A randomized trial of a community health worker led intervention using HPV self-sampling to increase cervical cancer screening among minority women: Preliminary findings

Minority and immigrant women face numerous barriers to Pap smear screening including lack of knowledge, limited access to care and cultural norms. Self-sampling for the human papilloma virus (HPV) holds great promise as a screening strategy among hard to reach populations. Our ongoing randomized trial is testing this approach in 3 minority communities in Miami. With various community partners, we are recruiting 600 minority women ages 30-65 who have not had a Pap smear in three years. Participants are randomized to one of three arms: 1) standard educational materials (control), 2) community health workers (CHW) led individualized health education and navigation to health centers for Pap smears 3) CHW education and HPV self-sampling. Using various community outreach strategies, CHWs have assessed 2,884 women for study inclusion. Of these, 604 were study eligible and under 5% have declined to participate in the study. Among the 318 already randomized, 51% are Hispanic, 31% Haitian, and 18% African American; with >50% are uninsured. Among women in group 2, 44% have been screened (via PAP). Among women in Group 3, 78% have been screened (Pap or HPV). In group 3, 84% of women preferred to have the HPV self-sampling versus a Pap smear. Our study suggests that culturally and linguistically competent CHWs are an efficient mechanism to recruit underserved populations into randomized trials. Preliminary data suggests that a CHW led HPV self-sampling strategy leads to high rates of cervical cancer screening among unscreened minority women.