2. The Health Promotion Model for the Clinic-Based HPV Self-Sampling Approach
DISEASE, SECONDARY, CERVICAL CANCER
The health promotion model (HPM) has been chosen as the conceptual framework to guide this study, because health-promoting behavior is interpreted as a broad conceptualization, including the secondary prevention of CC. The theory could be used to interpret the effectiveness of clinic-based HPV self-sampling, in comparison with home-based HPV self-sampling approaches. It could be used to assess the difference in the uptake, HPV prevalence, associated factors, performance of clinic-based screening among HIV-infected women and their experiences, and costs related to patient-led HPV screening. The HPM would be used to interpret the factors affecting the uptake of clinic-based versus home-based HPV self-sampling among HIV-infected women. It was chosen because it suits the tailoring of public health interventions and dissemination [The three concepts that were chosen to guide this study were the concept of personal factors, the concept of situational influences, and the concept of health-promoting behavior. The concept of personal factors could be used to identify the demographic characteristics (age, parity, level of education, CD4 count, viral load, knowledge of CC screening, screening preference, ART status, WHO stage, STI status, ART adherence status, fear of finding disease, type of HPV 16/18 by sample), knowledge, sexual history, reproductive health history, social factors, economic factors, and culture, concerning the prevention of HPV and eventually cervical cancer. The concept of situational influences could support the identification of the personal, family, community (perceived embarrassment of the screening procedure, knowledge of the disease, family support, peer support groups), and health system factors (distance to the health facility, waiting time, appointment scheduling, counseling status, peer support group, trained HWs, referral, the return of laboratory tests), and the cost-effectiveness, of the clinic-based versus home-based HPV self-sampling approach.Health-promoting behavior could be interpreted as activities related to HPV self-sampling, at the clinic or at home, among HIV-infected women. The model could also examine the relationship between personal factors and health-promoting behavior; situational influences and health-promoting behavior; and personal factors and health promotion. Additionally, the HPM has been widely used in health promotion research involving people of different age groups regarding participation in HPV self-sampling and CC screening [