{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T03:53:30Z","timestamp":1783655610561,"version":"3.55.0"},"reference-count":71,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Research indicates disproportionately low cervical screening uptake by diverse ethnic groups in England. If acceptable, self\u2010sampling might address population\u2010specific barriers and improve screening uptake. The Alternative CErvical Screening (ACES) Diversity study aimed to explore the prospective acceptability of self\u2010sampling (urine sampling and self\u2010swabbing), as an alternative to current cervical screening, among women from diverse ethnic groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative study design was employed using focus groups. Forty\u2010eight women from diverse ethnic groups were recruited via community partners in Northwest England and a cross\u2010sectional survey. Eight focus groups were conducted (one online and seven in\u2010person; four with interpreters for Mandarin, Cantonese, Polish and Urdu). Data were transcribed, translated and analysed in English using thematic framework analysis guided by the Theoretical Framework of Acceptability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three themes were identified. \u2018Cultural considerations\u2019 explored how aspects of culture and faith influenced perceptions of self\u2010sampling. \u2018Desire for comfort and control\u2019 reflected views of how self\u2010sampling increases autonomy by maintaining privacy, potentially reducing both pain and tension associated with screening. \u2018Confidence in testing\u2019 illustrates beliefs about self\u2010sampling, around ease of use, practical challenges and accuracy concerns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Self\u2010sampling for cervical screening was considered highly acceptable. If introduced, self\u2010sampling could increase cervical screening uptake amongst women from diverse ethnic groups. Having a choice in how to interact with the screening programme and continuing to raise awareness of cervical screening were considered important. Future research should explore the concurrent or retrospective acceptability of urine self\u2010sampling for cervical screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>Multiple public involvement discussion sessions in Northwest England\u2010based community centres were arranged with women to explore and build understanding about cervical screening and speak about the ACES Diversity study. A further session was held, with an interpreter, to discuss the focus group topic guide and study design with women and create an opportunity for any feedback. Written feedback was provided for the recruitment poster from seven women (two East Asian, two Central and Eastern European, two African\u2010Caribbean and one South Asian).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70338","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T14:38:57Z","timestamp":1753972737000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Acceptability of Self\u2010Sampling for Cervical Screening in Ethnically Diverse Groups in Northwest England: A Focus Group Study"],"prefix":"10.1111","volume":"28","author":[{"given":"Sophie","family":"Whitley","sequence":"first","affiliation":[{"name":"Manchester Centre for Health Psychology, Division of Psychology &amp; Mental Health, Faculty of Biology, Medicine and Health University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1837-4409","authenticated-orcid":false,"given":"Rachel L.","family":"Hawkins","sequence":"additional","affiliation":[{"name":"NIHR Manchester Biomedical Research Centre Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer C.","family":"Davies","sequence":"additional","affiliation":[{"name":"NIHR Manchester Biomedical Research Centre Manchester UK"},{"name":"Division of Cancer Sciences, Faculty of Biology, Medicine and Health University of Manchester Manchester UK"},{"name":"Department of Obstetrics and Gynaecology, St Mary's Hospital Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2808-7024","authenticated-orcid":false,"given":"Jiexin","family":"Cao","sequence":"additional","affiliation":[{"name":"Division of Cancer Sciences, Faculty of Biology, Medicine and Health University of Manchester Manchester UK"},{"name":"Department of Obstetrics and Gynaecology, St Mary's Hospital Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Malcomson","sequence":"additional","affiliation":[{"name":"NIHR Manchester Biomedical Research Centre Manchester UK"},{"name":"Division of Cancer Sciences, Faculty of Biology, Medicine and Health University of Manchester Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0284-8630","authenticated-orcid":false,"given":"Emma J.","family":"Crosbie","sequence":"additional","affiliation":[{"name":"NIHR Manchester Biomedical Research Centre Manchester UK"},{"name":"Division of Cancer Sciences, Faculty of Biology, Medicine and Health University of Manchester Manchester UK"},{"name":"Department of Obstetrics and Gynaecology, St Mary's Hospital Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6414-2732","authenticated-orcid":false,"given":"Lorna","family":"McWilliams","sequence":"additional","affiliation":[{"name":"Manchester Centre for Health Psychology, Division of Psychology &amp; Mental Health, Faculty of Biology, Medicine and Health University of Manchester Manchester UK"},{"name":"NIHR Manchester Biomedical Research Centre Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"key":"e_1_2_17_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0969141316654197"},{"key":"e_1_2_17_3_1","unstructured":"NHS England.2025.Cervical Screening: Helping You Decide https:\/\/www.gov.uk\/government\/publications\/cervical-screening-description-in-brief\/cervical-screening-helping-you-decide--2."},{"key":"e_1_2_17_4_1","unstructured":"NHS Digital.2025. Cervical Screening Coverage Statistics\u2014CSV [Data Set] accessed February 3 2025 https:\/\/digital.nhs.uk\/data-and-information\/publications\/statistical\/cervical-screening-programme\/cervical-screening-programme-coverage-statistics-management-information."},{"key":"e_1_2_17_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdad275"},{"key":"e_1_2_17_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2025"},{"key":"e_1_2_17_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2015.248"},{"key":"e_1_2_17_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.13287"},{"key":"e_1_2_17_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/jfprhc-2011-100144"},{"key":"e_1_2_17_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2009.09.011"},{"key":"e_1_2_17_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-019-0736-z"},{"key":"e_1_2_17_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2021.106900"},{"key":"e_1_2_17_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102672"},{"key":"e_1_2_17_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k4823"},{"key":"e_1_2_17_15_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-20-1226"},{"key":"e_1_2_17_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17831"},{"key":"e_1_2_17_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-068940"},{"key":"e_1_2_17_18_1","unstructured":"C.Mathews A.Brentnall M.Rebolj A.Sargent K.Cuschieri andK.Denton.2024.HPValidate: Clinical Validation of hrHPV Test System Using Self\u2010Collected Vaginal Samples in NHS England Commissioned Laboratories Providing Cervical Screening Services. Queen Mary University of London https:\/\/www.qmul.ac.uk\/fmd\/media\/smd\/documents\/research\/hpv-self-collection-test-accuracy-report-hpvalidate-lot1.pdf."},{"key":"e_1_2_17_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2021.06.010"},{"key":"e_1_2_17_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2022.105271"},{"key":"e_1_2_17_21_1","unstructured":"Novosanis. Colli\u2010Pee: An Innovative Solution for Non\u2010Invasive Urine Collection and Preservation https:\/\/novosanis.com\/our-products."},{"key":"e_1_2_17_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17722"},{"key":"e_1_2_17_23_1","unstructured":"UK National Screening Committee.2022.Criteria for a Population Screening Programme https:\/\/www.gov.uk\/government\/publications\/evidence-review-criteria-national-screening-programmes\/criteria-for-appraising-the-viability-effectiveness-and-appropriateness-of-a-screening-programme."},{"key":"e_1_2_17_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0969141314555247"},{"key":"e_1_2_17_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-052609"},{"key":"e_1_2_17_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-003743"},{"key":"e_1_2_17_27_1","doi-asserted-by":"publisher","DOI":"10.1200\/JGO.2016.005629"},{"key":"e_1_2_17_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13690-021-00667-4"},{"key":"e_1_2_17_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.14118"},{"key":"e_1_2_17_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-024-12098-2"},{"key":"e_1_2_17_31_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16112066"},{"key":"e_1_2_17_32_1","doi-asserted-by":"publisher","DOI":"10.1258\/jms.2009.009069"},{"key":"e_1_2_17_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.13961"},{"key":"e_1_2_17_34_1","unstructured":"National Institute for Health and Care Research.2023.Research Inclusion Strategy 2022\u20102027 https:\/\/www.nihr.ac.uk\/about-us\/who-we-are\/research-inclusion\/strategy-2022-27."},{"key":"e_1_2_17_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-017-2031-8"},{"key":"e_1_2_17_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-058635"},{"key":"e_1_2_17_37_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n2061"},{"key":"e_1_2_17_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119410867.ch5"},{"key":"e_1_2_17_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752-7325.2011.00241.x"},{"key":"e_1_2_17_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/jac5.1441"},{"key":"e_1_2_17_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-015-0484-z"},{"key":"e_1_2_17_42_1","unstructured":"Faculty of Biology Medicine and Health UoM. January 6 2022.ACES Study: How to Use a Colli\u2010Pee. YouTube https:\/\/www.youtube.com\/watch?v=_W65D1rtfas."},{"key":"e_1_2_17_43_1","unstructured":"Australian Government Department of Health and Aged Care. July 1 2022.How to Take Your Own Cervical Screening Test sample (for Aboriginal & Torres Strait Islander Women). [Video]. YouTube https:\/\/www.youtube.com\/watch?v=PepX0ahKvj4&t=8s."},{"key":"e_1_2_17_44_1","unstructured":"Copan. FLOQSwabs. Flocked Swabs. Patented Original Technology for Optimal Sample Collection and Diagnostics https:\/\/www.copanusa.com\/products\/flocked-swabs-traditional-swabs\/floqswabs-flocked-swabs\/."},{"key":"e_1_2_17_45_1","doi-asserted-by":"publisher","DOI":"10.4324\/9780203413081_chapter_9"},{"key":"e_1_2_17_46_1","doi-asserted-by":"publisher","DOI":"10.1258\/096914104774061065"},{"key":"e_1_2_17_47_1","doi-asserted-by":"publisher","DOI":"10.1177\/0959354307073153"},{"key":"e_1_2_17_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-018-4404-z"},{"key":"e_1_2_17_49_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0274974"},{"key":"e_1_2_17_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(23)00076-2"},{"key":"e_1_2_17_51_1","doi-asserted-by":"publisher","DOI":"10.1177\/17455065221075905"},{"key":"e_1_2_17_52_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-019-0778-2"},{"key":"e_1_2_17_53_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4126"},{"key":"e_1_2_17_54_1","doi-asserted-by":"publisher","DOI":"10.1177\/1354067X14551297"},{"key":"e_1_2_17_55_1","doi-asserted-by":"publisher","DOI":"10.1080\/13552600.2014.929188"},{"key":"e_1_2_17_56_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-14-1188"},{"key":"e_1_2_17_57_1","doi-asserted-by":"publisher","DOI":"10.1080\/09503110.2011.580629"},{"key":"e_1_2_17_58_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.12544"},{"key":"e_1_2_17_59_1","doi-asserted-by":"publisher","DOI":"10.1177\/09691413241274312"},{"key":"e_1_2_17_60_1","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2021.0350"},{"key":"e_1_2_17_61_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19031527"},{"key":"e_1_2_17_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30641-1"},{"key":"e_1_2_17_63_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-022-00688-9"},{"key":"e_1_2_17_64_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40900-021-00292-z"},{"key":"e_1_2_17_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2024.100932"},{"key":"e_1_2_17_66_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-021-01489-2"},{"issue":"3","key":"e_1_2_17_67_1","first-page":"149","article-title":"The Politics of Difference? Providing a Cancer Genetics Service in a Culturally and Linguistically Diverse Society","volume":"6","author":"Atkin K.","year":"2009","journal-title":"Diversity and Equality in Health and Care"},{"key":"e_1_2_17_68_1","doi-asserted-by":"publisher","DOI":"10.1080\/07347332.2024.2361642"},{"key":"e_1_2_17_69_1","doi-asserted-by":"publisher","DOI":"10.1177\/1609406915621419"},{"key":"e_1_2_17_70_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17207473"},{"key":"e_1_2_17_71_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2023.102363"},{"key":"e_1_2_17_72_1","doi-asserted-by":"publisher","DOI":"10.1177\/1468794119874599"}],"container-title":["Health Expectations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hex.70338","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T17:09:06Z","timestamp":1765991346000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hex.70338"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,31]]},"references-count":71,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1111\/hex.70338"],"URL":"https:\/\/doi.org\/10.1111\/hex.70338","archive":["Portico"],"relation":{},"ISSN":["1369-6513","1369-7625"],"issn-type":[{"value":"1369-6513","type":"print"},{"value":"1369-7625","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,31]]},"assertion":[{"value":"2025-03-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70338"}}