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Article ; Online: Understanding the participation of breast screening among women born in predominantly Muslim countries living in Victoria, Australia from record-linkage data.

Tahira Yeasmeen / Margaret Kelaher / Julia M L Brotherton / Michael J Malloy

PLoS ONE, Vol 15, Iss 8, p e

2020 Volume 0237341

Abstract: Background Early detection of breast cancer can improve survival rates and decrease mortality rates. This study investigates whether there are significant differences in participation in breast screening among women born in Muslim countries compared to ... ...

Abstract	Background Early detection of breast cancer can improve survival rates and decrease mortality rates. This study investigates whether there are significant differences in participation in breast screening among women born in Muslim countries compared to women born in Non-Muslim countries and Australia. Methods Screening data from January 1st, 2000 to December 31st, 2013 from the Breast Screen Victoria Registry (BSV) was linked with hospital records from the Victorian Admitted Episodes Dataset (VAED). Countries having more than 50% of their population as Muslim were categorised as Muslim countries. Age adjusted rates were calculated for women born in Muslim and Non-Muslim countries and compared with the Australian age adjusted rates. Logistic regression assessed the association between screening status and other factors which include country of birth, marital status, age and socio-economic status. Results Women born in Muslim countries (Odds Ratio (OR) = 0.70, 95%CI = 0.68-0.72) and in other Non-Muslim countries (OR = 0.87, 95%CI = 0.86-0.88) had lower odds of participation in breast screening than Australian born women. Women aged 60-64 years (OR = 1.42, 95%CI = 1.40-1.44) had higher odds of participation in the BreastScreen program than 50-54 age group. Conclusion This study provides valuable insights to understanding breast screening participation among women born in Muslim countries residing in Victoria. This population level study contributes to the broader knowledge of screening participation of women born in Muslim countries, an understudied population group in Australia and across the world. This study has implications for breast screening programs as it highlights the need for culturally sensitive approaches to support breast screening participation among women born in Muslim countries.
Keywords	Medicine ; R ; Science ; Q
Subject code	331 ; 290
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Study protocol

Allison Tong / Julia M L Brotherton / Gail Garvey / Joan Cunningham / Lisa J Whop / Kate Anderson / Tamara L Butler

BMJ Open, Vol 11, Iss

Yarning about HPV Vaccination: a qualitative study of factors influencing HPV vaccination among Aboriginal and Torres Strait Islander adolescents in Australia

2021 Volume 8

Abstract: Introduction Aboriginal and Torres Strait Islander women experience a higher burden of cervical cancer than non-Indigenous women in Australia. Cervical cancer is preventable partly through human papillomavirus (HPV) vaccination; in Australia, this is ... ...

Abstract	Introduction Aboriginal and Torres Strait Islander women experience a higher burden of cervical cancer than non-Indigenous women in Australia. Cervical cancer is preventable partly through human papillomavirus (HPV) vaccination; in Australia, this is delivered through the national school-based immunisation programme. While HPV vaccination uptake is high among Australian adolescents, there remain gaps in uptake and completion among Aboriginal and Torres Strait Islander adolescents. This study aims to gain a comprehensive understanding of the barriers and facilitators to HPV vaccination uptake and completion among Aboriginal and Torres Strait Islander adolescents in Queensland, Australia.Methods and analysis The study will be guided by an Indigenist research approach and an ecological model for health promotion. Yarning, a qualitative Indigenous research method, will be conducted in up to 10 schools. Participants will include Year 7 (12/13 years old) Aboriginal and Torres Strait Islander adolescents; parents/caregivers; and local key informants and immunisation programme partners involved in the delivery of school-based HPV immunisation programme. Participants will be recruited through school representatives and investigator networks using purposive and snowball sampling and samples of convenience. Field notes, HPV vaccination clinic observations and sequential diagramming of the HPV vaccination process will be conducted. Thematic analysis of data will be led by Aboriginal and Torres Strait Islander researchers. Synthesised sequential diagrams of the process of HPV vaccination and qualitative themes summarising key findings will be produced.Ethics and dissemination The Aboriginal Health and Medical Research Council of New South Wales Ethics Committee (1646/20), the Australian National University Human Research Ethics Committee (HREC, 2020/478), the HREC of the Northern Territory Department of Health and Menzies School of Health Research (19-3484) and the Townsville Hospital and Health Service HREC ...
Keywords	Medicine ; R
Subject code	170
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Protocol for the formative phase of a trial (SHE-CAN) to test co-designed implementation strategies for HPV-based cervical screening among vulnerable women in two diverse settings in India

Anu Mary Oommen / Partha Basu / Anne George Cherian / Eric Zomawia / Ravikumar Manoharan / Ruby Angeline Pricilla / Vidhya Viswanathan / Brian Oldenburg / Sujha Subramanian / David Hawkes / Marion Saville / Julia M. L. Brotherton / on behalf of the SHE-CAN collaborators

Implementation Science Communications, Vol 4, Iss 1, Pp 1-

2023 Volume 11

Abstract: Abstract Background In view of the WHO’s call for the elimination of cervical cancer as a public health problem, and current low screening coverage, Indian policy makers need evidence on how to effectively implement cervical screening programmes, ... ...

Abstract	Abstract Background In view of the WHO’s call for the elimination of cervical cancer as a public health problem, and current low screening coverage, Indian policy makers need evidence on how to effectively implement cervical screening programmes, ensuring equity in access. Our study will follow the INSPIRE implementation framework to co-design and test HPV-based screening approaches in two states of India with different health system organisation, based on understanding the status of screening as currently implemented, readiness and challenges to transition to HPV-based screening, and preferences of key stakeholders. Here, we describe our protocol for the formative phase of the study (SHE-CAN). Methods The study population includes women from vulnerable populations, defined as residents of tribal areas, rural villages, and urban slums, in the states of Mizoram and Tamil Nadu. The baseline assessment will use mixed methods research, with desktop reviews, qualitative studies, and surveys. A capacity assessment survey of screening and treatment facilities will be done, followed by interviews with healthcare providers, programme managers, and community health workers. Interviews will be conducted with previously screened women and focus group discussions with under and never-screened women and community members. Stakeholder workshops will be held in each state to co-design the approaches to delivering HPV-based screening among 30–49-year-old women. Discussion The quality and outcomes of existing screening services, readiness to transition to HPV-based screening, challenges in providing and participating in the cervical cancer care continuum, and acceptability of screening and treatment approaches will be examined. The knowledge gained about the current system, as well as recognition of actions to be taken, will inform a stakeholder workshop to co-design and evaluate implementation approaches for HPV-based screening through a cluster randomised implementation trial.
Keywords	HPV ; Cervical ; Screening ; Co-design ; Implementation ; India ; Medicine (General) ; R5-920
Subject code	360
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Measuring HPV vaccination coverage in Australia

Bianca Barbaro / Julia M.L. Brotherton

Australian and New Zealand Journal of Public Health, Vol 39, Iss 4, Pp 326-

comparing two alternative population‐based denominators

2015 Volume 330

Abstract: Abstract Objective: To compare the use of two alternative population‐based denominators in calculating HPV vaccine coverage in Australia by age groups, jurisdiction and remoteness areas. Method: Data from the National HPV Vaccination Program Register ( ... ...

Abstract	Abstract Objective: To compare the use of two alternative population‐based denominators in calculating HPV vaccine coverage in Australia by age groups, jurisdiction and remoteness areas. Method: Data from the National HPV Vaccination Program Register (NHVPR) were analysed at Local Government Area (LGA) level, by state/territory and by the Australian Standard Geographical Classification Remoteness Structure. The proportion of females vaccinated was calculated using both the ABS ERP and Medicare enrolments as the denominator. Results: HPV vaccine coverage estimates were slightly higher using Medicare enrolments than using the ABS estimated resident population nationally (70.8% compared with 70.4% for 12 to 17‐year‐old females, and 33.3% compared with 31.9% for 18 to 26‐year‐old females, respectively.) The greatest differences in coverage were found in the remote areas of Australia. Conclusion: There is minimal difference between coverage estimates made using the two denominators except in Remote and Very Remote areas where small residential populations make interpretation more difficult. Adoption of Medicare enrolments for the denominator in the ongoing program would make minimal, if any, difference to routine coverage estimates.
Keywords	Human papillomavirus (HPV) ; vaccine ; HPV coverage ; population estimates ; remoteness ; Public aspects of medicine ; RA1-1270
Subject code	310
Language	English
Publishing date	2015-08-01T00:00:00Z
Publisher	Wiley
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Getting the timing right

Rachael H. Dodd / Brooke Nickel / Megan A. Smith / Julia M.L. Brotherton / Kirsten J. McCaffery

Preventive Medicine Reports, Vol 20, Iss , Pp 101268- (2020)

Women’s views on the best time to announce changes to cancer screening policy recommendations

2020

Abstract: In December 2017, the Australian National Cervical Screening Program (NCSP) changed from 2-yearly cervical cytology to 5-yearly primary human papillomavirus (HPV) testing, starting at age 25 and with an exit test when aged 70–74. Women showed limited ... ...

Abstract	In December 2017, the Australian National Cervical Screening Program (NCSP) changed from 2-yearly cervical cytology to 5-yearly primary human papillomavirus (HPV) testing, starting at age 25 and with an exit test when aged 70–74. Women showed limited awareness of these changes prior to their implementation. We explored women’s preferences for how similar cancer screening changes could be communicated to the public in the future, including when, how, and using what methods. Six focus groups including 49 women aged 18–74 were conducted in November 2017. Focus groups were guided by information available on the NCSP website and information developed by the researchers. Generally, women suggested that communication of changes to cancer screening programs would ideally occur between 6 and 12 months ahead of their implementation and that they would like the opportunity to be involved in consultation about the changes. The NCSP website was described as answering basic questions, but also raising further questions for which there were no answers provided. Most groups preferred information which included evidence behind the changes and wanted an option of more information. Similar suggestions were made across all focus groups about how communications could be delivered, with recognition that the mode of delivery should differ by age. Women were still seeking information about the test itself and a symptom list, in order to be aware of these over the five-year period. These findings make an important and timely contribution which could help inform other countries considering making changes to their cancer screening programs in the future.
Keywords	Cervical screening ; Communication ; Preferences ; Qualitative research ; Medicine ; R
Subject code	300
Language	English
Publishing date	2020-12-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Implementation of Australia's renewed cervical screening program

Farhana Sultana / Lara Roeske / Michael J Malloy / Tracey L McDermott / Marion Saville / Julia M L Brotherton

PLoS ONE, Vol 15, Iss 1, p e

Preparedness of general practitioners and nurses.

2020 Volume 0228042

Abstract: The National Cervical Screening Program (NCSP) in Australia underwent major changes on December 1st, 2017. The program changed from 2-yearly Pap testing for women aged 18-69 years to 5-yearly HPV testing for women aged 25-74 years including differential ... ...

Abstract	The National Cervical Screening Program (NCSP) in Australia underwent major changes on December 1st, 2017. The program changed from 2-yearly Pap testing for women aged 18-69 years to 5-yearly HPV testing for women aged 25-74 years including differential management pathways for oncogenic HPV 16/18 positive versus HPV non16/18 positive test results and the option of self-collection for under-screened women. We conducted a survey among cervical screening providers in primary care to assess their level of preparedness in undertaking cervical screening before (pre-renewal) and after (post-renewal) the new program was implemented. Surveys were conducted between 14th August and 30th November 2017 (pre-renewal) and 9th February and 26th October 2018 (post-renewal) among cervical screening providers who attended education sessions related to the new guidelines. Preparedness was assessed in three areas: 1) level of comfort implementing the new guidelines (7 questions), 2) level of confidence in their ability to convey information about the new guidelines (9 questions) and 3) level of agreement regarding access to resources to support implementation (11 questions). Proportions were calculated for each question response and pre- and post-renewal periods compared using generalised linear models. Open-ended questions related to anticipated barriers and ways to overcome barriers were also included in the questionnaires. Compared to the pre-renewal period, a higher proportion of practitioners in the post-renewal period were more comfortable offering routine screening to women ≥25 years (p = 0.005) and more confident explaining the rationale for not screening before 25 years (p = 0.015); confident explaining a positive HPV 16/18 (p = 0.04) and HPV non 16/18(p = 0.013) test result and were comfortable with not referring women with a positive HPV non 16/18 test result and low grade/negative cytology for colposcopy (p = 0.01). A higher proportion of Victorian practitioners in the post-renewal period sample were also comfortable (p ...
Keywords	Medicine ; R ; Science ; Q
Subject code	027
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Assessing HPV vaccine coverage in Australia by geography and socioeconomic status

Bianca Barbaro / Julia M.L. Brotherton

Australian and New Zealand Journal of Public Health, Vol 38, Iss 5, Pp 419-

are we protecting those most at risk?

2014 Volume 423

Abstract: Abstract Objective: To determine whether HPV vaccine coverage in 12–13‐year‐olds varies by geographical area, remoteness and ecological level indicators of socioeconomic status (SES). Method: Data from the National HPV Vaccination Program Register (NHVPR) ...

Abstract	Abstract Objective: To determine whether HPV vaccine coverage in 12–13‐year‐olds varies by geographical area, remoteness and ecological level indicators of socioeconomic status (SES). Method: Data from the National HPV Vaccination Program Register (NHVPR) were analysed at Statistical Local Area (SLA) level, by the Index of Relative Disadvantage (IRSD) and the Australian Standard Geographical Classification Remoteness Structure. Results: Nationally, 73% of females aged 12–13 years in 2007 were fully vaccinated against HPV. Coverage in low SES areas (71.5%) was 4.1 percentage points lower than coverage in high SES areas (75.6%). Uptake of the first two doses was higher in the very remote parts of Australia (dose 1 – 88.5%, dose 2 – 81.8%) than in major cities (dose 1 – 83.4%, dose 2 – 80.2%), but not for dose 3 where coverage in major cities was 3% higher (73.6% versus 71.4%). Conclusion: Notifications of HPV vaccine doses delivered to females aged 12–13 through schools suggest a high and relatively equal uptake across socioeconomic groups. Females in remote regions have the highest uptake of dose 1 but are least likely to complete the course. This may be due to particular challenges in vaccine delivery to residents of remote areas.
Keywords	Human papillomavirus (HPV) ; vaccine ; health inequality ; socioeconomic status ; remoteness ; Public aspects of medicine ; RA1-1270
Subject code	910
Language	English
Publishing date	2014-10-01T00:00:00Z
Publisher	Wiley
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Hepatitis B Vaccines and HPV Vaccines Have Been Hailed as Major Public Health Achievements in Preventing Cancer--Could a Schistosomiasis Vaccine be the Third?

Michael H Hsieh / Julia M L Brotherton / Afzal A Siddiqui

PLoS Neglected Tropical Diseases, Vol 9, Iss 5, p e

2015 Volume 0003598

Keywords	Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2015-05-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: “So, if she wasn’t aware of it, then how would everybody else out there be aware of it?” —Key Stakeholder Perspectives on the Initial Implementation of Self-Collection in Australia’s Cervical Screening Program

Claire M. Zammit / Nicola S. Creagh / Tracey McDermott / Megan A. Smith / Dorothy A. Machalek / Chloe J. Jennett / Khic-Houy Prang / Farhana Sultana / Claire E. Nightingale / Nicole M. Rankin / Margaret Kelaher / Julia M. L. Brotherton

International Journal of Environmental Research and Public Health, Vol 19, Iss 15776, p

A Qualitative Study

2022 Volume 15776

Abstract: 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 ... ...

Abstract	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’s 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 ...
Keywords	self-collection ; self-sampling ; cervical screening ; implementation science ; qualitative ; experience ; Medicine ; R
Subject code	360
Language	English
Publishing date	2022-11-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Under-screened Aboriginal and Torres Strait Islander women's perspectives on cervical screening.

Tamara L Butler / Natasha Lee / Kate Anderson / Julia M L Brotherton / Joan Cunningham / John R Condon / Gail Garvey / Allison Tong / Suzanne P Moore / Clare M Maher / Jacqueline K Mein / Eloise F Warren / Lisa J Whop

PLoS ONE, Vol 17, Iss 8, p e

2022 Volume 0271658

Abstract: Aboriginal and Torres Strait Islander women have lower participation in Australia's National Cervical Screening Program than other Australian women. Under-screened (including never screened) women's voices are rarely heard in research evidence, despite ... ...

Abstract	Aboriginal and Torres Strait Islander women have lower participation in Australia's National Cervical Screening Program than other Australian women. Under-screened (including never screened) women's voices are rarely heard in research evidence, despite being a priority group for interventions to increase cervical screening participation. This study aimed to describe under-screened Aboriginal and Torres Strait Islander women's perspectives on cervical screening. Participants were 29 under-screened (women who had either never screened, had not screened in the previous five years or had recently screened in the past three months after more than five years) Aboriginal and Torres Strait Islander women from five communities across three states/territories. Female Aboriginal and Torres Strait Islander researchers Yarned with women about why they did not participate in screening and how to improve screening. Yarning is an Indigenous qualitative research method in which relationships and trust facilitate culturally safe conversation. Transcripts were analysed thematically. The proportion of eligible women who screened within 30 days after the Yarn was calculated. We identified four themes describing how the harms outweighed the benefits of cervical screening for under-screened women. These were: 1) distress, discomfort, and trauma; 2) lack of privacy and control; 3) complicated relationships with health care providers (HCPs); and 4) pressured, insensitive, and/or culturally unsafe communication from HCPs. Under-screened women who had recently screened had maintained privacy and control through self-collection and had experienced trauma-informed and empathetic care from their HCPs. While we cannot unequivocally attribute women's subsequent participation in screening to their involvement in this study, it is notable that one third of eligible under-screened women were screened within 30 days after the Yarn. Enhancing privacy, implementing trauma-informed approaches to care and sensitivity to the clinician-client ...
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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