Objectives/Goals: People experiencing homelessness (PEH) face disproportionate cervical cancer burden and screening barriers. Our goal was to design a tailored intervention involving community health worker (CHW)-led education and delivery of context-appropriate screening options in two homeless shelters in Indiana. Methods/Study Population: Guided by a community advisory board and following a human-centered design (HCD) framework, interviews with 30 PEH were conducted in the inspiration phase to explore experiences, knowledge, and attitudes toward cervical cancer screening, including human papillomavirus (HPV) self-sampling, a novel approach where patients collect their own vaginal swab. Rapid qualitative analysis informed an HCD session with 12 PEH in the ideation phase to further explore screening motivators and key messages to encourage uptake of HPV self-sampling. Data were synthesized into an educational flipbook and iteratively refined with participant feedback. Results/Anticipated Results: Findings from interviews and the HCD session highlighted a strong desire to be screened and the need for clear information, access to a trusted CHW, and choice in screening options. The final intervention consisted of an individual cervical cancer education session with a CHW utilizing the educational flipbook, followed by optional screening through HPV self-sampling at the shelter and/or navigation to a clinic. To date, a total of 200 participants have enrolled in the education session. Preliminary results show significant knowledge gains and retention and positive shifts in attitudes toward screening. After an education flipbook redesign, HPV self-sampling uptake significantly increased. Discussion/Significance of Impact: Applying a HCD approach enabled meaningful engagement to iteratively develop and refine an intervention that addressed community needs, increased HPV self-sampling uptake, and expanded cervical cancer screening access for people experiencing homelessness in Indiana.
Balian et al. (Wed,) studied this question.