Optimising opportunities for self-collection to improve cervical screening access for people with physical disability in Australia: a qualitative study of service provider perspectives
10 affiliations
- 1Evaluation and Implementation Science Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria Australia
- 2Australian Centre for the Prevention of Cervical Cancer, Melbourne, Australia
- 3Cancer Elimination Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
- 4Specialty of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine and Health, Sydney Medical School, at the University of Sydney, Sydney, Australia
- 5School of Health Sciences, The University of Sydney, Sydney, Australia
- 6Independent consultant with lived experience of disability, Victoria, Australia
- 7Independent consultant with lived experience of disability, Canberra, Australia
- 8Implementation to Impact (i2i), School of Population Health, UNSW Sydney, Sydney, Australia
- 9Kirby Institute, UNSW, Sydney, Australia
- 10School of Nursing and Midwifery, College of Health Medicine and Wellbeing, University of Newcastle, Newcastle, NSW Australia
Abstract
Objective: People with physical disability experience systemic and societal barriers to accessing cervical screening. Service providers play an important role in supporting access to cervical screening for this population. In 2017 Australia’s National Cervical Screening Program introduced the choice to self-collect using a vaginal swab, with universal access available from July 2022. This study aimed to understand service providers’ perspectives on the opportunities self-collection provides to improve access to cervical screening for people with physical disability.
Methods: Semi-structured interviews were conducted online between June and August 2023 with 22 clinical and non-clinical service providers from all States and Territories except the Northern Territory. The Updated Consolidated Framework for Implementation Research informed the analysis.
Results: All participants believed that self-collection was a highly acceptable option, both for people with physical disability and service providers, due to its potential to reduce anxiety and discomfort for screening participants, and the opportunities it provides to increase access to screening in non-clinical settings, including at home and in supported accommodation. To date, few services providing disability support had integrated self-collection into their practice. Key barriers to offering self-collection included confusion regarding whether cervical screening was within all provider’s scope of practice, a lack of communication between the health system and the disability sector and an absence of education and resources for providers and people with disability. Attitudes toward people with disability held by healthcare providers, such as general practitioners and other health and wellbeing services, and the quality of relationships between services were seen as either barriers or enablers depending on whether these were positive or not. Several providers expressed concern that the swab may be difficult for some people with physical and sensory disability to use, with adaptations recommended.
Conclusion: Self-collection offers opportunities to improve access to cervical screening for people with physical disability, if supported by providers who have the required knowledge and skills.
Implementation strategies to support uptake of self-collection for people with physical disability are required at the individual, device, service, and system level.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28364-3.
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BibTeX
@article{flynn2026optimising,
title = {{Optimising opportunities for self-collection to improve cervical screening access for people with physical disability in Australia: a qualitative study of service provider perspectives}},
author = {Kate Flynn and Tessa Saunders and Amelia Hyatt and Claire Bavor and Julia ML Brotherton and Deborah Bateson and Nicola S Creagh and Karleen Plunkett and Louise Bannister and Madeleine Clarke and Natalie Taylor and Paula Jops and Allison Cummins and Angela Kelly-Hanku and Megan Smith and Claire Nightingale},
journal = {BMC Public Health},
year = {2026},
month = jul,
doi = {10.1186/s12889-026-28364-3},
url = {https://doi.org/10.1186/s12889-026-28364-3},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Optimising opportunities for self-collection to improve cervical screening access for people with physical disability in Australia: a qualitative study of service provider perspectives
AU - Kate Flynn
AU - Tessa Saunders
AU - Amelia Hyatt
AU - Claire Bavor
AU - Julia ML Brotherton
AU - Deborah Bateson
AU - Nicola S Creagh
AU - Karleen Plunkett
AU - Louise Bannister
AU - Madeleine Clarke
AU - Natalie Taylor
AU - Paula Jops
AU - Allison Cummins
AU - Angela Kelly-Hanku
AU - Megan Smith
AU - Claire Nightingale
PY - 2026
DA - 2026/07/10
JO - BMC Public Health
DO - 10.1186/s12889-026-28364-3
UR - https://doi.org/10.1186/s12889-026-28364-3
AB - Objective: People with physical disability experience systemic and societal barriers to accessing cervical screening. Service providers play an important role in supporting access to cervical screening for this population. In 2017 Australia’s National Cervical Screening Program introduced the choice to self-collect using a vaginal swab, with universal access available from July 2022. This study aimed to understand service providers’ perspectives on the opportunities self-collection provides to improve access to cervical screening for people with physical disability. Methods: Semi-structured interviews were conducted online between June and August 2023 with 22 clinical and non-clinical service providers from all States and Territories except the Northern Territory. The Updated Consolidated Framework for Implementation Research informed the analysis. Results: All participants believed that self-collection was a highly acceptable option, both for people with physical disability and service providers, due to its potential to reduce anxiety and discomfort for screening participants, and the opportunities it provides to increase access to screening in non-clinical settings, including at home and in supported accommodation. To date, few services providing disability support had integrated self-collection into their practice. Key barriers to offering self-collection included confusion regarding whether cervical screening was within all provider’s scope of practice, a lack of communication between the health system and the disability sector and an absence of education and resources for providers and people with disability. Attitudes toward people with disability held by healthcare providers, such as general practitioners and other health and wellbeing services, and the quality of relationships between services were seen as either barriers or enablers depending on whether these were positive or not. Several providers expressed concern that the swab may be difficult for some people with physical and sensory disability to use, with adaptations recommended. Conclusion: Self-collection offers opportunities to improve access to cervical screening for people with physical disability, if supported by providers who have the required knowledge and skills. Implementation strategies to support uptake of self-collection for people with physical disability are required at the individual, device, service, and system level. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28364-3.
SN - 1471-2458
ER -