{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T05:16:11Z","timestamp":1773119771249,"version":"3.50.1"},"reference-count":46,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,11,27]],"date-time":"2022-11-27T00:00:00Z","timestamp":1669507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Health and Medical Research Council","award":["APP1159491"],"award-info":[{"award-number":["APP1159491"]}]},{"name":"National Health and Medical Research Council","award":["ECF181561"],"award-info":[{"award-number":["ECF181561"]}]},{"name":"Cancer Institute NSW","award":["APP1159491"],"award-info":[{"award-number":["APP1159491"]}]},{"name":"Cancer Institute NSW","award":["ECF181561"],"award-info":[{"award-number":["ECF181561"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: In December 2017, the Australian National Cervical Screening Program transitioned from 2-yearly cytology-based to 5-yearly human papillomavirus (HPV)-based cervical screening, including a vaginal self-collection option. Until July 2022, this option was restricted to under- or never-screened people aged 30 years and older who refused a speculum exam. We investigated the perspectives and experiences of stakeholders involved in, or affected by, the initial implementation of the restricted self-collection pathway. Methods: Semi-structured interviews were conducted with 49 stakeholders as part of the STakeholder Opinions of Renewal Implementation and Experiences Study. All interviews were audio recorded and transcribed. Data were thematically analysed and coded to the Conceptual Framework for Implementation Outcomes. Results: Stakeholders viewed the introduction of self-collection as an exciting opportunity to provide under-screened people with an alternative to a speculum examination. Adoption in clinical practice, however, was impacted by a lack of clear communication and promotion to providers, and the limited number of laboratories accredited to process self-collected samples. Primary care providers tasked with communicating and offering self-collection described confusion about the availability, participant eligibility, pathology processes, and clinical management processes for self-collection. Regulatory delay in developing an agreed protocol to approve laboratory processing of self-collected swabs, and consequently initially having one laboratory nationally accredited to process samples, led to missed opportunities and misinformation regarding the pathway\u2019s availability. Conclusions: Whilst the introduction of self-collection was welcomed, clear communication from Government regarding setbacks in implementation and how to overcome these in practice were needed. As Australia moves to a policy of providing everyone eligible for screening the choice of self-collection, wider promotion to providers and eligible people, clarity around pathology processes and the scaling up of test availability, as well as timely education and communication of clinical management practice guidelines, are needed to ensure smoother program delivery in the future. Other countries implementing self-collection policies can learn from the implementation challenges faced by Australia.<\/jats:p>","DOI":"10.3390\/ijerph192315776","type":"journal-article","created":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T03:28:49Z","timestamp":1669606129000},"page":"15776","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["\u201cSo, if she wasn\u2019t aware of it, then how would everybody else out there be aware of it?\u201d\u2014Key Stakeholder Perspectives on the Initial Implementation of Self-Collection in Australia\u2019s Cervical Screening Program: A Qualitative Study"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3199-6715","authenticated-orcid":false,"given":"Claire M.","family":"Zammit","sequence":"first","affiliation":[{"name":"Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0908-5453","authenticated-orcid":false,"given":"Nicola S.","family":"Creagh","sequence":"additional","affiliation":[{"name":"Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracey","family":"McDermott","sequence":"additional","affiliation":[{"name":"Australian Centre for the Prevention of Cervical Cancer, Melbourne, VIC 3010, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0401-2653","authenticated-orcid":false,"given":"Megan A.","family":"Smith","sequence":"additional","affiliation":[{"name":"The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW 2011, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorothy A.","family":"Machalek","sequence":"additional","affiliation":[{"name":"The Kirby Institute, Wallace Wurth Building, University of New South Wales Kensington, Sydney, NSW 2052, Australia"},{"name":"Centre for Women\u2019s Infectious Diseases, The Royal Women\u2019s Hospital, Melbourne, VIC 3052, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chloe J.","family":"Jennett","sequence":"additional","affiliation":[{"name":"The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW 2011, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khic-Houy","family":"Prang","sequence":"additional","affiliation":[{"name":"Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farhana","family":"Sultana","sequence":"additional","affiliation":[{"name":"National Cancer Screening Register, Telstra Health, Melbourne, VIC 3000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4103-6240","authenticated-orcid":false,"given":"Claire E.","family":"Nightingale","sequence":"additional","affiliation":[{"name":"Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole M.","family":"Rankin","sequence":"additional","affiliation":[{"name":"Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Kelaher","sequence":"additional","affiliation":[{"name":"Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia M. L.","family":"Brotherton","sequence":"additional","affiliation":[{"name":"Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia"},{"name":"Australian Centre for the Prevention of Cervical Cancer, Melbourne, VIC 3010, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e19","DOI":"10.1016\/S2468-2667(18)30183-X","article-title":"The projected timeframe until cervical cancer elimination in Australia: A modelling study","volume":"4","author":"Hall","year":"2018","journal-title":"Lancet Public Health"},{"key":"ref_2","unstructured":"NHMRC Centre of Research Excellence in Cervical Cancer Control (2021). 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