Table 3

Secondary outcome measures

Understanding of resultsUnderstanding of screening results will be measured via a scale developed for this study, which consists of six questions considering perceived meaning of results and cervical screening information sources.Participants will be asked:
  1. What do you think your screening result means for your current health?—I have/am likely to have/am unlikely to have/am very unlikely to have/definitely do not have cervical cancer, or I do not know.

  2. Can you remember what your screening result was?—HPV and cytology results indicated separately via prompted responses.

  3. How confident are you that you understand the meaning of your screening result?—five-point Likert scale ranging from ‘not at all confident’ to ‘very confident’.

  4. When you were invited for your recent screening test, how much of the information did you read?—six-point Likert scale ranging from ‘none’ to ‘all of it’, or ‘cannot remember’.

  5. Did you look for any extra information about the screening test or your results?—Yes/no/cannot remember.

  6. Do you have any unanswered questions about cervical screening or HPV testing?—Presented with free text box.

  •   Understanding of results will only be measured at baseline.

Self-reported by participant in questionnaire.
Knowledge of HPVKnowledge of HPV will be measured using an adapted tool23 which asks participants to answer true or false to 10 statements about HPV. This tool has been adapted by only including those questions reflective of the information provided to women in the NHSCSP materials. Participants will also be asked whether they have heard of HPV before today and how they would rate their knowledge on a five-point Likert scale between ‘very poor’ and ‘very good’. Knowledge will only be measured at baseline.Self-reported by participant in questionnaire.
Perceived risk of cervical cancerPerceived risk of developing cervical cancer will be assessed by asking participants to answer: ‘Compared with other women the same age as you, do you think your chances of developing cervical cancer in the next 10 years are…?’ Answers will range on a five-point Likert scale from ‘much below average’ to ‘much above average’. This is an adapted scale from Maissi et al.11 12Self-reported by participant in questionnaire.
ConcernAs in Maissi et al,11 12 concern will be measured by asking (1) how concerned and (2) how reassured do you feel about your recent screening result? Participants will also be asked an additional question: ‘how worried are you about getting cervical cancer in the next 10 years?’Self-reported by participant in questionnaire.
Intention to attend future screeningParticipants will be asked one question: ‘will you go for cervical screening next time you are invited?’ Answers will be indicated on a five-point Likert scale ranging between ‘yes, definitely’ and ‘definitely not’.Self-reported by participant in questionnaire.
Psychosexual functioningThe Psychosocial Effects of Abnormal Pap Smears Questionnaire short-form (PEAPS-Q-5) is a five-item validated questionnaire used to measure distress experienced by women undergoing follow-up investigation after an abnormal Pap smear result.24 Not all participants will have received abnormal test results; therefore, we slightly adapted this scale by inserting a ‘not applicable’ option after each question.Self-reported by participants with HPV+results in questionnaire.
Health-related quality of lifeThe Health-Related Quality of Life Questionnaire short-form (EQ-5D) is a 5-item validated tool used to assess five dimensions related to quality of life: mobility, self-care, usual activities, pain/discomfort and anxiety/depression.25 This will be collected by UCL but analysed and reported as part of the PHE health-economic evaluation.Self-reported by participant in questionnaire.
  • HPV, human papillomavirus; NHSCSP, National Health Service Cervical Screening Programme; PHE, Public Health England; UCL, University College London.