practise. The review was conducted using two behavioural science research databases: PsychInfo and Medline. Articles selected were limited to those pertaining to studies conducted in Western countries; so as to maximize relevance to Australia, in total 30 articles formed the base of the review. Three overall themes emerged from the articles: (a) the efficacy of reminder letters in screening programs, (b) message framing and letter content, and (c) strategies to incorporate with a reminder letter. The literature review provides recommendations for developing a reminder letter based on the available evidence.
Contact: cbrc@cancervic.org.au
Journal Articles:
Mullins R, Wakefield M, Broun K. Encouraging the right women to attend for cervical cancer screening: results from a targeted television campaign in Victoria, Australia. Health Education Research 2008: 23(3): 477-486.
Fernbach M. The impact of a media campaign on cervical screening knowledge and self-efficacy. Journal of Health Psychology 2002; 7(1): 85-97. [Abstract only]
Reports:
2006: Evaluation of Pap Screen Victoria's 2005 media campaign "Don't just sit there" [ Volume 2 Report: 234 KB]
Figures from the Victorian Cervical Cytology Registry show there was a decline in the number of women having Pap tests between 1999-2000 and 2002-2003. It was suggested that the decline might be due to the absence of a media campaign since 1999. This report outlines an evaluation of a media campaign developed by Pap Screen Victoria in 2004, which was aimed at encouraging under screened women to have a Pap test whilst avoiding over screening amongst women that are adequately screened. The evaluation of the 2004 campaign was based on a telephone survey conducted with 1000 women and data from the Victorian Cervical Cytology Registry. The campaign succeeded in increasing the number of women having Pap tests whilst it was on air, without leading to over-screening among women who had been screened within the last 12 months. Whilst the number of tests increased during the campaign, effects of the advertisement were short lived, tests returning to their usual levels immediately after the campaign ended. It was suggested that the campaign be utilised again in the future, but should be reinforced with other motivational strategies.
2003: Hoey L, Dempsey D, Mullins R. Evaluation of PapScreen's magazine advertisement 2003: focus groups with early re-screeners. CBRC Research Paper Series No. 8. Melbourne, Australia: Centre for Behavioural Research in Cancer, The Cancer Council Victoria, August 2004. [ Report: 418 KB] Download Abstract Only
2003: Pap Screen media 2003/2004: Pre campaign interviews report [ Volume 2 Report: 163 KB]
The purpose of the study was to assist in preparation of an advertising brief for a television campaign to encourage under-screened women to have a Pap test. 34 female participants were interviewed, examining their knowledge of Pap tests, emotions surrounding the process of a Pap test and perceived barriers to having a Pap test. Several reasons were given for these women had not having obtained regular Pap tests, for some it was the fact that it was painful, uncomfortable and embarrassing. Some women said that finding the time for a Pap test was difficult, while others thought they were not at risk either due to their age or lack of sexual activity. A number of women stated they had allowed their Pap test to lapse because they felt they would know if there were something wrong with their body. Most women had an understanding of the purpose of the Pap test as well as the recommended two-year tine frame between screenings, however Pap tests were not a high priority for these women. It is thought that the feeling of relief women experience when they obtain their test results might be a useful point to emphasize.
Contact: cbrc@cancervic.org.au
Reports:
2007: Mullins R, Anderson J. Cancer Issues Population Survey 2007: PapScreen Victoria Component. CBRC Research Paper Series No. 33. Melbourne, Australia: Centre for Behavioural Research in Cancer, Cancer Council Victoria, June 2008. [ Report: 304 KB] Download Abstract Only
2005: Cancer issues population survey 2005: Cervical screening [ Volume 2 Report: 333 KB]
As part of a broader survey conducted by the Centre for Behavioural Research in Cancer, 1500 Victorian women were surveyed by telephone about their cervical screening behavior and their feelings about having a Pap test with a nurse Pap test provider. Receiving a letter was the most common external prompt to seek a Pap test, however more than half the women interviewed said their doctor had suggested their last test, exemplifying the importance of doctor's promoting Pap tests. Women who were inadequately screened were most likely to think experiencing symptoms would prompt them to be tested, but also stated they would be influenced by a letter. Of the women surveyed who had seen a nurse Pap test provider, their stated reasons for doing so were access and availability, and as a way of accessing a female practitioner. The women who indicated they did not think they would be prepared to see a nurse for a Pap test preferred to see the doctor or gynaecologist they were familiar with. Those who said they would consider seeing a nurse wanted assurance the nurses possessed adequate training and experience, so it is important to emphasize the additional training completed by nurse Pap test providers when promoting that service to women.
Contact: cbrc@cancervic.org.au
Journal Articles:
Reports:
2007: Literature review of cervical screening barriers for older women: Brief report [ Volume 2 Report: 267 KB]
Data from the Victorian Cervical Cytology Registry consistently show women aged 60 to 69 are less likely to screen than women in younger age groups. The aim of the review was to examine the literature for evidence barriers for older women. Relevant research papers for the review were obtained from those held at The Cancer Council Victoria as well as by completing a search utilising electronic databases PsychInfo and Medline. Barriers to screening were identified across several studies of women aged 60 to 69. These included: being widowed, the belief that feeling healthy means a Pap test is not required, embarrassment and a fear that the practitioner completing the test might be male. Papers assessing barriers for older women were compared with papers that assessed barriers to screening of women of all ages. In general, barriers were similar amongst women of all ages.
2006: Evaluation of the impact of Pap Screen's campaign on Culturally and Linguistically Diverse (CALD) women [ Volume 2 Report: 133 KB]
For most women the process of a Pap test is uncomfortable and embarrassing. For women from Culturally and Linguistically Diverse (CALD) backgrounds there are additional barriers such as language, access to appropriate services and cultural values which make the choice to have a Pap smear even more problematic. A media campaign was launched in order to provide information to CALD women about the importance of Pap tests. The aim of the evaluation was to determine the effectiveness of the campaign in increasing the number of CALD women obtaining Pap tests. Although the evaluation did not reveal any obvious effects of the campaign, it cannot be assumed that there were none. It is important that Pap Screen Victoria continues to target women that may otherwise not be reached by broad population based interventions.
2004: Pap test Quality: Women's perceptions of service provision [ Volume 2 Report: 179 KB]
The study was conducted to assess women's perceptions of quality of their most recent Pap test, as well as aspects of the test that can be improved. 1058 women completed a 15-minute telephone interview. The majority of women who participated in the study were either very satisfied or satisfied with their last Pap test; very few expressed any sort of dissatisfaction. From participants' point-of-view, there may be only a small area for improvement in the procedures surrounding the test, however, despite this high level of satisfaction there were some aspects of the provision that were not optimal. Compared to women who had screened within the last two years, more women who had not been recently screened reported feeling embarrassed and uncomfortable during their most recent Pap test, and fewer felt in control or relaxed. Future research could explore the extent to which embarrassment and lack of comfort are an intrinsic part of having a Pap test, and the extent to which these negative emotions can be overcome.
2004: Brief report on a survey conducted at the Chillout Festival about lesbians' cervical screening practices [ Volume 2 Report: 182 KB]
It has long been believed that lesbian women do not need Pap tests, as they do not engage in sex with men. However the HPV (Human Papilloma Virus) has been detected in lesbian women illustrating the fact that Pap test are required. To address the lack of information known about the cervical screening practises of lesbian women a survey was conducted on behalf of PapScreen at the Chillout festival, a gay and lesbian community event held in Daylesford. 315 respondents completed the survey; the findings were compared to those obtained from a survey conducted at the Midsumma festival in Melbourne in 2002 (and published in the Health Promotion Journal of Australia, see below). Most respondents had been adequately screened and the percentage of women intending to re-screen within the next two years was also high, indicating awareness of the need for tests. As with the Midsumma data, women at Chillout reported being screened at similar rates to the overall population of women. The experience of the Pap test itself as well the difficulty in choosing a practitioner presented as the biggest barriers to screening. It is likely these barriers to screening can be overcome with similar prompts to that needed by the heterosexual community, as screening rates of lesbian women are similar to that of women overall.
2002: Screened Out! Women with disabilities and cervical screening [ Volume 2 Report: 401 KB]
Screened out! was a study targeted at discovering the barriers women with disabilities encountered when they had cervical screening, which was conducted by the Australian Research Centre for Sex, Health and Society (ARCSHS) at La Trobe University on behalf of PapScreen. 25 women who had sensory, intellectual, psychiatric or physical disabilities were interviewed. Discussions were also held with cervical screening providers to determine their views on the barriers these women face. It was found that while some women didn't have any problems with Pap smears others found it quite difficult. Women with disabilities encountered barriers that can be divided into three broad groups, social barriers, life circumstances and subjectivity.
The people consulted during this study wanted to make changes that will enable cervical screening to become easier for women with disabilities. It was evident that there was a need for more accessible information, better education and training for health professionals and staff working with women with disabilities.
2001: Young women's cervical screening: A literature review [ Volume 2 Report: 195 KB]
In the late 90s cervical cancer was the 9th most prevalent cancer among Australian women, yet it is the most preventable. This report reviews literature to 2000 on cervical screening, in particular as it relates to young women. A reduction in the incidence and mortality from cervical cancer demonstrates the effectiveness of cervical screening programs. Results indicate that while the majority of younger adult women have Pap smears, it appears many are lacking knowledge surrounding testing and risk factors of cervical cancer. Although HPV occurs mainly amongst young women, improved education will ensure women are aware HPV is often short lived and commonly undergoes spontaneous regression, preventing early re-screening. It is likely that by increasing young women's knowledge of cervical cancer, the Pap smear test, and the effectiveness of treatment, a reduction in anxiety will occur, resulting in improved adherence to Pap smear screening behavior.
Contact: cbrc@cancervic.org.au
The below reports are also mentioned above, under their various topics
2007: Literature review of cervical screening barriers for older women: Brief report
2006: Literature Review of women's understanding of HPV: Australian research and current gaps
2004: Literature review of effective reminder letter strategies used in screening programs
A list of peer reviewed publications from 1990 onwards. Articles from 2001 are also included in the above summaries.
All Cervical Cancer (behavioural) reports produced by CBRC listed in year order from 2001 onwards. Most of these reports are also listed above.
