Presentations (under construction)
2016
Pamela Wakewich, Ingeborg Zehbe and on behalf of the ACCSS group. “Social Determinants of Health and Cervical Cancer Screening Uptake: Barriers and Facilitators for Vulnerable and Marginalized Women in Canada.” HPV Prevention and Control Board “Barriers in HPV Vaccination & Cervical Screening Programmes” Meeting, University of Antwerp, Belgium, June 26-27, 2016. (Invited presentation)
https://www.uantwerpen.be/en/projects/hpv-prevention-control-board/meetings-/barriers-in-hpv-vacc/
https://www.uantwerpen.be/en/projects/hpv-prevention-control-board/meetings-/barriers-in-hpv-vacc/
Ingeborg Zehbe, Pamela Wakewich, Julian Little, Ann Burchell, Alberto Severini, Nicholas Escott, Pauline Sameshima, Gina Ogilvie, Brenda Magajna, Lisa Bishop, Kyla Morrisseau, Crystal Davey, Ashley LaFramboise, Mel Krajden and on behalf of the ACCSS group. The Anishinaabek Cervical Cancer Screening Study (ACCSS): Barriers to and Strategies for Increasing Cervical Cancer Screening amongst First Nations Communities in Northwest Ontario. Society of Obstetricians and Gynaecologists of Canada, Annual Clinical and Scientific Conference 2016, Vancouver, BC - June 14-17, 2016
Objectives: In Canada, (Pap)anicolaou screening has reduced cervical cancer incidence in general, but rates remain disproportionately high for Indigenous women. ACCSS addressed this health disparity through a mixed methods research and education project to create awareness for cervical screening and to test the efficacy of human papillomavirus (HPV) self-sampling as an alternative to Pap cytology.
Study Methods: Using a community-engagement model with 10 First Nations in the northwest Ontario Robinson Superior Treaty area, 16 interviews and 8 focus groups were conducted with healthcare providers and women from the communities. Culturally sensitive educational strategies were developed to encourage participation in the following controlled, randomized screening trial.
Results: Average participation was less than a quarter of eligible women by either
method with high variability of uptake between communities (range 0 – 62%) reflecting individual community challenges and the need for individualized community educational and engagement strategies. Twice as many women were willing to be screened by HPV self-sampling compared to Pap testing. High-risk HPV was detected in 20% of the self-samples. Identified barriers to screening included: lack of access to appropriate services and recall, poor social determinants of health, generational and gender effects as well as colonial legacy. At a post-trial reflection gathering all partner communities expressed strong interest in continuing to a second round of education and self-sampling screening.
Conclusion: Sustainable screening interventions in First Nations communities require approaches that resolve structural barriers, explore new ways of screening, and provide community-determined educational and engagement strategies for all ages, both genders and stakeholders.
Objectives: In Canada, (Pap)anicolaou screening has reduced cervical cancer incidence in general, but rates remain disproportionately high for Indigenous women. ACCSS addressed this health disparity through a mixed methods research and education project to create awareness for cervical screening and to test the efficacy of human papillomavirus (HPV) self-sampling as an alternative to Pap cytology.
Study Methods: Using a community-engagement model with 10 First Nations in the northwest Ontario Robinson Superior Treaty area, 16 interviews and 8 focus groups were conducted with healthcare providers and women from the communities. Culturally sensitive educational strategies were developed to encourage participation in the following controlled, randomized screening trial.
Results: Average participation was less than a quarter of eligible women by either
method with high variability of uptake between communities (range 0 – 62%) reflecting individual community challenges and the need for individualized community educational and engagement strategies. Twice as many women were willing to be screened by HPV self-sampling compared to Pap testing. High-risk HPV was detected in 20% of the self-samples. Identified barriers to screening included: lack of access to appropriate services and recall, poor social determinants of health, generational and gender effects as well as colonial legacy. At a post-trial reflection gathering all partner communities expressed strong interest in continuing to a second round of education and self-sampling screening.
Conclusion: Sustainable screening interventions in First Nations communities require approaches that resolve structural barriers, explore new ways of screening, and provide community-determined educational and engagement strategies for all ages, both genders and stakeholders.
Pamela Wakewich, Ingeborg Zehbe, and on behalf of the ACCSS group. Ethical Space, Community Engagement and Culturally Sensitive Cervical Cancer Screening: Lessons from the ACCSS Project, Indigenous Health Conference, Towards Health and Reconciliation, Hilton Mississauga Meadowvale Hotel, Toronto, Canada, May 26-27, 2016.
2015
Under construction