Preferences for interventions designed to increase cervical screening uptake in non-attending young women: how findings from a discrete choice experiment compare with observed behaviours in a trial

Helen E. Campbell; Alastair M. Gray; Judith Watson; Cath Jackson; Carly Moseley; Margaret E. Cruickshank; Henry C. Kitchener; Oliver Rivero-Arias

doi:10.1111/hex.12992

Preferences for interventions designed to increase cervical screening uptake in non-attending young women: how findings from a discrete choice experiment compare with observed behaviours in a trial

Helen E. Campbell, Alastair M. Gray, Judith Watson, Cath Jackson, Carly Moseley, Margaret E. Cruickshank, Henry C. Kitchener, Oliver Rivero-Arias^* (Corresponding Author)

^*Corresponding author for this work

Medical Education

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

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Abstract

Background

Young women’s attendance at cervical screening in the UK is continuing to fall, and the incidence of invasive cervical cancer is rising.

Objectives

We assessed the preferences of non‐attending young women for alternative ways of delivering cervical screening.

Design

Postal discrete choice experiment (DCE) conducted during the STRATEGIC study of interventions for increasing cervical screening uptake. Attributes included action required to arrange a test, location of the test, availability of a nurse navigator and cost to the National Health Service.

Setting and participants

Non‐attending young women in two UK regions.

Main outcome measures

Responses were analysed using a mixed multinomial logit model. A predictive analysis identified the most preferable strategy compared to current screening. Preferences from the DCE were compared with observed behaviours during the STRATEGIC trial.

Results

The DCE response rate was 5.5% (222/4000), and 94% of respondents agreed screening is important. Preference heterogeneity existed around attributes with strong evidence for test location. Relative to current screening, unsolicited self‐sampling kits for home use appeared most preferable. The STRATEGIC trial showed this same intervention to be most effective although many women who received it and were screened, attended for conventional cytology instead.

Conclusions

The DCE and trial identified the unsolicited self‐sampling kit as the most preferred/effective intervention. The DCE suggested that the decision of some women receiving the kit in the trial to attend for conventional cytology may be due to anxieties around home testing coupled with a knowledge that ignoring the kit could potentially have life‐changing consequences.

Original language	English
Pages (from-to)	202-211
Number of pages	10
Journal	Health Expectations
Volume	23
Issue number	1
Early online date	28 Oct 2019
DOIs	https://doi.org/10.1111/hex.12992
Publication status	Published - 1 Feb 2020

Bibliographical note

ACKNOWLEDGEMENTS
We are grateful to Sara Rodgers and Laura Clark at the University of York for conducting the qualitative interviews. We are grateful to Maggie Redshaw at the National Perinatal Epidemiology Unit (NPEU) for helpful suggestions on how to improve the response rate in our study. We also would like to thank the NPEU design team who significantly improved the look of our final questionnaire, and the NPEU administration team for their assistance preparing the mail‐out material. Special thanks are given to our data entry team Sissi Hernandez‐Quesada, Jacob Stevens and Pamela White. We would also like to express our gratitude to the teams at the English and Scottish screening agencies for their willingness to collaborate in this study. Finally, we would like to thank all of the women who completed the DCE questionnaire and took part in the STRATEGIC trial; without them, this work would not have been possible.

Keywords

cervical cancer
discrete choice experiments
heterogeneity
preferences
screening uptake
United Kingdom
young women

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

Campbell, H. E., Gray, A. M., Watson, J., Jackson, C., Moseley, C., Cruickshank, M. E., Kitchener, H. C., & Rivero-Arias, O. (2020). Preferences for interventions designed to increase cervical screening uptake in non-attending young women: how findings from a discrete choice experiment compare with observed behaviours in a trial. Health Expectations, 23(1), 202-211. https://doi.org/10.1111/hex.12992

Preferences for interventions designed to increase cervical screening uptake in non-attending young women: how findings from a discrete choice experiment compare with observed behaviours in a trial. / Campbell, Helen E.; Gray, Alastair M.; Watson, Judith et al.
In: Health Expectations, Vol. 23, No. 1, 01.02.2020, p. 202-211.

Research output: Contribution to journal › Article › peer-review

Campbell, HE, Gray, AM, Watson, J, Jackson, C, Moseley, C, Cruickshank, ME, Kitchener, HC & Rivero-Arias, O 2020, 'Preferences for interventions designed to increase cervical screening uptake in non-attending young women: how findings from a discrete choice experiment compare with observed behaviours in a trial', Health Expectations, vol. 23, no. 1, pp. 202-211. https://doi.org/10.1111/hex.12992

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abstract = "BackgroundYoung women{\textquoteright}s attendance at cervical screening in the UK is continuing to fall, and the incidence of invasive cervical cancer is rising.ObjectivesWe assessed the preferences of non‐attending young women for alternative ways of delivering cervical screening.DesignPostal discrete choice experiment (DCE) conducted during the STRATEGIC study of interventions for increasing cervical screening uptake. Attributes included action required to arrange a test, location of the test, availability of a nurse navigator and cost to the National Health Service.Setting and participantsNon‐attending young women in two UK regions.Main outcome measuresResponses were analysed using a mixed multinomial logit model. A predictive analysis identified the most preferable strategy compared to current screening. Preferences from the DCE were compared with observed behaviours during the STRATEGIC trial.ResultsThe DCE response rate was 5.5% (222/4000), and 94% of respondents agreed screening is important. Preference heterogeneity existed around attributes with strong evidence for test location. Relative to current screening, unsolicited self‐sampling kits for home use appeared most preferable. The STRATEGIC trial showed this same intervention to be most effective although many women who received it and were screened, attended for conventional cytology instead.ConclusionsThe DCE and trial identified the unsolicited self‐sampling kit as the most preferred/effective intervention. The DCE suggested that the decision of some women receiving the kit in the trial to attend for conventional cytology may be due to anxieties around home testing coupled with a knowledge that ignoring the kit could potentially have life‐changing consequences.",

keywords = "cervical cancer, discrete choice experiments, heterogeneity, preferences, screening uptake, United Kingdom, young women",

author = "Campbell, {Helen E.} and Gray, {Alastair M.} and Judith Watson and Cath Jackson and Carly Moseley and Cruickshank, {Margaret E.} and Kitchener, {Henry C.} and Oliver Rivero-Arias",

note = "ACKNOWLEDGEMENTS We are grateful to Sara Rodgers and Laura Clark at the University of York for conducting the qualitative interviews. We are grateful to Maggie Redshaw at the National Perinatal Epidemiology Unit (NPEU) for helpful suggestions on how to improve the response rate in our study. We also would like to thank the NPEU design team who significantly improved the look of our final questionnaire, and the NPEU administration team for their assistance preparing the mail‐out material. Special thanks are given to our data entry team Sissi Hernandez‐Quesada, Jacob Stevens and Pamela White. We would also like to express our gratitude to the teams at the English and Scottish screening agencies for their willingness to collaborate in this study. Finally, we would like to thank all of the women who completed the DCE questionnaire and took part in the STRATEGIC trial; without them, this work would not have been possible.",

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AU - Campbell, Helen E.

AU - Gray, Alastair M.

AU - Watson, Judith

AU - Jackson, Cath

AU - Moseley, Carly

AU - Cruickshank, Margaret E.

AU - Kitchener, Henry C.

AU - Rivero-Arias, Oliver

N1 - ACKNOWLEDGEMENTS We are grateful to Sara Rodgers and Laura Clark at the University of York for conducting the qualitative interviews. We are grateful to Maggie Redshaw at the National Perinatal Epidemiology Unit (NPEU) for helpful suggestions on how to improve the response rate in our study. We also would like to thank the NPEU design team who significantly improved the look of our final questionnaire, and the NPEU administration team for their assistance preparing the mail‐out material. Special thanks are given to our data entry team Sissi Hernandez‐Quesada, Jacob Stevens and Pamela White. We would also like to express our gratitude to the teams at the English and Scottish screening agencies for their willingness to collaborate in this study. Finally, we would like to thank all of the women who completed the DCE questionnaire and took part in the STRATEGIC trial; without them, this work would not have been possible.

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N2 - BackgroundYoung women’s attendance at cervical screening in the UK is continuing to fall, and the incidence of invasive cervical cancer is rising.ObjectivesWe assessed the preferences of non‐attending young women for alternative ways of delivering cervical screening.DesignPostal discrete choice experiment (DCE) conducted during the STRATEGIC study of interventions for increasing cervical screening uptake. Attributes included action required to arrange a test, location of the test, availability of a nurse navigator and cost to the National Health Service.Setting and participantsNon‐attending young women in two UK regions.Main outcome measuresResponses were analysed using a mixed multinomial logit model. A predictive analysis identified the most preferable strategy compared to current screening. Preferences from the DCE were compared with observed behaviours during the STRATEGIC trial.ResultsThe DCE response rate was 5.5% (222/4000), and 94% of respondents agreed screening is important. Preference heterogeneity existed around attributes with strong evidence for test location. Relative to current screening, unsolicited self‐sampling kits for home use appeared most preferable. The STRATEGIC trial showed this same intervention to be most effective although many women who received it and were screened, attended for conventional cytology instead.ConclusionsThe DCE and trial identified the unsolicited self‐sampling kit as the most preferred/effective intervention. The DCE suggested that the decision of some women receiving the kit in the trial to attend for conventional cytology may be due to anxieties around home testing coupled with a knowledge that ignoring the kit could potentially have life‐changing consequences.

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Preferences for interventions designed to increase cervical screening uptake in non-attending young women: how findings from a discrete choice experiment compare with observed behaviours in a trial

Abstract

Bibliographical note

Keywords

UN SDGs

Access to Document

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