Procedures
CERVICAL CANCER
The Johns Hopkins Institutional Review Board approved the study protocol. Once eligible women were identified, trained research assistants scheduled a visit to obtain written informed consent and collect baseline data at several community sites (e.g., nurse‐run community health centres or community organizations serving people with HIV). Upon completion of the baseline assessment, a trained community health worker delivered health literacy education to women assigned to the intervention arm.Initially, education sessions were scheduled for groups of six to eight women. However, the group‐based format presented substantial scheduling challenges to the study team with high rates of no‐shows. This led to the study team's decision to adopt individual education delivery. The education sessions lasted about 30 min, when offered individually, and 45–60 min, when offered as a group due to discussion during the group session. Within 1–2 weeks after completing education, intervention participants received monthly phone counselling sessions for 6 months. During each phone call, a counsellor checked the participant's progress toward completing a Pap test and answered questions or concerns about Pap test screening.For both intervention and control arms, we provided a copy of the Pap test brochure tailored to WLH, highlighting causes and symptoms of cervical cancer, risk factors for cervical cancer among WLH, the value of Pap screening and how to prepare for a Pap test. All of our educational materials were written at a sixth grade level or lower, as assessed by Flesch‐Kincaid grade‐level statistics in Microsoft Word. Additionally, all women in the study received a list of local community resources where a Pap test could be obtained free, or at a reduced cost, based on a sliding scale.Trained study staff who were blinded to the group assignment collected data at baseline, 3 and 6 months from the start of the intervention. After 6 months, intervention women were invited to postintervention qualitative interviews to share their experiences with CHECC‐uP. Every woman provided informed written consent. Enrolled participants received $20 at baseline and 3 months and $40 at 6 months for their time. Postintervention interview participants received an additional $30.