# Factors Associated with Mailed Return of Self-Sampling for Human Papillomavirus (HPV) Testing

> **NIH NIH F31** · INDIANA UNIVERSITY INDIANAPOLIS · 2020 · $32,590

## Abstract

Project Summary/Abstract
Cervical cancer disproportionately affects women who are low-income and never/underscreened (never
screened or under screened) especially in Indiana, where cervical cancer incidence and mortality are higher
than the US national average, and screening is lower than the US national average. Women who are low-
income have structural and intrapersonal barriers to screening that may prevent them from obtaining provider-
based screening. Although HPV testing is now accepted by USPTF guidelines, it is only endorsed for provider-
collected sampling. Self-sampling for HPV testing, a method for women to collect their own cervico-vaginal
sample, has been established as a feasible and acceptable alternative to provider-based cervical cancer
screening in other countries and is supported by US pilot studies. HPV self-sampling is likely to be
implemented as a screening option in the US in the future due to its comparable sensitivity to provider-
collected HPV samples, acceptability, and potential to reach populations who are never/underscreeners. Self-
sampling may overcome barriers to provider-based cervical cancer screening experienced by women who are
low-income and never/underscreened and provide a convenient way to access screening. Studies testing
mailed HPV kits, however, have demonstrated that 30-50% of women do not return a mailed HPV kit. Prior to
widespread implementation, research is needed to identify characteristics of returners and non-returners of
mailed HPV self-sampling kits. The purpose of this descriptive study is to identify factors associated with
mailed return of HPV self-sampling kits using concepts from the Diffusion of Innovations Theory (advantages,
compatibility, complexity, and self-efficacy) while controlling for sociodemographic, healthcare, and health
behavior variables in a group of low-income and never/underscreened women.
Data for this cross-sectional study will be collected at time of study consent from women (n=200) at a food
pantry and nonadherent to cervical cancer screening using valid and reliable instruments. Self-sampling kits
will be mailed to the women’s home within one week of consent, and women will have 4 weeks to return the kit
to be considered “returners”. Logistic regression analyses will be used to analyze the relationship between the
data collected at baseline consent (attributes of innovation-advantages, compatibility, complexity, and self-
efficacy) and return of the self-sampling kit via mail (y/n).
The results of this study will provide knowledge about factors associated with return of self-sampling kits to
better understand the characteristics of returners and non-returners. Results of this project will help guide
implementation of HPV self-sampling in populations who are low-income and never/underscreened whom self-
sampling may most likely benefit. This study will provide a foundation for the applicant’s long-term goal of
reducing morbidity and mortality from cervical cancer th...

## Key facts

- **NIH application ID:** 10025580
- **Project number:** 5F31NR018791-02
- **Recipient organization:** INDIANA UNIVERSITY INDIANAPOLIS
- **Principal Investigator:** Erika Biederman
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $32,590
- **Award type:** 5
- **Project period:** 2019-09-01 → 2021-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10025580

## Citation

> US National Institutes of Health, RePORTER application 10025580, Factors Associated with Mailed Return of Self-Sampling for Human Papillomavirus (HPV) Testing (5F31NR018791-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10025580. Licensed CC0.

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