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Background <p>Indigenous peoples in high-income settler-colonial countries experience disproportionately high cervical cancer incidence and mortality compared to non-Indigenous populations, reflecting systemic inequities and barriers to culturally safe care. HPV self-collection offers a potential solution to overcoming inequities by enabling women and people with a cervix to collect their own sample, improving autonomy, privacy, and access, and supporting culturally responsive models of care. While self-collection is accurate, acceptable, and increases screening participation, evidence is needed on how best to support implementation to reach Indigenous women and people with a cervix.</p> Objectives <p>This scoping review aimed to identify and describe implementation strategies, barriers, facilitators, and context-specific adaptations to HPV self-collection for cervical screening among Indigenous women and people with a cervix in high-income settler colonial countries.</p> Methods <p>Eligible sources included peer-reviewed and grey literature published between August 2013 and November 2025 that described barriers, facilitators, implementation strategies, or context-specific adaptations to HPV self-collection among Indigenous women and people with a cervix in Australia, Aotearoa New Zealand, Canada, or the United States of America (USA). Database (PubMed, SCOPUS, ProQuest CINAHL) and grey literature searches targeting Indigenous-specific organisations, government websites were conducted, using the broad search terms: cervical screening, HPV, self-collection, and Indigenous peoples. Data were extracted and mapped against the Health Equity Implementation Framework to identify barriers, facilitators, and strategies relevant to the implementation of HPV self-collection.</p> Results <p>32 publications were included, comprising 28 academic publications and 4 from the grey literature. Identified facilitators included client health literacy and knowledge, flexible models of care, culturally responsive care, supportive data and systems, and strengths-based messaging. Indigenous-led solutions were central to enabling these facilitators.</p> Conclusions <p>While evidence comparing the impact of individual strategies is not available, community-driven, multi-component strategies were recommended. The most effective strategies appeared to combine flexible delivery models, such as home-based or outreach approaches, with tailored education focusing on increasing knowledge and building trust. Indigenous-led approaches and the involvement of Indigenous health workers and community leaders were central to strategies.</p>

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Implementing HPV self-collection: a scoping review of facilitators and strategies among Indigenous women and people with a cervix

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月23日

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  • Louise Mitchell,
  • Deb Wong,
  • Tamara Butler,
  • Julia Brotherton,
  • Joan Cunningham,
  • Sonya Egert,
  • Kristine Falzon,
  • Gail Garvey,
  • Beverley Lawton,
  • Claire Nightingale,
  • Marion Saville,
  • Natalie Taylor,
  • Claudette Tyson,
  • Kate Wilkinson,
  • Claire Zammit,
  • Lisa J. Whop

摘要

Background

Indigenous peoples in high-income settler-colonial countries experience disproportionately high cervical cancer incidence and mortality compared to non-Indigenous populations, reflecting systemic inequities and barriers to culturally safe care. HPV self-collection offers a potential solution to overcoming inequities by enabling women and people with a cervix to collect their own sample, improving autonomy, privacy, and access, and supporting culturally responsive models of care. While self-collection is accurate, acceptable, and increases screening participation, evidence is needed on how best to support implementation to reach Indigenous women and people with a cervix.

Objectives

This scoping review aimed to identify and describe implementation strategies, barriers, facilitators, and context-specific adaptations to HPV self-collection for cervical screening among Indigenous women and people with a cervix in high-income settler colonial countries.

Methods

Eligible sources included peer-reviewed and grey literature published between August 2013 and November 2025 that described barriers, facilitators, implementation strategies, or context-specific adaptations to HPV self-collection among Indigenous women and people with a cervix in Australia, Aotearoa New Zealand, Canada, or the United States of America (USA). Database (PubMed, SCOPUS, ProQuest CINAHL) and grey literature searches targeting Indigenous-specific organisations, government websites were conducted, using the broad search terms: cervical screening, HPV, self-collection, and Indigenous peoples. Data were extracted and mapped against the Health Equity Implementation Framework to identify barriers, facilitators, and strategies relevant to the implementation of HPV self-collection.

Results

32 publications were included, comprising 28 academic publications and 4 from the grey literature. Identified facilitators included client health literacy and knowledge, flexible models of care, culturally responsive care, supportive data and systems, and strengths-based messaging. Indigenous-led solutions were central to enabling these facilitators.

Conclusions

While evidence comparing the impact of individual strategies is not available, community-driven, multi-component strategies were recommended. The most effective strategies appeared to combine flexible delivery models, such as home-based or outreach approaches, with tailored education focusing on increasing knowledge and building trust. Indigenous-led approaches and the involvement of Indigenous health workers and community leaders were central to strategies.