In order to reach the target sample size and to increase sample variation in terms of sociodemographic factors, alternative recruitment was initiated at sites including a sexual health clinic, community groups and GP practices.
4.3.2.1 Procedures
The same inclusion/exclusion criteria applied to primary recruitment were applied to the supplementary recruitment. Participants recruited through the sexual health clinic were provided with a study recruitment card from the receptionist at the clinic. The receptionist briefly outlined the study and asked women if they would be happy to be provided with more information about the study. Potential participants
85 were provided with a study pack containing an information sheet, consent form, questionnaire and a pre-paid return envelope. The majority of participants completed their questionnaire whilst waiting for their appointment.
Community leaders were initially approached and asked if they would be happy for the researcher to attend a group meeting and provide information about the study.
If community leaders expressed interest in the study, the researcher attended the group to present the study to group members and distributed recruitment cards.
The researcher returned during the subsequent meeting to distribute
questionnaires to the individuals who had expressed an interest in participating in the study. The researcher left the study information packs and surveys with the potential participants and returned after the ‘session’ had ended and collected any completed surveys. Subsequent return and collection of the surveys ensured that potential participants did not feel obliged to participate due to researcher
presence.
Recruitment through GP practices involved practice nurses distributing study
recruitment card and pre-paid return envelopes to women aged 20-64 in their clinic appointments. Women who returned a completed recruitment card were sent the study pack.
4.4 Measures
The development of items used to investigate women’s intentions to HPV self-sample was presented in detail in Chapter 3. Please refer to Table 4.1 for an outline of items used to investigate HBM a priori survey constructs and women’s intentions to HPV self-sample. All HBM and intention items were scored on a Likert scale ranging from one to five. Three items were used to measure perceived benefits and three items were used to measure perceived barriers to self-sampling, whilst five items were used to measure barriers to cervical smear tests and three items were used to measure benefits to cervical smear tests. Five items were used to measure perceived self-efficacy in conducting HPV self-sampling. Perceived susceptibility to
86 and perceived severity of HPV and cervical cancer were investigated with one item each (four items in total). One item was used to measure the effect of cues to action in relation to cervical smear screening.
HPV knowledge, clinical variables such as cervical screening history and variables such as age, socioeconomic status (determined by postcode deprivation level), home ownership, ethnicity and educational level were measured using categorical response formats. Women were asked for consent for re-contact by the inclusion of an item asking women to indicate whether they would be happy to participate in a follow-up interview study.
87 Variable Item/s in questionnaire and response scale range.
Intention to HPV self-sample
I would be likely to use a self-sampling kit for HPV. 1= Not at all likely, 5= Very likely
How likely would you be to use the self-sampling kit instead of going for a smear test? 1= Not at all likely, 5= Very likely I expect that I would use a self-sampling kit for HPV. 1= Not at all likely, 5= Very likely
If made available to me, I would use the self-sampling kit for HPV. 1= Not at all likely, 5= Very likely Self-efficacy How certain are you that you would do the test well enough? 1=Not certain, 5= Very certain
How certain are you that you would be able to carry out the sampling procedure (placing swab in vagina)?
1= Not certain, 5= Very certain
How certain are you that you would be able to place the swab into the tube containing the special liquid without touching or dropping the swab? 1=Not certain, 5= Very certain
How certain are you that you would be able to carry out the self-sampling procedure despite other commitments (e.g.
work/children)? 1= Not certain, 5= Very certain
How certain are you that you would be able to send off the completed test within the time allowed (2 weeks)?
1= Not certain, 5= Very certain Benefits to
HPV self-sampling.
Using a self-sample kit is convenient because it can be done at home and means that I would not have to make arrangements (e.g. going to a GP surgery/taking time off work /arranging childcare.)
1= Strongly disagree, 5= Strongly agree
Using a self-sample kit would mean that no-one will know that I am having cervical screening.
1= Strongly disagree, 5= Strongly agree
Using a self-sample kit would be less embarrassing than having a GP or nurse do a smear test.
1= Strongly disagree, 5= Strongly agree
88 Barriers to
HPV self-sampling.
I am worried that I would hurt myself using the self-sample kit. 1= Strongly disagree, 5= Strongly agree I wouldn’t trust the results of the self-sample kit. 1= Strongly disagree, 5= Strongly agree
I would be worried about the self-sampling kit getting lost in the post and not reaching the laboratory.
1= Strongly disagree, 5= Strongly agree Perceived
susceptibility to HPV
Compared to most women your age, how likely do you think it is that you will come into contact with HPV?
1= Much less likely, 5= Much more likely
Perceived severity of HPV
How serious an infection do you think HPV is? 1= Not at all serious, 5= Extremely serious
Benefits to cervical smear screening
Going for cervical smear tests means that cervical abnormalities would be found early on.
1= Strongly disagree, 5= Strongly agree
Going for smear tests provides me with reassurance. 1= Strongly disagree, 5= Strongly agree I trust the nurse/doctor to take a good sample. 1= Strongly disagree, 5= Strongly agree Barriers to
cervical smear testing
Having a smear test is painful. 1= Strongly disagree, 5= Strongly agree
Going for smear tests can be difficult because I have to make arrangements (e.g. time off work, childcare).
1= Strongly disagree, 5= Strongly agree
I worry about my sample getting lost. 1= Strongly disagree, 5= Strongly agree
Having a cervical smear test is embarrassing. 1= Strongly disagree, 5= Strongly agree
I worry that others (e.g. family members, friends, people at the GP surgery) will know that I am having cervical screening. 1= Strongly disagree, 5= Strongly agree
Perceived susceptibility
Compared to other women your age, how likely do you think it is that you would get cervical cancer at some time in your life? Would you say you are…? 1= Much less likely, 5= Much more likely
89