Discovering a culturally-appropriate alternative to the Pap smear for Haitian American women: The Fournier self-sampling device

Background/significance: Cervical cancer incidence has decreased substantially in the US due to adoption of the Pap smear. However, in Little Haiti, the predominately Haitian neighborhood in Miami, Florida, the incidence of invasive cervical carcinoma remains high. Numerous barriers, including poverty, limited access to healthcare, language difficulties, and cultural norms preclude Haitian women from obtaining regular Pap smears.

Objective/purpose: Our community-based research project examined the acceptability of the Fournier self-sampling device as an alternative screening technique among women in Little Haiti. The Fournier device has similar efficacy for detecting cervical dysplasia as the Pap smear, yet enables women to be screened within their home. This approach circumvents many of the barriers to routine screening among Haitian women.

Methods: Creole-speaking, Haitian Community Health Workers canvassed door-to-door in Little Haiti to identify 350 women who met study eligibility criteria. Women who agreed to participate used the Fournier self-sampler and completed a short interview assessing cervical cancer knowledge and experience using the self-sampler.

Results: Preliminary findings indicate that the majority of Haitian women have limited knowledge of cervical cancer. Moreover, when asked about their experience using the Fournier self-sampler, study participants indicated that the device was easy to use and preferable to a Pap smear.

Discussion/conclusions: The excess incidence of invasive cervical carcinoma among Haitian women necessitates identifying a culturally-appropriate alternative to the Pap smear for this population sub-group. The Fournier self-sampler may be one such alternative, and may have similar benefits for other underserved, immigrant women.