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Tackling the declining uptake of cervical screening is one of our biggest challenges at Jo's. Women at the first age of invitation and women at the end of the screening programme are of particular concern to us and we are constantly producing new publications, campaigns and adverts targeted at these, and other groups of women.
However, the need to reach women with low health literacy is also a challenge, this includes women who might not understand what the test is for, what will happen at it and why it's important they attend. Studies have in fact shown that in the UK 43% of adults (18-65) do not have adequate literacy skills to understand health information . Awareness of cervical cancer and prevention is even lower amongst women from Black, Asian and Minority Ethnic (BAME) groups. BAME women may have different perceptions and barriers to screening and, where English is a second language, health literacy can create significant health inequalities. Some communities do not recognise that 'cervical screening' and 'smear test' are the same test . In one of our surveys a third more BAME women of screening age (12%) compared to white women (8%) said they had never attended screening and 30% of Asian women didn't know what cervical screening is . All these barriers can be linked to health literacy and perceived risk of cervical cancer.
Making sure all women have access to information in the format that suits them and is written in plain, easy to read English is crucial to helping them make an informed decision about attending their screening invitation, reducing health inequalities and potentially saving lives.
We knew that we weren't going to reach this group of women through our standard approach which is why two years ago the Information team began a unique collaborative project working directly with women from BAME communities to produce an information resource on cervical screening. We combined forces with the Community Health and Learning Foundation, specialists in engaging community groups, to help us create focus groups that could provide feedback at the all stages of the project. Film was selected as a preferred format by the focus group and with more help from the groups, health care professionals and expert peer reviewers we produced "Your Guide to Cervical Screening (smear tests)" in 2015.
It features real women from different ethnic backgrounds alongside animation to clearly explain the process and what to expect at screening. The film offers another way for women to gain information about cervical screening, covering what will happen during the test and how the test can help to prevent cancer. We believe that this may be the first time that a health education film has been co-created and co-produced this way and that it offers an innovative future best practice model. The script used in the voiceover was reviewed by our expert focus groups to ensure the words used were understandable and the narrator was chosen because her voice was clear and easy to follow. The animation uniquely created for Jo's by Formed Films was designed to be illustrative and explain health messages so that the viewer can follow even if their English vocabulary is limited.
Another first is providing voiceovers for the film. It can now be viewed in: Arabic, Bengali (Sylheti and Standard), Chinese Mandarin, Hindi, Polish, Tamil and Urdu and available free on our website and YouTube channel. A DVD featuring all 8 new language films and the English version (with subtitles and without) has been produced and can be ordered for just £5.
Over the next year we will be widely promoting the new films, hoping that you help us spread the word and remind all women that #SmearTestsSaveLives.
 Rowlands G, Protheroe J, Winkley J, Richardson M, Seed PT, Rudd R. 2015. A mismatch between population health literacy and the complexity of health information: an observational study. Br J Gen Pract 65(635)
 Marlow LAV, Waller J, Wardle J. 2015. Barriers to cervical cancer screening among ethnic minority women: a qualitative study. J Fam Plann Reprod Health Care. Accessed online: http://jfprhc.bmj.com/content/early/2015/01/12/jfprhc-2014-101082.full?rss=1