{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T12:29:39Z","timestamp":1793104179534,"version":"4.5.0"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01 CA248558"],"award-info":[{"award-number":["R01 CA248558"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J GEN INTERN MED"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Somali American women have lower cervical cancer screening rates than the general US population. Human papillomavirus (HPV) testing on self-collected samples (HPV self-sampling) has the potential to address cervical cancer screening disparities affecting Somali American women. This study aimed to understand Somali American women\u2019s perspectives on cervical cancer screening and HPV self-sampling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty-four Somali American women participated in six focus groups. Participants were between 30 and 65\u00a0years old and were eligible for cervical cancer screening. The discussions focused on women\u2019s experiences with cervical cancer screening, barriers to screening, views on HPV self-sampling, and recommendations to increase screening participation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>While some participants\u2019 prior experiences with cervical cancer screening were positive, many reported coercive, distressing, and frightening experiences with screening. A range of barriers was reported, and these included fear, distrust, low awareness of cervical cancer, modesty concerns, being circumcised, and limited access, including not being offered screening. Participants viewed HPV self-sampling favorably, with minor concerns about test validity or ability to collect samples correctly. Overall, participants felt HPV self-sampling should be routinely offered to all Somali American patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Offering HPV self-sampling to Somali American women could be an important tool to address barriers related to modesty and access to care and may be most effective implemented alongside education to raise awareness about cervical cancer. This modality may be particularly important for patients who have had traumatic or coercive screening experiences and for patients who have experienced female genital circumcision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>NCT05453006<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11606-025-10080-0","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T15:58:53Z","timestamp":1766073533000},"page":"2154-2164","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Experience with Cervical Cancer Screening and Views on HPV Self-Sampling Among Somali American Women"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3561-8276","authenticated-orcid":false,"given":"Rebekah","family":"Pratt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Bliss Barsness","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatumastar","family":"Adan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumeiya","family":"Abdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharif","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huda","family":"Farah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Trofholz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Desai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristi","family":"Fordyce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahel","family":"Ghebre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anisa","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Ramer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Szpiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan J.","family":"Weiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Yohe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel L.","family":"Winer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"10080_CR1","doi-asserted-by":"crossref","unstructured":"Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-263.  https:\/\/doi.org\/10.3322\/caac.21834.","DOI":"10.3322\/caac.21834"},{"key":"10080_CR2","unstructured":"Centers for Disease Control and Prevention. Cancers Associated with Human Papillomavirus, United States\u20142015\u20132019. USCS Data Brief, no. 32. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2022."},{"key":"10080_CR3","doi-asserted-by":"crossref","unstructured":"Leyden WA, Manos MM, Geiger AM, et al. Cervical cancer in women with comprehensive health care access: attributable factors in the screening process. J Natl Cancer Inst. 2005;97(9):675\u201383.","DOI":"10.1093\/jnci\/dji115"},{"key":"10080_CR4","doi-asserted-by":"crossref","unstructured":"Kinney W, Sung HY, Kearney KA, Miller M, Sawaya G, Hiatt RA. Missed opportunities for cervical cancer screening of HMO members developing invasive cervical cancer (ICC). Gynecol Oncol. 1998;71(3):428-430.","DOI":"10.1006\/gyno.1998.5135"},{"key":"10080_CR5","doi-asserted-by":"publisher","unstructured":"Janerich DT, Hadjimichael O, Schwartz PE, et al. The screening histories of women with invasive cervical cancer, Connecticut. Am J Public Health. 1995;85(6):791\u20134. https:\/\/doi.org\/10.2105\/AJPH.85.6.791","DOI":"10.2105\/AJPH.85.6.791"},{"key":"10080_CR6","doi-asserted-by":"crossref","unstructured":"US Preventive Services Task Force. Screening for Cervical Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;320(7):674\u2013686.  https:\/\/jamanetwork.com\/journals\/jama\/article-abstract\/2697704. Accessed 1  Mar 2024.","DOI":"10.1001\/jama.2018.10897"},{"key":"10080_CR7","doi-asserted-by":"crossref","unstructured":"Fontham ETH, Wolf AMD, Church TR, et al. Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA- 2020 - CA: A Cancer J Clin. 2020;70(5):321\u2013346. Wiley Online Library.   https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/full\/10.3322\/caac.21628. Accessed 1 Mar 2024.","DOI":"10.3322\/caac.21628"},{"key":"10080_CR8","doi-asserted-by":"publisher","unstructured":"Canfell K, Caruana M, Gebski V, et al. Cervical screening with primary HPV testing or cytology in a population of women in which those aged 33 years or younger had previously been offered HPV vaccination: Results of the Compass pilot randomised trial. PLOS Med. 2017;14(9):e1002388.  https:\/\/doi.org\/10.1371\/journal.pmed.1002388.","DOI":"10.1371\/journal.pmed.1002388"},{"key":"10080_CR9","doi-asserted-by":"publisher","unstructured":"Arbyn M, Smith SB, Temin S, Sultana F, Castle P. Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses. BMJ. 2018;363:k4823.  https:\/\/doi.org\/10.1136\/bmj.k4823.","DOI":"10.1136\/bmj.k4823"},{"key":"10080_CR10","doi-asserted-by":"publisher","unstructured":"Polman NJ, Ebisch RMF, Heideman DAM, et al. 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. 2019;20(2):229-238.  https:\/\/doi.org\/10.1016\/S1470-2045(18)30763-0.","DOI":"10.1016\/S1470-2045(18)30763-0"},{"key":"10080_CR11","doi-asserted-by":"publisher","unstructured":"Camara H, Zhang Y, Lafferty L, Vallely AJ, Guy R, Kelly-Hanku A. Self-collection for HPV-based cervical screening: a qualitative evidence meta-synthesis. BMC Publ Health. 2021;21(1):1503. https:\/\/doi.org\/10.1186\/s12889-021-11554-6","DOI":"10.1186\/s12889-021-11554-6"},{"key":"10080_CR12","doi-asserted-by":"publisher","unstructured":"Hawkes D, Keung MHT, Huang Y, et al. Self-Collection for Cervical Screening Programs: From Research to Reality. Cancers. 2020;12(4):1053.  https:\/\/doi.org\/10.3390\/cancers12041053.","DOI":"10.3390\/cancers12041053"},{"key":"10080_CR13","unstructured":"World Health Organization. WHO Guideline on Self-Care Interventions for Health and Well-Being. Geneva: World Health Organization; 2021."},{"key":"10080_CR14","doi-asserted-by":"crossref","unstructured":"Serrano B, Ib\u00e1\u00f1ez R, Robles C, Peremiquel-Trillas P, de Sanjos\u00e9 S, Bruni L. Worldwide use of HPV self-sampling for cervical cancer screening. Prev Med. 2022;154:106900.  https:\/\/doi.org\/10.1016\/j.ypmed.2021.106900.","DOI":"10.1016\/j.ypmed.2021.106900"},{"key":"10080_CR15","doi-asserted-by":"publisher","unstructured":"Costa S, Verberckmoes B, Castle PE, Arbyn M. Offering HPV self-sampling kits: an updated meta-analysis of the effectiveness of strategies to increase participation in cervical cancer screening. Br J Cancer. 2023;128(5):805-813.  https:\/\/doi.org\/10.1038\/s41416-022-02094-w.","DOI":"10.1038\/s41416-022-02094-w"},{"key":"10080_CR16","unstructured":"Minnesota Community Measurement. Minnesota HealthScores Medical Group Profile: Cedar Riverside People's. [Cited 2024 Mar 1] Available from:  http:\/\/www.mnhealthscores.org\/medical-group\/cedar-riverside-peoples-center."},{"key":"10080_CR17","doi-asserted-by":"publisher","unstructured":"Morrison TB, Flynn PM, Weaver AL, Wieland ML. Cervical Cancer Screening Adherence Among Somali Immigrants and Refugees to the United States. Health Care Women Int. 2013;34(11):980-988.  https:\/\/doi.org\/10.1080\/07399332.2013.770002.","DOI":"10.1080\/07399332.2013.770002"},{"key":"10080_CR18","doi-asserted-by":"publisher","unstructured":"Pratt R, Mohamed S, Dirie W, et al. Testing a religiously tailored intervention with Somali American Muslim Women and Somali American Imams to increase participation in breast and cervical cancer screening. J Immigr Minor Health. 2020;22(1):87\u201395.  https:\/\/doi.org\/10.1007\/s10903-019-00881-x.","DOI":"10.1007\/s10903-019-00881-x"},{"key":"10080_CR19","doi-asserted-by":"publisher","unstructured":"Sewali B, Okuyemi KS, Askhir A, et al. Cervical cancer screening with clinic-based Pap test versus home HPV test among Somali immigrant women in Minnesota: a pilot randomized controlled trial. Cancer Med. 2015;4(4):620-631.  https:\/\/doi.org\/10.1002\/cam4.429.","DOI":"10.1002\/cam4.429"},{"key":"10080_CR20","doi-asserted-by":"publisher","unstructured":"Raymond NC, Osman W, O\u2019Brien JM, et al. Culturally informed views on cancer screening: a qualitative research study of the differences between older and younger Somali immigrant women. BMC Publ Health. 2014;14(1):1188.  https:\/\/doi.org\/10.1186\/1471-2458-14-1188.","DOI":"10.1186\/1471-2458-14-1188"},{"key":"10080_CR21","doi-asserted-by":"crossref","unstructured":"Chalmers B, Hashi KO. 432 Somali Women\u2019s Birth Experiences in Canada after Earlier Female Genital Mutilation. Birth. 2000;27(4):227-234.  https:\/\/doi.org\/10.1046\/j.1523-536x.2000.00227.x.","DOI":"10.1046\/j.1523-536x.2000.00227.x"},{"key":"10080_CR22","doi-asserted-by":"publisher","unstructured":"Johnson-Agbakwu CE, Helm T, Killawi A, Padela AI. Perceptions of obstetrical interventions and female genital cutting: insights of men in a Somali refugee community. Ethn Health. 2014;19(4):440\u201357.https:\/\/doi.org\/10.1080\/13557858.2013.828829.","DOI":"10.1080\/13557858.2013.828829"},{"key":"10080_CR23","doi-asserted-by":"publisher","unstructured":"Braddy CM, Files JA. Female Genital Mutilation: Cultural Awareness and Clinical Considerations. J Midwifery Womens Health. 2007;52(2):158-163.  https:\/\/doi.org\/10.1016\/j.jmwh.2006.11.001.","DOI":"10.1016\/j.jmwh.2006.11.001"},{"key":"10080_CR24","doi-asserted-by":"publisher","unstructured":"Jacoby SD, Smith A. Increasing certified nurse-midwives\u2019 confidence in managing the obstetric care of women with female genital mutilation\/cutting. J Midwifery Womens Health. 2013;58(4):451\u20136.  https:\/\/doi.org\/10.1111\/j.1542-2011.2012.00262.x.","DOI":"10.1111\/j.1542-2011.2012.00262.x"},{"key":"10080_CR25","doi-asserted-by":"publisher","unstructured":"Pavlish CL, Noor S, Brandt J. Somali immigrant women and the American health care system: discordant beliefs, divergent expectations, and silent worries. Soc Sci Med 1982. 2010;71(2):353\u2013361.  https:\/\/doi.org\/10.1016\/j.socscimed.2010.04.010.","DOI":"10.1016\/j.socscimed.2010.04.010"},{"key":"10080_CR26","doi-asserted-by":"publisher","unstructured":"Carroll J, Epstein R, Fiscella K, Volpe E, Diaz K, Omar S. Knowledge and beliefs about health promotion and preventive health care among somali women in the United States. Health Care Women Int. 2007;28(4):360-380.  https:\/\/doi.org\/10.1080\/07399330601179935.","DOI":"10.1080\/07399330601179935"},{"key":"10080_CR27","doi-asserted-by":"publisher","unstructured":"Al-Amoudi S, Ca\u00f1as J, Hohl SD, Distelhorst SR, Thompson B. Breaking the silence: breast cancer knowledge and beliefs among Somali Muslim Women in Seattle, Washington. Health Care Women Int.  https:\/\/doi.org\/10.1080\/07399332.2013.857323.","DOI":"10.1080\/07399332.2013.857323"},{"key":"10080_CR28","doi-asserted-by":"publisher","unstructured":"Abakporo U, Hussein A, et al. Knowledge, Beliefs and Attitudes of Somali Men in Olmsted County, Minnesota, U.S., on the Human Papillomavirus Vaccine and Cervical Cancer Screening: January 17, 2015. J Immigr Minor Health. 2018;20(5):1230\u20131235. https:\/\/doi.org\/10.1007\/s10903-017-0642-0.","DOI":"10.1007\/s10903-017-0642-0"},{"key":"10080_CR29","doi-asserted-by":"publisher","unstructured":"Downs LS, Scarinci I, Einstein MH, Collins Y, Flowers L. Overcoming the barriers to HPV vaccination in high-risk populations in the US. Gynecol Oncol. 2010;117(3):486\u2013490.  https:\/\/doi.org\/10.1016\/j.ygyno.2010.02.011.","DOI":"10.1016\/j.ygyno.2010.02.011"},{"key":"10080_CR30","doi-asserted-by":"publisher","unstructured":"Otanez S, Torr BM. Ethnic and racial disparities in HPV vaccination attitudes. J Immigr Minor Health. 2018;20(6):1476\u201382.  https:\/\/doi.org\/10.1007\/s10903-017-0685-2.","DOI":"10.1007\/s10903-017-0685-2"},{"key":"10080_CR31","doi-asserted-by":"crossref","unstructured":"Bigby J, Ko LK, Johnson N, David MMA, Ferrer B. A community approach to addressing excess breast and cervical cancer mortality among women of African descent in Boston. Public Health Rep Wash DC (1974). 2003;118(4):338\u2013347.","DOI":"10.1016\/S0033-3549(04)50258-3"},{"key":"10080_CR32","doi-asserted-by":"publisher","unstructured":"Khaja K, Lay K, Boys S. Female circumcision: toward an inclusive practice of care. Health Care Women Int. 2010;31(8):686-699.  https:\/\/doi.org\/10.1080\/07399332.2010.490313.","DOI":"10.1080\/07399332.2010.490313"},{"key":"10080_CR33","doi-asserted-by":"publisher","unstructured":"Degni F, Suominen S, Ess\u00e9n B, El Ansari W, Vehvil\u00e4inen-Julkunen K. Communication and cultural issues in providing reproductive health care to immigrant women: health care providers\u2019 experiences in meeting the needs of [corrected] Somali women living in Finland. J Immigr Minor Health Cent Minor Public Health. 2012;14(2):330\u201343.  https:\/\/doi.org\/10.1007\/s10903-011-9465-6.","DOI":"10.1007\/s10903-011-9465-6"},{"key":"10080_CR34","doi-asserted-by":"publisher","unstructured":"Johnson CE, Ali SA, Shipp MPL. Building community-based participatory research partnerships with a Somali refugee community. Am J Prev Med. 2009;37(6 Suppl 1):S230-6.  https:\/\/doi.org\/10.1016\/j.amepre.2009.09.036.","DOI":"10.1016\/j.amepre.2009.09.036"},{"key":"10080_CR35","doi-asserted-by":"publisher","unstructured":"Pratt R, Mohamed S, Dirie W, et al. Views of Somali women and men on the use of faith-based messages promoting breast and cervical cancer screening for Somali women: a focus-group study. BMC Public Health. 2017;17(1):270.  https:\/\/doi.org\/10.1186\/s12889-017-4182-2.","DOI":"10.1186\/s12889-017-4182-2"},{"key":"10080_CR36","unstructured":"Dailey P, Education JKJ of C, 2017 undefined. Communication and US-Somali Immigrant Human Papillomavirus (HPV) Vaccine Decision-Making. Springer."},{"key":"10080_CR37","doi-asserted-by":"publisher","unstructured":"Sewali B, Pratt R, Abdiwahab E, Fahia S, Call KT, Okuyemi KS. Understanding cancer screening service utilization by Somali Men in Minnesota. J Immigr Minor Health. 2015;17(3):773\u201380.  https:\/\/doi.org\/10.1007\/s10903-014-0032-9.","DOI":"10.1007\/s10903-014-0032-9"},{"key":"10080_CR38","doi-asserted-by":"crossref","unstructured":"Pratt R, Barsness CB, Lin J, et al. Integrating HPV self-collect into primary care to address cervical cancer screening disparities. Prev Med Rep. 2024;38:102599.  https:\/\/doi.org\/10.1016\/j.pmedr.2024.102599.","DOI":"10.1016\/j.pmedr.2024.102599"},{"key":"10080_CR39","doi-asserted-by":"publisher","unstructured":"Allen EM, Lee HY, Pratt R, et al. Facilitators and Barriers of Cervical Cancer Screening and Human Papilloma Virus Vaccination Among Somali Refugee Women in the United States: A Qualitative Analysis. J Transcult Nurs. 2019;30(1):55-63.  https:\/\/doi.org\/10.1177\/1043659618796909.","DOI":"10.1177\/1043659618796909"},{"key":"10080_CR40","unstructured":"What Do My Cervical Cancer Screening Test Results Mean? | CDC. Published August 25, 2023.  https:\/\/www.cdc.gov\/cancer\/cervical\/basic_info\/test-results.html.Accessed March 4, 2024."},{"key":"10080_CR41","unstructured":"QSR International. NVivo [software]. Published online 2012."},{"key":"10080_CR42","unstructured":"Charmaz K. Constructing Grounded Theory. 2nd Ed. SAGE Publications; 2014."},{"key":"10080_CR43","doi-asserted-by":"publisher","unstructured":"Jetty A, Jabbarpour Y, Pollack J, Huerto R, Woo S, Petterson S. Patient-physician racial concordance associated with improved healthcare use and lower healthcare expenditures in minority populations. J Racial Ethn Health Disparities. 2022;9(1):68\u201381.  https:\/\/doi.org\/10.1007\/s40615-020-00930-4.","DOI":"10.1007\/s40615-020-00930-4"},{"key":"10080_CR44","doi-asserted-by":"publisher","unstructured":"Shen MJ, Peterson EB, Costas-Mu\u00f1iz R, et al. The Effects of Race and Racial Concordance on Patient-Physician Communication: A Systematic Review of the Literature. J Racial Ethn Health Disparities. 2018;5(1):117-140.  https:\/\/doi.org\/10.1007\/s40615-017-0350-4.","DOI":"10.1007\/s40615-017-0350-4"},{"key":"10080_CR45","doi-asserted-by":"crossref","unstructured":"Alsan M, Garrick O, Graziani G. Does diversity matter for health? Experimental evidence from Oakland. Am Econ Rev. 2019;109(12):4071-4111.","DOI":"10.1257\/aer.20181446"},{"key":"10080_CR46","doi-asserted-by":"crossref","unstructured":"Street RL, O\u2019Malley KJ, Cooper LA, Haidet P. Understanding concordance in patient-physician relationships: personal and ethnic dimensions of shared identity. Ann Fam Med. 2008;6(3):198\u2013205.","DOI":"10.1370\/afm.821"}],"container-title":["Journal of General Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-025-10080-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11606-025-10080-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-025-10080-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T13:33:14Z","timestamp":1780666394000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11606-025-10080-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,18]]},"references-count":46,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10080"],"URL":"https:\/\/doi.org\/10.1007\/s11606-025-10080-0","relation":{},"ISSN":["0884-8734","1525-1497"],"issn-type":[{"value":"0884-8734","type":"print"},{"value":"1525-1497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,18]]},"assertion":[{"value":"17 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 December 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 University of Minnesota Institutional Review Board provided ethical approval for the conduct of this study (STUDY00012408, SITE00001416). University of Washington IRB approval was granted through a reliance agreement with the University of Minnesota (STUDY00013359). All participants provided consent to take part in the focus groups. The study is registered with ClinicalTrials.gov (NCT05453006).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval and Consent to Participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}},{"value":"The authors have no conflicts of interest to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}