11110 Background: Successful implementation of cervical cancer screening in low- and middle-income countries (LMICs) depends on community acceptance. Although general awareness of cancer is rising, limited understanding of screening procedures continues to hinder participation. This study examined the factors influencing cervical cancer awareness, procedural knowledge, and sources of screening information among Nepali women undergoing HPV-based screening. Methods: HPV screening was conducted through two community health fairs in Janakpur, Nepal, in 2025. Clinician-collected samples were tested using an isothermal amplification assay. Survey data collected included participants’ age, education level, cervical cancer awareness, procedural knowledge on vaginal sampling, sources of screening information, and health decision-making practices. Multivariate logistic regression was used to identify factors associated with cervical cancer awareness, procedural knowledge, and information sources. Results: Valid survey data from 274 Nepali women, including 32 HrHPV-positive cases, were analyzed. Cervical cancer awareness was significantly associated with education. Women with secondary education or higher were more likely to have heard of cervical cancer (aOR 4.45; 95% CI 1.81-10.95, p = 0.001), compared to those with less education. However, education was not associated with specific knowledge of vaginal sampling. Procedural knowledge was instead hindered by low health autonomy (husband or in-laws as decision-maker: aOR 0.42, 95% CI 0.25-0.72, p = 0.002, vs. self-decision making). Women who tested HrHPV-positive were significantly less likely to understand the sampling procedure prior to testing than those who tested negative (aOR 0.33, 95% CI 0.14-0.78, p = 0.01). Regarding information sources, women aged 30-44 years relied more on community networks, i.e., female community health volunteers (FCHVs) than medical providers, compared to women < 30 years (aOR 1.89, 95% CI 1.01-3.53, p = 0.048). Conclusions: Cervical cancer awareness in Nepali women is driven by education, but procedural knowledge is limited by low health autonomy. Middle-aged and older women rely on FCHVs or their community networks to acquire information about cervical screening. Future implementation strategies should address interventions that empower women and improve understanding of screening procedures, as well as tailored training on FCHVs to promote cervical screening among middle-aged women. Keywords: Cervical Cancer, Procedural Knowledge, Awareness, Implementation Science, Health Literacy, Global Health
Mou et al. (Wed,) studied this question.