Facilitating engagement: Individual meaning-making and relationship-based trust in women’s experiences of cervical screening

Cervical screening rates in the UK are declining. While previous research has identified barriers to screening uptake, less is known about why many women attend cervical screening despite these barriers. This qualitative study explores factors influencing cervical screening decision-making. Through reflexive thematic analysis of semi-structured interviews (n=44), two overall themes were developed: Perceived purpose of Screening and Experience of Screening. The analysis indicates that beliefs are central to decision-making and relate to individual meaning-making in relation to knowledge and information. The same information may be interpreted differently by different women and therefore impact cervical screening decision-making in different ways. Women associate cervical screening with pain, embarrassment and potential violation, but many choose to attend despite this. Trust, person-centred care and continuity of care are important for mitigating these negative perceptions and experiences. Implications of findings are discussed and include moving beyond knowledge-based public health interventions for enhancing cervical screening uptake.