Method: An Option Grid tool (OG) was informed by focus groups with 62 rural women. Nine key messages were included as the rows in the English OG and provided to 20 health practitioners at a VIA training program and feedback collected. Forward and backward translation to Tamil was completed and conceptual and linguistic challenges for shared decision-making noted. The OG was then field tested by four health workers and 22 women as a group and one individually. Direct observation notes and written feedback was collected.
Result: Key messages include average CC incidence/mortality per village, signs and symptoms, aetiology, screening test information and benefits, the meaning of a positive result (including false positives), treatment of abnormal results, and who should be screened. The 20 health workers were positive about the grid. Most felt it could be used to counsel women prior to screening but none had done so after four months. Translation highlighted difficulties in conveying outcomes over time in communities with no calendars/diaries, difficulty adapting trial evidence to the local context and the need to find new ways of explaining pre-cancerous lesions due to lack of words in the Tamil language. In field testing the OG was useful for identifying gaps in women’s knowledge, facilitating interactive discussion, and staff used existing flipcharts to enhance and expand information visually. The individual was able to identify knowledge gaps about abnormal test results and treatment not previously addressed in traditional education and took a copy home. Staff felt the OG allowed women to ‘speak out more freely’, it was ‘clear’ and ‘sufficient’ ‘allowed discussion of new issues’ and helped to ‘motivate and raise awareness’.
Conclusion: Health workers in a low resource setting found a one-page OG to be a useful tool to facilitate informed participation in cervical cancer screening.