{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T07:29:53Z","timestamp":1781854193811,"version":"3.54.5"},"reference-count":53,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Research Directorate of the University of Cuenca, Ecuador."},{"name":"European Union\u2019s Horizon 2020","award":["825747"],"award-info":[{"award-number":["825747"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Cervical Cancer (CC) is a preventable and treatable disease if detected early, yet it remains a global health challenge. In Ecuador, CC is the second most common cancer; however, screening uptake remains suboptimal due to poor knowledge, low willingness, and limited access to healthcare. Traditionally, CC screening requires a healthcare professional, creating social and access barriers. Innovative techniques such as \u201cself-sampling\u201d (SS) for human papillomavirus (HPV) detection offer a promising alternative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This study evaluates the acceptability, attitudes, and user experience of a community-based SS program among a hard-to-reach population following a local educational session.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A quasi-experimental study was conducted in a rural community in Cuenca, Ecuador. Educational sessions were organized, after which women were offered the option to perform SS for HPV detection. Three questionnaires were administered to assess population characteristics, risk factors, and experiences toward the process.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of the 130 participants, 90% accepted SS, and 10% rejected SS. A significant number of women reported that SS was faster and less painful compared to traditional Papanicolaou tests ( P\u2009&lt;\u2009.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>SS shows strong potential for increasing CC screening, especially in hard-to-reach areas, emphasizing the need to adapt screening programs to meet diverse community needs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501319251320172","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T12:35:51Z","timestamp":1739968551000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Assessing the Acceptability of a Vaginal Self-Sampling Device in a Rural Parish of Cuenca, Ecuador"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8285-328X","authenticated-orcid":false,"given":"Dayanara","family":"Delgado L\u00f3pez","sequence":"first","affiliation":[{"name":"Faculty of Medical Sciences, University of Cuenca, Cuenca, Ecuador"},{"name":"Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4989-4440","authenticated-orcid":false,"given":"Ana","family":"Acosta Bed\u00f3n","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, University of Cuenca, Cuenca, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1586-8852","authenticated-orcid":false,"given":"Roque","family":"Rivas-P\u00e1rraga","sequence":"additional","affiliation":[{"name":"Biomass to Resources Group, IKIAM Regional Amazonian University, Tena, Napo, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1491-1243","authenticated-orcid":false,"given":"Micaela","family":"Heredia","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, University of Cuenca, Cuenca, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7158-8233","authenticated-orcid":false,"given":"Carolina","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, University of Cuenca, Cuenca, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2545-4733","authenticated-orcid":false,"given":"Bernardo","family":"Vega Crespo","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, University of Cuenca, Cuenca, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1274-8537","authenticated-orcid":false,"given":"Heleen","family":"Vermandere","sequence":"additional","affiliation":[{"name":"International Center for Reproductive Health, Deparment of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8491-7768","authenticated-orcid":false,"given":"Marie","family":"Hendrickx","sequence":"additional","affiliation":[{"name":"International Center for Reproductive Health, Deparment of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Gama","sequence":"additional","affiliation":[{"name":"NOVA National School of Public Health, Public Health Research Centre, NOVA University Lisbon, Lisbon, Portugal"},{"name":"Comprehensive Health Research Center (CHRC), Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1615-0746","authenticated-orcid":false,"given":"Vivian Alejandra","family":"Neira","sequence":"additional","affiliation":[{"name":"Department of Biosciences, Faculty of Chemical Sciences, University of Cuenca, Cuenca, Ecuador"},{"name":"Faculty of Medicine, University of Azuay, Cuenca, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,2,19]]},"reference":[{"key":"bibr1-21501319251320172","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"bibr2-21501319251320172","volume-title":"Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem","author":"World Health Organization","year":"2020"},{"key":"bibr3-21501319251320172","volume-title":"Cancer Incidence in Five Continents","author":"The International Agency for Research on Cancer","year":"2021"},{"key":"bibr4-21501319251320172","doi-asserted-by":"publisher","DOI":"10.3390\/idr15030027"},{"key":"bibr5-21501319251320172","doi-asserted-by":"publisher","DOI":"10.20892\/j.issn.2095-3941.2020.0370"},{"key":"bibr6-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1172\/JCI57149"},{"key":"bibr7-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1038\/488S2a"},{"key":"bibr8-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.1.87"},{"key":"bibr9-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djq562"},{"key":"bibr10-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.16.1.1-17.2003"},{"key":"bibr11-21501319251320172","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21628"},{"key":"bibr12-21501319251320172","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-156-12-201206190-00424"},{"key":"bibr13-21501319251320172","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19084619"},{"key":"bibr14-21501319251320172","unstructured":"INEC. Encuesta Nacional de Salud y Nutricion. 2018. Accessed September 15, 2024. https:\/\/www.ecuadorencifras.gob.ec\/documentos\/web-inec\/Estadisticas_Sociales\/ENSANUT\/ENSANUT_2018\/Principales%20resultados%20ENSANUT_2018.pdf"},{"key":"bibr15-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1177\/1049732317742129"},{"key":"bibr16-21501319251320172","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.1003461"},{"key":"bibr17-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0262213"},{"key":"bibr18-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-14601-y"},{"key":"bibr19-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1186\/s12914-020-00237-9"},{"key":"bibr20-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29813"},{"key":"bibr21-21501319251320172","volume-title":"Proyecto de Educaci\u00f3n Para La Prevenci\u00f3n Y Detecci\u00f3n Temprana Del C\u00e1ncer Cervicouterino En Mujeres Ind\u00edgenas - Comunidad Cabeceras Del Bobonaza","author":"Saula Rodr\u00edguez JK"},{"key":"bibr22-21501319251320172","unstructured":"Aponte M, Natalia K. Nivel de conocimientos sobre prevenci\u00f3n de c\u00e1ncer cervical en mujeres de edad f\u00e9rtil; del Centro de Salud Aguas Verdes Per\u00fa y Centro de Saludla Paz Ecuador. Junio \u2013 Octubre 2015. Universidad Alas Peruanas; 2015. Accessed October 28, 2024. https:\/\/hdl.handle.net\/20.500.12990\/1823"},{"key":"bibr23-21501319251320172","unstructured":"Guerrero PJ, Zumarraga DAA, Rojas HM. Prevenci\u00f3n y atenci\u00f3n del c\u00e1ncer cervicouterino en Ecuador. Rev cuba investig biom\u00e9d. 2023;42(2):10,16. Accessed October 28, 2024. https:\/\/revibiomedica.sld.cu\/index.php\/ibi\/article\/view\/3030"},{"key":"bibr24-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-003743"},{"key":"bibr25-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30763-0"},{"key":"bibr26-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-21-3710"},{"key":"bibr27-21501319251320172","doi-asserted-by":"publisher","DOI":"10.18502\/espoch.v3i1.14422"},{"key":"bibr28-21501319251320172","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10091614"},{"key":"bibr29-21501319251320172","unstructured":"INEC. Censo Ecuador. Accessed April 15, 2024. https:\/\/censoecuador.ecudatanalytics.com\/"},{"key":"bibr30-21501319251320172","doi-asserted-by":"publisher","DOI":"10.25259\/CMAS_03_05_2021"},{"key":"bibr31-21501319251320172","unstructured":"Evalyn\u00ae Brush. Rovers Medical Devices. 2016. Accessed November 19, 2024. https:\/\/www.roversmedicaldevices.com\/cell-sampling-devices\/evalyn-brush\/"},{"key":"bibr32-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1136\/bmjoq-2023-002252"},{"key":"bibr33-21501319251320172","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2022.914516"},{"key":"bibr34-21501319251320172","doi-asserted-by":"publisher","DOI":"10.18537\/RFCM.40.03.04"},{"key":"bibr35-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0025493"},{"key":"bibr36-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1038\/mi.2016.129"},{"key":"bibr37-21501319251320172","doi-asserted-by":"publisher","DOI":"10.4103\/apjon.apjon_73_18"},{"key":"bibr38-21501319251320172","doi-asserted-by":"publisher","DOI":"10.17843\/rpmesp.2017.342.2453"},{"key":"bibr39-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2013.01.026"},{"key":"bibr40-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1289\/isee.2024.0801"},{"key":"bibr41-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2010.2189"},{"key":"bibr42-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1089\/152460902753668466"},{"key":"bibr43-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000424"},{"key":"bibr44-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1186\/s13027-017-0123-z"},{"key":"bibr45-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2016.5965"},{"key":"bibr46-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.121076"},{"key":"bibr47-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-017384"},{"key":"bibr48-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1258\/jms.2009.009069"},{"key":"bibr49-21501319251320172","doi-asserted-by":"publisher","DOI":"10.14423\/SMJ.0000000000000132"},{"key":"bibr50-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000134"},{"key":"bibr51-21501319251320172","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2004.03.040"},{"key":"bibr52-21501319251320172","doi-asserted-by":"publisher","DOI":"10.2190\/IQ.31.3.d"},{"key":"bibr53-21501319251320172","unstructured":"Soldan V, Bayer A, Nussbaum L, Cabrera L. Structural Barriers to Screening for and Treatment of Cervical Cancer in Peru. SSRN; 2013. https:\/\/play.google.com\/store\/books\/details?id=XF7fzwEACAAJ"}],"container-title":["Journal of Primary Care &amp; Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501319251320172","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21501319251320172","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501319251320172","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:23:03Z","timestamp":1777508583000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21501319251320172"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":53,"alternative-id":["10.1177\/21501319251320172"],"URL":"https:\/\/doi.org\/10.1177\/21501319251320172","relation":{},"ISSN":["2150-1319","2150-1327"],"issn-type":[{"value":"2150-1319","type":"print"},{"value":"2150-1327","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"article-number":"21501319251320172"}}