The development, usability and acceptability of a cervical screening informed-choice tool for women with severe mental illness

Lamontagne-Godwin, Frederique ORCID: https://orcid.org/0000-0002-9628-7450 (2021) The development, usability and acceptability of a cervical screening informed-choice tool for women with severe mental illness. Doctoral thesis, University of West London.

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Abstract

People with severe mental illness (SMI) die on average 10–20 years younger than the general population, including those with morbidity relating to cancer. People with SMI face specific barriers to attending cancer screening, including for cervical cancer and, as a consequence, they are underrepresented in cancer screening generally and have poorer survival rates following a positive diagnosis. The aim of this PhD was to develop a cervical screening ‘informed-choice tool’ for women with SMI. The tool was designed to address barriers to cervical screening uptake in order to help women with SMI make an informed choice about participating in screening. This research focused on three questions: (1) What are, if any, the specific design(s) and theoretical underpinning(s) of informed-choice tools developed for people with SMI? (2) What are service users’ and clinicians’ experiences of using the tool? (3) Does the tool have any impact on service users’ decisional conflict to attend screening?
The tool was informed by a realist review of physical health interventions for people with SMI and by a systematic review of informed-choice tools for this population, which have now been published. A mixed-methods research design was used to develop the tool. The usability and acceptability of the tool was tested by service users and clinicians in two NHS Trusts using semi-structured interviews and the ‘think-aloud’ method. A preliminary evaluation of the tool was conducted to assess the impact on service users’ decisional conflict to attend cervical screening sessions. Results from the evaluation (n = 25) showed that the tool may have an impact on some
women who are either overdue for their screening or have never attended. This work has resulted in a tool which is usable and acceptable by women with SMI and may impact on their screening uptake and hence their mortality rates from cervical cancer. An animated video has also been developed to illustrate the key findings of the tool. The tool and video have since been disseminated widely across the NHS and third sector organisations. Future research may involve further assessments of the real-world impact of the tool and its adaptation to other health-related decisions.

Item Type: Thesis (Doctoral)
Subjects: Medicine and health > Health promotion and public health
Medicine and health > Mental health
Depositing User: Frederique Lamontagne-Godwin
Date Deposited: 01 Apr 2021 22:43
Last Modified: 01 Apr 2021 22:44
URI: http://repository.uwl.ac.uk/id/eprint/7787

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