Pilot Project

Cervical cancer mortality is increased among immigrant U.S. women, despite decreasing rates among U.S. born women. Pap test utilization among immigrant women inthe U.S. is 61%, far below the national goals. Cervical cancer screening behavior among the largest recent immigrant community to Minnesota, Somali women, is poorly documented. Multiple barriers exist to cervical cancer screening completion for women who immigrate from Somalia. Home vaginal bio-specimen collection for identification of human papillomavirus (HPV) provides a novel and alternative pathway to increase cervical cancer screening and thereby reduce cervical cancer mortality. This project is working toward three specific aims to explore the feasibility of this new approach. (1) conduct key informant interviews with immigrant Somali women and community advocates to find suitable language, structure, and context to describe cervical cancer prevention and screening methods;(2) conduct focus groups with immigrant Somali women to identify facilitators of and barriers to cen/ical cancer screening, and assess women's attitudes towards home vaginal bio-specimen collection for human papillomavirus (HPV) testing;(3) conduct a pilot study to estimate rates of successful completion of cervical cancer screening by home vaginal bio-specimen collection for HPV testing compared to standard clinic-based Pap test. We will test the hypotheses that women who are offered home vaginal biospecimen collection will have higher rate of cervical cancer screening completion than that of women referred for clinic-based Pap test. In year 1, we will conduct key informant interviews in collaboration with our community partner to inform the design of focus groups. In year 1, we will also conduct focus groups among Somali women and outcomes will inform materials for use during the pilot study. In year 2, we will conduct a pilot study to test recruitment and estimate effect size that can be used to design a full randomized controlled study in the future. The overall objective to reduce morbidity and mortality from cervical cancer among women who migrate from Somalia to the U.S. can be achieved by developing a community engaged research program utilizing HPV testing.