Integrating cervical cancer screening within the outpatient emergency departments in Kenya This application is in response to Notice of Special Interest (NOSI): Administrative Supplements for NCI Global Oncology Mentored Research Notice Number: NOT-CA-24-028. Our U54 grant “Enhanced BReast and cErvical cAncer screening in Kenya THROUGH implementation science research and training (BREAKTHROUGH) Center led by Drs. Michael Chung (Emory), Mohammed Ali (Emory) and John Kinuthia (KNH) aim to inform the effective and sustainable integration of early detection and successful treatment of precancerous cervical lesions in primary care for women in Kenya. We propose in this supplement application to explore acceptability, barriers, facilitators and strategies to integrate cervical cancer screening into outpatient emergency departments. The proposed study will provide an opportunity for research training and mentorship of Dr. Rita Arogo, a Gynaecologist at Kenyatta National Hospital and Honorary lecturer at the University of Nairobi, provide preliminary data for her K43 application and will complement the currently ongoing U54 award by accessing women missed by current screening approaches. Kenya's guidelines recommend cervical cancer screening for all women, but coverage remains low at 16%. Cervical cancer screening is primarily offered in maternal-and-child health, family planning, and HIV comprehensive care clinics, leaving out women not seeking care in these clinics. Outpatient emergency departments offer an opportunity to reach these underserved women. Understanding barriers and facilitators to integrating screening in outpatient emergency departments can inform strategies to optimize screening. The specific objectives of this mentored research are to: To assess the acceptability of cervical cancer screening among women presenting to 3 outpatient emergency departments within Nairobi County, explore barriers and facilitators of integrating cervical cancer screening services in the outpatient emergency departments within Nairobi County and to identify feasible, and effective strategies to promote integration of cervical cancer screening in the outpatient departments and develop roadmaps for implementation. We will employ an explanatory sequential design, conducting 369 quantitative surveys followed by 36 qualitative in-depth interviews at three Nairobi County health facilities' outpatient emergency departments. Using the Consolidated Framework for Implementation Research, we will conduct 15 in-depth interviews with healthcare workers to grasp their perceived barriers and facilitators to the integration. Key stakeholders will then convene in a 2-day workshop to prioritize identified barriers and propose implementation strategies. This approach aims to promote cervical cancer screening uptake, capturing missed women and bolstering national screening initiatives.