{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T13:34:38Z","timestamp":1763559278327,"version":"3.45.0"},"reference-count":57,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000048","name":"American Cancer Society","doi-asserted-by":"crossref","award":["PASD-RSG-23-1077156-01"],"award-info":[{"award-number":["PASD-RSG-23-1077156-01"]}],"id":[{"id":"10.13039\/100000048","id-type":"DOI","asserted-by":"crossref"}]},{"name":"NCI","award":["P30CA046592"],"award-info":[{"award-number":["P30CA046592"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cancer Causes Control"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Barriers to cervical cancer screening are significantly higher among US rural populations. To understand these barriers and explore potential remedies, we compare perceptions of screening exam techniques, pelvic exam vs. self-sampling, and how perceptions vary by participants\u2019 beliefs, physician characteristics, and known barriers among under-screened rural people in Michigan, United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Our mixed-methods study explored experiences with a vaginal self-sampling technique in comparison to the memory of the most recent pelvic exam. We developed quantitative survey questions using Health Information National Trends Survey (HINTS) modules. We created the qualitative interview guide using Likert scales and the Theoretical Domains Framework (TDF). We provided vaginal self-sampling kits (HerSwab) to participants to try this new test modality. We used descriptive statistics and t tests to analyze quantitative data. We analyzed the interview responses thematically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the forty rural white women who shared their experiences of the two screening techniques, the pelvic exam technique had significantly worse negative ratings across all fourteen perceptions than the self-sampling technique, and the self-sampling technique had significantly higher positive ratings.<\/jats:p>\n                    <jats:p>Analysis of interviews revealed four themes that elaborated survey results: 1) preference for the self-sampling technique; 2) physical and emotional discomfort with the pelvic exam technique; 3) convenience of the self-sampling technique; and 4) empowerment through self-sampling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The powerful negative perceptions of the pelvic exam may be why people do not participate in screening. The self-sampling cervical cancer screening technique offers a quick and easy method for screening that many prefer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10552-025-02081-5","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T09:22:18Z","timestamp":1761556938000},"page":"2023-2037","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rural women choose self-sampling over a pelvic exam for cervical cancer screening: a mixed-method study"],"prefix":"10.1007","volume":"36","author":[{"given":"Timothy C.","family":"Guetterman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Vinson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Stack","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha L.","family":"Alves","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Haro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Alman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"family":"Butcher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christelle El","family":"Khoury","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"DeJonckheere","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diane M.","family":"Harper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"key":"2081_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2019.105880","volume":"130","author":"DM Harper","year":"2020","unstructured":"Harper DM, Plegue M, Harmes KM, Jimbo M, SheinfeldGorin S (2020) Three large scale surveys highlight the complexity of cervical cancer under-screening among women 45\u201365years of age in the United States. Prev Med 130:105880. https:\/\/doi.org\/10.1016\/j.ypmed.2019.105880","journal-title":"Prev Med"},{"key":"2081_CR2","unstructured":"NORC at the University of Chicago. Only 14% of cancers are detected through a preventive screening test. Accessed March 12, 2024, https:\/\/www.norc.org\/content\/dam\/norc-org\/pdfs\/State-Specific%20PCDSs%20chart%201213.pdf"},{"key":"2081_CR3","unstructured":"US Preventive Services Task Force. Cervical Cancer: Screening. Accessed July 3, 2024, https:\/\/www.uspreventiveservicestaskforce.org\/uspstf\/recommendation\/cervical-cancer-screening"},{"key":"2081_CR4","unstructured":"US Cancer Statistics Working Group. US Cancer Statistics Data Visualizations Tool. US Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; https:\/\/www.cdc.gov\/cancer\/dataviz,, released in June 2024"},{"key":"2081_CR5","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.76070","author":"DM Harper","year":"2022","unstructured":"Harper DM, Plegue M, Jimbo M, Sheinfeld Gorin S, Sen A (2022) US women screen at low rates for both cervical and colorectal cancers than a single cancer: a cross-sectional population-based observational study. Elife. https:\/\/doi.org\/10.7554\/eLife.76070","journal-title":"Elife"},{"issue":"2","key":"2081_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.ss6602a1","volume":"66","author":"MC Garcia","year":"2017","unstructured":"Garcia MC, Faul M, Massetti G et al (2017) Reducing potentially excess deaths from the five leading causes of death in the rural United States. MMWR Surveill Summ 66(2):1\u20137. https:\/\/doi.org\/10.15585\/mmwr.ss6602a1","journal-title":"MMWR Surveill Summ"},{"key":"2081_CR7","doi-asserted-by":"publisher","first-page":"E70","DOI":"10.5888\/pcd16.180447","volume":"16","author":"L Yu","year":"2019","unstructured":"Yu L, Sabatino SA, White MC (2019) Rural-Urban and Racial\/Ethnic Disparities in Invasive Cervical Cancer Incidence in the United States, 2010\u20132014. Prev Chronic Dis 16:E70. https:\/\/doi.org\/10.5888\/pcd16.180447","journal-title":"Prev Chronic Dis"},{"issue":"9","key":"2081_CR8","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.33429","volume":"5","author":"C Bauer","year":"2022","unstructured":"Bauer C, Zhang K, Xiao Q, Lu J, Hong YR, Suk R (2022) County-level social vulnerability and breast, cervical, and colorectal cancer screening rates in the US, 2018. JAMA Netw Open 5(9):e2233429. https:\/\/doi.org\/10.1001\/jamanetworkopen.2022.33429","journal-title":"JAMA Netw Open"},{"issue":"2","key":"2081_CR9","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1016\/j.socscimed.2007.09.009","volume":"66","author":"SS Coughlin","year":"2008","unstructured":"Coughlin SS, Leadbetter S, Richards T, Sabatino SA (2008) Contextual analysis of breast and cervical cancer screening and factors associated with health care access among United States women, 2002. Soc Sci Med 66(2):260\u2013275. https:\/\/doi.org\/10.1016\/j.socscimed.2007.09.009","journal-title":"Soc Sci Med"},{"key":"2081_CR10","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1016\/j.pmedr.2018.01.010","volume":"9","author":"M Watson","year":"2018","unstructured":"Watson M, Benard V, Flagg EW (2018) Assessment of trends in cervical cancer screening rates using healthcare claims data: United States, 2003\u20132014. Prev Med Rep 9:124\u2013130. https:\/\/doi.org\/10.1016\/j.pmedr.2018.01.010","journal-title":"Prev Med Rep"},{"issue":"2","key":"2081_CR11","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1111\/j.1748-0361.2005.tb00075.x","volume":"21","author":"KR Yabroff","year":"2005","unstructured":"Yabroff KR, Lawrence WF, King JC et al (2005) Geographic disparities in cervical cancer mortality: what are the roles of risk factor prevalence, screening, and use of recommended treatment? J Rural Health 21(2):149\u2013157. https:\/\/doi.org\/10.1111\/j.1748-0361.2005.tb00075.x","journal-title":"J Rural Health"},{"key":"2081_CR12","unstructured":"Sexual Truama. US Department of Veterans Affairs. https:\/\/www.ptsd.va.gov\/professional\/treat\/type\/sexual_trauma_women.asp#:~:text=However%2C%20the%20women%20who%20had,most%20common%20reason%20for%20anxiety."},{"issue":"7","key":"2081_CR13","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1089\/jwh.2021.0237","volume":"31","author":"ER Danan","year":"2022","unstructured":"Danan ER, Brunner J, Bergman A, Spoont M, Chanfreau C, Canelo I, Krebs EE, Yano EM (2022) The relationship between sexual assault history and cervical cancer screening completion among women veterans in the Veterans Health Administration. J Womens Health (Larchmt) 31(7):1040\u20131047. https:\/\/doi.org\/10.1089\/jwh.2021.0237","journal-title":"J Womens Health (Larchmt)"},{"key":"2081_CR14","doi-asserted-by":"publisher","first-page":"79S","DOI":"10.1097\/01.AOG.0000463221.43685.0d","volume":"125","author":"SE Gibbs","year":"2015","unstructured":"Gibbs SE, Rocca CH, Henderson JT, Westhoff CL, Darney PD, Harper CC (2015) Pelvic examination preferences by race-ethnicity among young women in reproductive health clinics [244]. Obstet Gynecol 125:79S. https:\/\/doi.org\/10.1097\/01.AOG.0000463221.43685.0d","journal-title":"Obstet Gynecol"},{"issue":"7","key":"2081_CR15","doi-asserted-by":"publisher","first-page":"e65555","DOI":"10.7759\/cureus.65555.PMID:39192892;PMCID:PMC11347962","volume":"16","author":"O Farajimakin","year":"2024","unstructured":"Farajimakin O (2024) Barriers to Cervical Cancer Screening: A Systematic Review. Cureus 16(7):e65555. https:\/\/doi.org\/10.7759\/cureus.65555.PMID:39192892;PMCID:PMC11347962","journal-title":"Cureus"},{"key":"2081_CR16","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2025.102971","volume":"50","author":"AP Young","year":"2025","unstructured":"Young AP, Olorunfemi M, Morrison L, Kelley SA, Laurie A, McEvoy A, Schneiderhan J, Prussack J, O\u2019Dwyer MC, Rockwell P, Zazove P, Gabison J, Chargot J, Gallagher K, Sen A, Chen D, Haro EA, Butcher EA, Alves ML, El Khoury C, Dendrinos ML, Brashear N, Smith R, Lieberman RW, Saunders N, Campbell E, Walline HM, Harper DM (2025) Cervical cancer screening: impact of collection technique on human papillomavirus detection and genotyping. Prev Med Rep 50:102971. https:\/\/doi.org\/10.1016\/j.pmedr.2025.102971","journal-title":"Prev Med Rep"},{"issue":"4","key":"2081_CR17","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.70714","volume":"14","author":"TC Guetterman","year":"2025","unstructured":"Guetterman TC, El Khoury C, Tariq M, Aziz G, Alhawli A, Alves ML, Haro E, Butcher EA, Vinson AH, Harper DM (2025) Acceptability of home-based urine self-collection for cervical cancer screening among women receiving care at the Arab Community Center for Economic and Social Services in Michigan. Cancer Med 14(4):e70714. https:\/\/doi.org\/10.1002\/cam4.70714","journal-title":"Cancer Med"},{"issue":"1","key":"2081_CR18","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.57290","volume":"8","author":"AH Vinson","year":"2025","unstructured":"Vinson AH, Norrid C, Haro EK, Ernst S, El Khoury C, Alves ML, Kieber-Emmons A, Kamath Mulki A, Butcher EA, Kalpakjian C, McKee MM, Harper DM (2025) Cervical cancer screening in women with physical disabilities. JAMA Netw Open 8(1):e2457290. https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.57290","journal-title":"JAMA Netw Open"},{"issue":"16","key":"2081_CR19","doi-asserted-by":"publisher","first-page":"3333","DOI":"10.1007\/s11606-024-09026-9","volume":"39","author":"CL Fosmore","year":"2024","unstructured":"Fosmore CL, Sullivan S, Brouwer AF, Goold SD, Reisner SL, Fendrick AM, Harper DM (2024) Strategies to optimize cervical cancer screening rates among transgender and gender-diverse people assigned female at birth. J Gen Intern Med 39(16):3333\u20133338. https:\/\/doi.org\/10.1007\/s11606-024-09026-9","journal-title":"J Gen Intern Med"},{"issue":"4","key":"2081_CR20","doi-asserted-by":"publisher","first-page":"10","DOI":"10.18103\/mra.v12i4.5209","volume":"2","author":"E Haro","year":"2024","unstructured":"Haro E, Butcher EA, Alves ML, El Khoury C, Vinson A, Harper DM (2024) Barriers to Cervical Cancer Screening and Satisfaction with Self-Sampling among Black Women in Michigan: a Mixed Methods Study. Med Res Arch 2(4):10. https:\/\/doi.org\/10.18103\/mra.v12i4.5209","journal-title":"Med Res Arch"},{"key":"2081_CR21","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-25-0116","author":"DM Harper","year":"2025","unstructured":"Harper DM, Young AP, O\u2019Dwyer MC, Olorunfemi M, Laurie A, Sen A, Chen D, Morrison L, Kelley SA, McEvoy A, Schneiderhan J, Rockwell P, Zazove P, Gabison J, Chargot JE, Gallagher K, Prussack J, Butcher EA, Alves ML, Haro EA, El Khoury C, Smith R, Saunders N, Campbell E, Walline HM (2025) Comparison of Human Papillomavirus genotyping by research vs clinical assay for two self-collection devices. Cancer Epidemiol Biomark Prev. https:\/\/doi.org\/10.1158\/1055-9965.EPI-25-0116","journal-title":"Cancer Epidemiol Biomark Prev"},{"issue":"6","key":"2081_CR22","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1089\/jwh.2016.5965","volume":"26","author":"C Mao","year":"2017","unstructured":"Mao C, Kulasingam SL, Whitham HK, Hawes SE, Lin J, Kiviat NB (2017) Clinician and patient acceptability of self-collected human papillomavirus testing for cervical cancer screening. J Womens Health 26(6):609\u2013615. https:\/\/doi.org\/10.1089\/jwh.2016.5965","journal-title":"J Womens Health"},{"issue":"1","key":"2081_CR23","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1186\/s12905-022-02043-y","volume":"22","author":"Z Petersen","year":"2022","unstructured":"Petersen Z, Jaca A, Ginindza TG et al (2022) Barriers to uptake of cervical cancer screening services in low-and-middle-income countries: a systematic review. BMC Womens Health 22(1):486. https:\/\/doi.org\/10.1186\/s12905-022-02043-y","journal-title":"BMC Womens Health"},{"issue":"3","key":"2081_CR24","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1097\/LGT.0b013e3181cd6d36","volume":"14","author":"A Balasubramanian","year":"2010","unstructured":"Balasubramanian A, Kulasingam SL, Baer A et al (2010) Accuracy and cost-effectiveness of cervical cancer screening by high-risk human papillomavirus DNA testing of self-collected vaginal samples. J Low Genit Tract Dis 14(3):185\u2013195. https:\/\/doi.org\/10.1097\/LGT.0b013e3181cd6d36","journal-title":"J Low Genit Tract Dis"},{"issue":"2","key":"2081_CR25","first-page":"95","volume":"10","author":"PE Gravitt","year":"2001","unstructured":"Gravitt PE, Lacey JV Jr, Brinton LA et al (2001) Evaluation of self-collected cervicovaginal cell samples for human papillomavirus testing by polymerase chain reaction. Cancer Epidemiol Biomarkers Prev 10(2):95\u2013100","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"3","key":"2081_CR26","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1067\/mob.2002.121076","volume":"186","author":"DM Harper","year":"2002","unstructured":"Harper DM, Noll WW, Belloni DR, Cole BF (2002) Randomized clinical trial of PCR-determined human papillomavirus detection methods: self-sampling versus clinician-directed\u2013biologic concordance and women\u2019s preferences. Am J Obstet Gynecol 186(3):365\u2013373. https:\/\/doi.org\/10.1067\/mob.2002.121076","journal-title":"Am J Obstet Gynecol"},{"issue":"6","key":"2081_CR27","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1097\/01.olq.0000240315.19652.59","volume":"34","author":"RL Winer","year":"2007","unstructured":"Winer RL, Feng Q, Hughes JP et al (2007) Concordance of self-collected and clinician-collected swab samples for detecting human papillomavirus DNA in women 18 to 32 years of age. Sex Transm Dis 34(6):371\u2013377. https:\/\/doi.org\/10.1097\/01.olq.0000240315.19652.59","journal-title":"Sex Transm Dis"},{"key":"2081_CR28","doi-asserted-by":"publisher","first-page":"k4823","DOI":"10.1136\/bmj.k4823","volume":"363","author":"M Arbyn","year":"2018","unstructured":"Arbyn M, Smith SB, Temin S, Sultana F, Castle P (2018) Collaboration on Self-Sampling and HPV Testing Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses. BMJ 363:k4823. https:\/\/doi.org\/10.1136\/bmj.k4823","journal-title":"BMJ"},{"key":"2081_CR29","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2021.100235","volume":"11","author":"F Inturrisi","year":"2021","unstructured":"Inturrisi F, Aitken CA, Melchers WJG et al (2021) Clinical performance of high-risk HPV testing on self-samples versus clinician samples in routine primary HPV screening in the Netherlands: an observational study. Lancet Reg Health 11:100235. https:\/\/doi.org\/10.1016\/j.lanepe.2021.100235","journal-title":"Lancet Reg Health"},{"key":"2081_CR30","unstructured":"Creswell JW. A concise introduction to mixed methods research. SAGE publications; 2014."},{"key":"2081_CR31","doi-asserted-by":"publisher","first-page":"139","DOI":"10.2147\/JMDH.S78458","volume":"8","author":"CJ Phillips","year":"2015","unstructured":"Phillips CJ, Marshall AP, Chaves NJ et al (2015) Experiences of using the theoretical domains framework across diverse clinical environments: a qualitative study. J Multidiscip Healthc 8:139\u2013146. https:\/\/doi.org\/10.2147\/JMDH.S78458","journal-title":"J Multidiscip Healthc"},{"key":"2081_CR32","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2021.114523","volume":"292","author":"M Hennink","year":"2022","unstructured":"Hennink M, Kaiser BN (2022) Sample sizes for saturation in qualitative research: a systematic review of empirical tests. Soc Sci Med 292:114523. https:\/\/doi.org\/10.1016\/j.socscimed.2021.114523","journal-title":"Soc Sci Med"},{"issue":"2","key":"2081_CR33","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1002\/(sici)1098-240x(199704)20:2<169::aid-nur9>3.0.co;2-i","volume":"20","author":"S Thorne","year":"1997","unstructured":"Thorne S, Kirkham SR, MacDonald-Emes J (1997) Interpretive description: a noncategorical qualitative alternative for developing nursing knowledge. Res Nurs Health 20(2):169\u2013177. https:\/\/doi.org\/10.1002\/(sici)1098-240x(199704)20:2%3c169::aid-nur9%3e3.0.co;2-i","journal-title":"Res Nurs Health"},{"key":"2081_CR34","doi-asserted-by":"publisher","DOI":"10.4159\/9780674028845","volume-title":"The ecology of human development: Experiments by nature and design","author":"U Bronfenbrenner","year":"1979","unstructured":"Bronfenbrenner U (1979) The ecology of human development: Experiments by nature and design. Harvard University Press, Cambridge, MA"},{"key":"2081_CR35","first-page":"43","volume":"5","author":"JF Sallis","year":"2015","unstructured":"Sallis JF, Owen N, Fisher E (2015) Ecological models of health behavior. Health Behav Theory Res Pract 5:43\u201364","journal-title":"Health Behav Theory Res Pract"},{"key":"2081_CR36","unstructured":"NCI Health Information National Trends Survey. Accessed August 16, 2023, https:\/\/hints.cancer.gov\/view-questions\/all-hints-questions.aspx"},{"issue":"3","key":"2081_CR37","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1111\/medu.14380","volume":"55","author":"J Thompson Burdine","year":"2021","unstructured":"Thompson Burdine J, Thorne S, Sandhu G (2021) Interpretive description: a flexible qualitative methodology for medical education research. Med Educ 55(3):336\u2013343. https:\/\/doi.org\/10.1111\/medu.14380","journal-title":"Med Educ"},{"issue":"10","key":"2081_CR38","doi-asserted-by":"publisher","first-page":"1875","DOI":"10.1017\/S0033291720003700","volume":"52","author":"D Kounali","year":"2022","unstructured":"Kounali D, Button KS, Lewis G et al (2022) How much change is enough? Evidence from a longitudinal study on depression in UK primary care. Psychol Med 52(10):1875\u20131882. https:\/\/doi.org\/10.1017\/S0033291720003700","journal-title":"Psychol Med"},{"issue":"8","key":"2081_CR39","doi-asserted-by":"publisher","first-page":"1641","DOI":"10.1016\/j.ajem.2019.158489","volume":"38","author":"M Bahreini","year":"2020","unstructured":"Bahreini M, Safaie A, Mirfazaelian H, Jalili M (2020) How much change in pain score does really matter to patients? Am J Emerg Med 38(8):1641\u20131646. https:\/\/doi.org\/10.1016\/j.ajem.2019.158489","journal-title":"Am J Emerg Med"},{"key":"2081_CR40","unstructured":"TIBCO Software Inc. (2020). Data Science Workbench, version 14. Accessed August 16, 2023, http:\/\/tibco.com"},{"key":"2081_CR41","unstructured":"Srygley S, Khairunnisa N, Elliot D, Population Reference Bureau. The Appalachian Region: A Data overview from the 2018\u20132022 American Community Survey Chartbook. June 2024. https:\/\/www.arc.gov\/wp-content\/uploads\/2024\/06\/PRB_ARC_Chartbook_ACS_2018-2022_FINAL_2024-06.pdf#page=189"},{"key":"2081_CR42","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2021.101375","volume":"22","author":"DM Harper","year":"2021","unstructured":"Harper DM, Plegue M, Sen A et al (2021) Predictors of screening for cervical and colorectal cancer in women 50\u201365 years old in a multi-ethnic population. Prev Med Rep 22:101375. https:\/\/doi.org\/10.1016\/j.pmedr.2021.101375","journal-title":"Prev Med Rep"},{"key":"2081_CR43","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2020.106400","volume":"144","author":"LN Fuzzell","year":"2021","unstructured":"Fuzzell LN, Perkins RB, Christy SM, Lake PW, Vadaparampil ST (2021) Cervical cancer screening in the United States: challenges and potential solutions for underscreened groups. Prev Med 144:106400. https:\/\/doi.org\/10.1016\/j.ypmed.2020.106400","journal-title":"Prev Med"},{"issue":"9","key":"2081_CR44","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.1089\/jwh.2020.8807","volume":"30","author":"CB Biddell","year":"2021","unstructured":"Biddell CB, Spees LP, Smith JS et al (2021) Perceived financial barriers to cervical cancer screening and associated cost burden among low-income, under-screened women. J Womens Health 30(9):1243\u20131252. https:\/\/doi.org\/10.1089\/jwh.2020.8807","journal-title":"J Womens Health"},{"issue":"1","key":"2081_CR45","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.sxmr.2019.09.005","volume":"8","author":"SL Bedell","year":"2020","unstructured":"Bedell SL, Goldstein LS, Goldstein AR, Goldstein AT (2020) Cervical cancer screening: past, present, and future. Sex Med Rev 8(1):28\u201337. https:\/\/doi.org\/10.1016\/j.sxmr.2019.09.005","journal-title":"Sex Med Rev"},{"issue":"2","key":"2081_CR46","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1016\/S1470-2045(18)30763-0","volume":"20","author":"NJ Polman","year":"2019","unstructured":"Polman NJ, Ebisch RMF, Heideman DAM et al (2019) Performance of human papillomavirus testing on self-collected versus clinician-collected samples for the detection of cervical intraepithelial neoplasia of grade 2 or worse: a randomised, paired screen-positive, non-inferiority trial. Lancet Oncol 20(2):229\u2013238. https:\/\/doi.org\/10.1016\/S1470-2045(18)30763-0","journal-title":"Lancet Oncol"},{"key":"2081_CR47","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2021.106900","volume":"154","author":"B Serrano","year":"2022","unstructured":"Serrano B, Ibanez R, Robles C, Peremiquel-Trillas P, de Sanjose S, Bruni L (2022) Worldwide use of HPV self-sampling for cervical cancer screening. Prev Med 154:106900. https:\/\/doi.org\/10.1016\/j.ypmed.2021.106900","journal-title":"Prev Med"},{"issue":"1","key":"2081_CR48","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1097\/LGT.0000000000000453","volume":"23","author":"J Jeronimo","year":"2019","unstructured":"Jeronimo J, Perkins RB, Scalici J, Pierce JY (2019) Should self-sampling be an option for women in the United States? J Low Genit Tract Dis 23(1):54\u201357. https:\/\/doi.org\/10.1097\/LGT.0000000000000453","journal-title":"J Low Genit Tract Dis"},{"issue":"4","key":"2081_CR49","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1097\/LGT.0000000000000424","volume":"22","author":"JC Molokwu","year":"2018","unstructured":"Molokwu JC, Penaranda E, Dwivedi A, Mallawaarachchi I, Shokar N (2018) Effect of educational intervention on self-sampling acceptability and follow-up paps in border dwelling Hispanic females. J Low Genit Tract Dis 22(4):295\u2013301. https:\/\/doi.org\/10.1097\/LGT.0000000000000424","journal-title":"J Low Genit Tract Dis"},{"issue":"4","key":"2081_CR50","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1097\/LGT.0000000000000430","volume":"22","author":"KA Kilfoyle","year":"2018","unstructured":"Kilfoyle KA, Des Marais AC, Ngo MA et al (2018) Preference for human papillomavirus self-collection and Papanicolaou: survey of underscreened women in North Carolina. J Low Genit Tract Dis 22(4):302\u2013310. https:\/\/doi.org\/10.1097\/LGT.0000000000000430","journal-title":"J Low Genit Tract Dis"},{"issue":"5","key":"2081_CR51","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.1007\/s10900-016-0189-3","volume":"41","author":"RL Winer","year":"2016","unstructured":"Winer RL, Gonzales AA, Noonan CJ, Cherne SL, Buchwald DS, Collaborative to Improve Native Cancer O (2016) Assessing acceptability of self-sampling kits, prevalence, and risk factors for human papillomavirus infection in American Indian women. J Community Health 41(5):1049\u20131061. https:\/\/doi.org\/10.1007\/s10900-016-0189-3","journal-title":"J Community Health"},{"issue":"5","key":"2081_CR52","first-page":"513","volume":"163","author":"JW Sellors","year":"2000","unstructured":"Sellors JW, Lorincz AT, Mahony JB et al (2000) Comparison of self-collected vaginal, vulvar and urine samples with physician-collected cervical samples for human papillomavirus testing to detect high-grade squamous intraepithelial lesions. CMAJ 163(5):513\u2013518","journal-title":"CMAJ"},{"key":"2081_CR53","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.jcv.2017.12.008","volume":"99","author":"MK Leinonen","year":"2018","unstructured":"Leinonen MK, Schee K, Jonassen CM et al (2018) Safety and acceptability of human papillomavirus testing of self-collected specimens: a methodologic study of the impact of collection devices and HPV assays on sensitivity for cervical cancer and high-grade lesions. J Clin Virol 99:22\u201330. https:\/\/doi.org\/10.1016\/j.jcv.2017.12.008","journal-title":"J Clin Virol"},{"key":"2081_CR54","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2019.105953","volume":"132","author":"C Malone","year":"2020","unstructured":"Malone C, Barnabas RV, Buist DSM, Tiro JA, Winer RL (2020) Cost-effectiveness studies of HPV self-sampling: a systematic review. Prev Med 132:105953. https:\/\/doi.org\/10.1016\/j.ypmed.2019.105953","journal-title":"Prev Med"},{"issue":"20 Suppl 1","key":"2081_CR55","doi-asserted-by":"publisher","first-page":"2639","DOI":"10.1370\/afm.20.s1.2639.PMID:36857034;PMCID:PMC10548924","volume":"20","author":"C El Khoury","year":"2022","unstructured":"El Khoury C, Crespo Albiac L, O\u2019Dwyer MC, Haro E, Alves M, Jimbo M, Harper D, Sheinfeld Gorin S, Meixner K, Capizzano JN, Salada C (2022) Patient-centered home cancer screening attitudes during SARS-CoV-2 pandemic. Ann Fam Med 20(20 Suppl 1):2639. https:\/\/doi.org\/10.1370\/afm.20.s1.2639.PMID:36857034;PMCID:PMC10548924","journal-title":"Ann Fam Med"},{"issue":"10","key":"2081_CR56","doi-asserted-by":"publisher","first-page":"3338","DOI":"10.1007\/s10461-024-04415-x","volume":"28","author":"C Goense","year":"2024","unstructured":"Goense C, Doan TP, Kpokiri EE, Evers YJ, Estcourt CS, Crutzen R, Klausner JD, Tang W, Baraitser P, Hoebe C, Dukers-Muijrers N (2024) Understanding Practical, Robust Implementation and Sustainability of Home-based Comprehensive Sexual Health Care: A Realist Review. AIDS Behav 28(10):3338\u20133349. https:\/\/doi.org\/10.1007\/s10461-024-04415-x","journal-title":"AIDS Behav"},{"key":"2081_CR57","unstructured":"Centers for Disease Control and Prevention. Fast Facts: Preventing sexual violence. Accessed August 16, 2023, https:\/\/www.cdc.gov\/violenceprevention\/sexualviolence\/fastfact.html"}],"container-title":["Cancer Causes &amp; Control"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10552-025-02081-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10552-025-02081-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10552-025-02081-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T13:30:50Z","timestamp":1763559050000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10552-025-02081-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,27]]},"references-count":57,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["2081"],"URL":"https:\/\/doi.org\/10.1007\/s10552-025-02081-5","relation":{},"ISSN":["0957-5243","1573-7225"],"issn-type":[{"type":"print","value":"0957-5243"},{"type":"electronic","value":"1573-7225"}],"subject":[],"published":{"date-parts":[[2025,10,27]]},"assertion":[{"value":"11 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 September 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"University of Michigan IRBMED: HUM00163301.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}