He Tapu Te Whare Tangata (sacred house of humanity): Under‐screened Māori women talk about HPV self‐testing cervical screening clinical pathways

Abstract

Objective To develop an in‐depth understanding of HPV self‐testing cervical screening clinical pathways for never‐/under‐screened Māori women. Methods Based on a community‐based cluster randomized controlled trial in Aotearoa (New Zealand), a Kaupapa Māori (by Māori, for Māori) qualitative study enrolled Māori women who met the eligibility criteria of the HPV trial intervention (aged 25–69 years, no screen in >4 years). In total, 28 were recruited (22 had a negative test, six had a positive test and colposcopy). They were asked about their clinical pathway. Results The HPV self‐test was seen as empowering and promoting bodily autonomy, although some women expressed fears or misconceptions about this new technology. While those with a negative test were relieved, for the six women who had a positive test, there were many fears, compounded by seeking out information on the Internet. When attending colposcopy, the importance of support and responsive care was emphasized. Conclusion HPV self‐testing has the potential to improve access to cervical screening and reduce inequities for Māori. Care must be taken in the delivery of screening and colposcopy results. Primary care and colposcopy services need to take special care with never‐/under‐screened Māori women to provide sensitive, responsive care, and mitigate trauma.

The lives of women and babies matter: A call for action in Indigenous and First Nations women’s health and wellbeing

“…The issue highlights the voices of those usually not heard in research, in clinical care, and in health service design, [1][2][3][4][5][6] and calls out the silence and invisibility commonly imposed on Indigenous women. [7][8][9][10][11] This Special Issue includes calls from Indigenous researchers through Indigenous-led and -conducted research; and calls from Indigenous women, either through telling the stories of their health and healthcare journeys, 1,12,13,14 or through risk factors and health outcomes being made visible in quantitative data, 8,15,16 or through looking at existing literature in new ways. 7,9,10,11…”

“…The articles in this special edition use positive approaches. This is done in order to empower women in healthcare, 12 to develop and trial culturally safe and community-based approaches, 2,6 to partner with communities, 3,5 to employ Indigenous methods and knowledge, 8,14 to privilege Indigenous voices, 4,9,10,11 to move towards risk assessment and management tailored to Indigenous populations and context, 15,16 and to explore women's experiences in new ways. 1,9,13 Much of the research responds to the silence/invisibility of First Nations and Indigenous women by challenging the norms of women's healthcare provision, such as persistent discrepancies in structural/social determinants of health, healthcare access and health outcomes, systemic racism, and trauma.…”

“…This review draws attention to a dearth of research and concludes that "Indigenous women's health in areas of seemingly inordinate importance to non-Indigenous Australian women has been left far behind." 11 Adcock et al 12 and Mitchell-Foster et al 6 used Indigenous research methodologies to explore HPV self-collection for cervical cancer screening in Aotearoa New Zealand and Canada, respectively. Adcock et al 12 found that for Māori women who were overdue for cervical cancer screening or had never had screening, HPV self-testing was acceptable and empowering, and had the potential to reduce inequities in cervical cancer.…”

“…11 Adcock et al 12 and Mitchell-Foster et al 6 used Indigenous research methodologies to explore HPV self-collection for cervical cancer screening in Aotearoa New Zealand and Canada, respectively. Adcock et al 12 found that for Māori women who were overdue for cervical cancer screening or had never had screening, HPV self-testing was acceptable and empowering, and had the potential to reduce inequities in cervical cancer. Mitchell-Foster et al 6 described the key strengths of a collaborative partnership to pilot HPV self-testing in rural and remote Indigenous communities in British Columbia.…”

“…This Special Issue includes calls from Indigenous researchers through Indigenous‐led and ‐conducted research; and calls from Indigenous women, either through telling the stories of their health and healthcare journeys, 1,12,13,14 or through risk factors and health outcomes being made visible in quantitative data, 8,15,16 or through looking at existing literature in new ways 7,9,10,11 …”