Toolkit for engaging Under-screened and Never-screened women in the National Cervical Screening Program

Engagement strategies

Page last updated: 22 September 2020 (this page is generated automatically and reflects updates to other content within the website)

There are several evidence-based strategies that healthcare providers can use to engage under-screened and never-screened women in cervical screening.



Education and support

Women view healthcare providers as an important source of information about cervical screening. It is important for healthcare providers to engage patients in a conversation about cervical screening to help patients understand:

  • What cervical screening involves
  • Why it is important i.e. because regular cervical screening is one of the main methods to prevent cervical cancer
  • Why it is relevant to them, and
  • What their test results mean.

Healthcare providers also have an important role in supporting their patient to undertake cervical screening and counselling them about any perceived barriers. Open communication will assist in creating a safe and secure environment that enables women to feel comfortable to have the test performed.
Include local women in the promotion of programs in their communities e.g. Where it is appropriate to advertise an event esp. women's business in remote/ Aboriginal  community. Although a healthcare provider may view the Cervical Screening Test as routine, it is important to remember that for women the experience is generally something that is out of the ordinary. Healthcare providers should acknowledge that cervical screening is a personal and potentially difficult experience for some women. This might include:

  • Encouraging patients to express their concerns
  • Acknowledging and addressing the patient’s feelings of embarrassment and/or anxiety
  • Before the proceedure begins , always give the woman the power and permission to stop you at any time
  • Being aware of and sensitive to any cultural issues
  • Reassuring the patient about the procedure, and
  • Offering the patient an opportunity to ask questions.

Making the screening experience as comfortable as possible

Some patients may prefer to insert their own speculum, and it can be helpful to offer this option.
Providing instructions on calming and deep breathing techniques can also help the woman to relax.
A prescription of vaginal oestrogen cream can be effective in decreasing pain or discomfort for post-menopausal women.
Provide a mirror in case women want to view their own cervix

Invitation, recall and reminder letters

Healthcare providers can either manually or electronically (using their practice’s clinical software) identify which patients have no record of screening, which are due for screening and which are overdue. These women can then be targeted individually with a personalised invitation, a phone call or reminder letter. Letters are particularly effective when they include an endorsement from a healthcare provider.
Consult with local women about how this would happen

Educational resources

Education resources may include printed or audio-visual materials. These materials work best when combined with other strategies (for example, when provided in the context of a healthcare consultation). Locally designed developed and owned resources always work best.
e.g. Something designed in Top End NT doesn’t necessarily work in Central Australia

Healthcare providers reminders

A note or flag identifying each patient’s cervical screening status can be added to the patient’s electronic record to prompt healthcare providers to discuss cervical screening when the patient next attends the health service.

Audit and feedback activity

Clinical audits involve assessing performance in delivering and/or offering screening to patients (using patient record management software), either at a practitioner or health service level. Healthcare providers are then presented with information/feedback about their performance. Results may be compared with a benchmark screening rate. It is expected that this activity will then prompt healthcare providers to improve their performance.