Introduction Aim and Objectives Constructivist ...

A grounded theory study of participation in cervical screening for young women: Sexual association the hidden issues Mabel .O. Okoeki, MSc, Alison Steven, PhD, Lesley Geddes, MPH Faculty of Health and Life sciences, Northumbria University

Introduction

Data Analysis

Model Development

Coding of Data and Analysis Stages

Research Design and data collection

Coding interview and focus group data

Cervical Cancer is the most common cancer in women under the age of 35years. About 3400 diagnosis are recorded each year in the UK The national cervical screening programme has reportedly prevented 75% of cervical cancer cases. There is still a continuous decline in uptake of cervical screening among young women especially in more deprived area like the North East of England. There is a need for a qualitative investigation into reasons for low uptake amongst young women under age 35 in the North East of England.

Aim and Objectives This study aims to develop an understanding into factors that influence participation and non-participation in the national cervical screening programme amongst young women aged 25-35years living in the North East of England To consider the health beliefs of young women in relation to cervical cancer prevention and screening. To identify factors that influence participation and nonparticipation in cervical screening by young women To obtain understanding from young women that would inform recommendations for appropriate interventions that could be used to encourage young women to go for a smear test and promote the cervical screening programme within the North East of England.

Methods

Creation of categories from both interview and focus group

Integration/conceptuali sation of categories to Core categories

Focused/axial coding

Open or initial coding

Design of study

development

Theoretical coding

Data collection

Ethical review/approv al

explanatory model

Transcription

Findings

Health views relative to self

Knowledge and organizational influence

Practicalities -issues associated with participation

Sexual Association

-Human issues -Acceptability

Emotional attribution to screening (Intimacy, violation, embarrassment)

Main Categories

Core category

Knowledge of inside and outside the body, (privacy)

Concepts/themes

Data analysis (N=24) (coding and mind genius)

Summary/Conclusion

Symbolic interactionism

Constructivist Grounded Theory

Theoretical sampling

Reflexivity and Memos

Interviews

Focus Group

Data Collection

• Awareness of cervical cancer prior to screening invitation was found to be relatively low mainly around screening procedure and body anatomy (location of the cervix). • Factors within ‘emotional attribution’ and ‘human issues’ played key impacts on screening behaviour and decision for those who haven’t been screened and from ethnic minority group. • The psychosocial impact (as fear, embarrassment, intrusiveness and taboos) of sex associated with cervical screening as well as practical issues such as busy schedule, was strongly linked to non-participation. • These psychological and sexual associations included screening procedure mimicking sex (penetration), screening intrusive nature (exposure ,intimate, private) and sociocultural beliefs (promiscuity, taboo and body insecurities). • The screening touched on deep primal issues such as reproduction (infertility) and mortality (death from cancer). • These hidden sexual issues associated with screening were sometimes unspoken and unconsciously influenced the decision making process. • Suggested service improvement strategies included alternative screening methods (e.g. home self-testing), educating health professionals on sensitivity, and invitation letter reflecting in-depth details of the procedure.