HOME Trial Intervention and Procedures
CERVICAL CANCER
Participants in the HOME control group received usual care, which involved outreach to attend Papanicolaou screening, including a birthday letter reminder, clinician-targeted alerts signaling overdue screening that remained active until overridden or a Papanicolaou procedure was ordered, and communication from primary care teams. Participants in this group did not receive the mailed HPV kit and were not contacted by the study team.Participants in the HOME intervention group received usual care plus a mailed HPV self-sampling kit with a prepaid return envelope addressed to the KPWA clinical laboratory. Mailings included an invitation letter, a research information sheet, and educational materials on self-collecting and returning a sample. The letter advised participants to receive routine Papanicolaou testing regardless of whether they chose to complete the HPV self-sampling kit. When the HOME trial was initiated, cervical cancer screening guidelines did not yet include primary HPV screening. Therefore, the KPWA Institutional Review Board and delivery system required that participants be advised to attend in-clinic screening regardless of whether they chose to complete the self-sampling kit. More recent guidelines recommend HPV testing for primary screening.