This study aims to determine the acceptability of Human Papilloma Virus (HPV) self-sampling and the factors associated with willingness to buy HPV self-sampling kit in the future. A total of 164 women aged 28-60 years old from Obstetrics & Gynaecology clinics at a teaching hospital performed HPV self-sampling using the Digene HC2 DNA collection kit. After samples were taken, the participants were given self-administered questionnaires. The majority of the participants were Malay (93.9%), had attained tertiary education (65.2%) and were employed (70.1%). The acceptability was good. More than half of the participants felt that self-sampling was easy. Only 1.2% felt that the procedure was difficult to perform. Most reported no pain at all during the procedure (66.9%). The commonest concern was getting a good sample (90.1%). A number of Pap smears were found to be significantly associated with the willingness to buy the HPV self-sampling kit. HPV self-sampling has the potential to be included in the cervical cancer screening programme. Impact Statement What is already known on this subject: HPV self-sampling is acceptable in some developed and developing countries. It is acceptable because it was easy to perform with very minimal pain or discomfort. Studies on the acceptance of self-screening are needed to plan a policy on self-sampling in the future. What the results of this study add: Our study adds new findings to the body of knowledge on self-sampling in the local population. We found that more women are willing to do the self-sampling at the clinic rather than at home. Although more than 90% expressed willingness to do self-sampling in the future, only 70% of them were willing to purchase the kit. Cost is a potential barrier to women who have the interest to perform the self-sampling. Given the global economic challenges, cost is inevitably an important predictor that we have to consider. What the implications are of these findings for clinical practice and/or further research: Future research should examine women from the rural areas and those who are resilient to Pap smear screening. In clinical practice, clinicians should acknowledge that cost is a potential barrier for women who are willing to do self-sampling. Self-sampling could be an option for women with no financial constraint to buy the kit. However, clinicians should counsel women so that they can make an informed choice in determining their screening method.

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The focus of this article is to evaluate the maximum likelihood estimation (MLE) performance in estimating the person parameters in the Rasch rating scale model (RRSM). For that purpose, 1000 iterations of the Markov Chain Monte Carlo (MCMC) simulation technique were performed based on a different number of sample sizes and several number of items. The performance of MLE in estimating the person parameters according to the different number of sample sizes was compared through accuracy and bias measures. Root mean square error (RMSE) and mean absolute error (MAE) were used to examine the accuracy of the estimates, while bias in estimation was assessed through the mean difference of estimates and true values of the person parameters. The simulated survey data sets in this study were generated according to the RRSM under the assumption of normality was satisfied. Results from the simulation analysis showed that in comparison to the larger sample sizes, smaller sample sizes tend to produce higher RMSE and MAE. In addition, the maximum likelihood estimates of the person parameters in smaller sample sizes also recorded a higher value of the mean difference of the person estimates and its true values compared to larger sample sizes. Findings from this study imply that the use of the MLE approach in small sample sizes results in less accurate and highly biased person estimates across the number of items.

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