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2022: Two-year Impact Factor: 4.4
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CiteScore (2022): 5.3
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Health Promot Perspect. 2024;14(1): 80-88.
doi: 10.34172/hpp.42485
PMID: 38623347
PMCID: PMC11016146
  Abstract View: 193
  PDF Download: 213

Original Article

Exploring the barriers to Pap smear test compliance: A qualitative study for improving cervical cancer screening in the primary health care

Mansoore Shariati Sarcheshme 1,2 ORCID logo, Mehrsadat Mahdizadeh 2,3 ORCID logo, Hadi Tehrani 2,3 ORCID logo, Mohammad Vahedian-Shahroodi 2,3* ORCID logo

1 Department of Midwifery, Neyshabur Branch, Islamic Azad University, Neyshabur, Iran
2 Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
3 Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
*Corresponding Author: Mohammad Vahedian-Shahroodi, Email: VahedianM@mums.ac.ir

Abstract

Background: Cervical cancer in Iran ranks as the fourth most frequent cancer among women. Pap smear (PS) is the best standard for detecting cervical cancer, but many people, even healthcare providers (HCPs), do not maintain it. HCPs play a critical role in promoting PS uptake. The purpose of the study was to explore barriers to cervical cancer PS screening compliance from the HCPs’ perspective.

Methods: The present qualitative content analysis was conducted through semi-structured in-depth interviews. A total of 28 HCPs were interviewed between July and August 2020. A diverse sample of HCPs was selected using purposive sampling. Data analysis was based on the five steps proposed by Graneheim and Lundman. MAXQDA (2020) was used for data analyzing.

Results: Ten key sub-categories were identified and organized into three categories: individual, environmental, and socio-cultural factors. The sub-categories included inadequate risk perception, inappropriate attitude, low commitment, emotional factors, low priority over health, requirements and consequences of the test, deficiencies of health centers, organizational factors, traditions and religious believes.

Conclusion: HCPs face multiple barriers for PS. Exploring and decreasing barriers of PS in HCPs may increase compliance in them and their clients because they play an influential role in instructing and persuading women to take the PS. There is need to explore these barriers and identify possible interventions to change them. Insights from this study are useful for developing policies around national PS programs, too.

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Submitted: 03 Sep 2023
Accepted: 19 Feb 2024
ePublished: 14 Mar 2024
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