Co-developing an intervention aiming to increase cervical screening acceptability for Autistic people using realist methods

Cervical cancer is the most common cancer in women aged under 35 in Wales. NHS Wales offers cervical screening (smear tests), but less than 70% of people attend their appointment. Failure to attend smears increases the risk of people dying from cancer.

Autism is a lifelong neurodevelopmental difference impacting 3% of people, with limited gender difference. Autistic people are much less likely than non-Autistic people to have smear tests, with 55% reporting to have never attended a smear. Our previous interview study found Autistic people find smear tests difficult because of lack of knowledge, worries about being touched and lack of pain relief offered.

Autistic people have informed this project and will be involved in designing the study throughout. We will:

1. Conduct an evidence review that examines existing research to ask: ‘why do cervical screening services not meet the needs of Autistic people?’

2. Test the concepts we identify through a Wales-wide survey of Autistic people eligible for smear tests.

3. Co-develop an intervention with Autistic people and health professionals, to increase knowledge and confidence relating to smear tests and HPV self-sampling.

4. Test the intervention with Autistic people and health professionals, to see if they think it is good.