Pap Chat

Agency: EASTERN ACCESS COMMUNITY HEALTH (EACH)

Timeframe: Four Months
Key Words: Intellectual disability, Acquired Brain Injury, Education

What was this project
about?

This project was about increasing the awareness of cervical cancer and the cervical screening program among clients, carers and service providers through education sessions and the dissemination of information. The project also supported women with intellectual disabilities or Acquired Brain Injury to have a Pap test.

What we were trying to do

  • Increase the proportion of female clients from EACH's Disability Services who participate in regular cervical screening.

  • Use targeted training and information provision to build the knowledge, skills and capacity of relevant service providers to better support the promotion and up-take of cervical screening.

Why we did it

To address the needs of marginalised women with an Acquired Brain Injury or intellectual disability who do not often have access to information about cervical cancer and access to screening.

When was this project carried out?

April 2003 to August 2003

Where was this done?

The project took place in the Eastern Metropolitan Region.

Who were we targeting?

  • Female clients of EACH's Disability Services

  • Carers of EACH's Disability Services

  • EACH Disability Support Staff

  • Disability Support Staff from other providers

  •  GP's

Who was involved?

In the implementation of this project, EACH built upon existing connections and partnerships with Women's Health East and Knox Division of General Practice. A project reference group was also established, bringing together specialist service providers and health promotion experts from within EACH, as well as representatives from other relevant community agencies.

What we did and what happened

As part of a Well Women's Health Day, we conducted two forums promoting cervical screening to disability service clients and their carers. Other topics and activities included exercise, massage, nutrition and visiting your GP. Approximately 40 clients and 6 carers attended these sessions.

The priority was to provide clear, accessible and inclusive information to as many women as possible during the project period. An article placed in program newsletters promoting cervical screening and highlighting tips for overcoming barriers was also initiated to further extend the reach of information provision to carers and clients that did not attend the forum.

Three training sessions were held for EACH Disability Support Staff, with 45 workers attending. The purpose of these sessions was to educate workers about cervical cancer and facilitate development of the skills required to effectively engage and respond to clients and carers and assist in breaking down barriers to cervical screening. A small number of disability support staff from other providers who share clients with EACH also attended.

A short article was included as part of the ‘Friday Fax' communication to all GP's in the Knox, Whitehorse and Yarra Ranges Division's of General Practice.

Outcomes

Information was disseminated to the clients and carers of EACH through a variety of mechanisms. Feedback regarding the provision of information was positive, particularly from participants of the Women's Health Forums.

Additionally, there were some barriers identified, including the provision of sensitive information in a clear and acceptable format and difficulties in tailoring information to suit a wide and complex range of disabilities.

What worked well?

The achievements of the project were greatly enhanced by the capacity within EACH and the linkages already established. This enabled a collaborative approach and access to representatives for the reference group from the target groups and specialist personnel. The reference group provided advice, direction and feedback.

The structures already in place, such as program newsletters, enabled us to easily disseminate information. The strong connections between workers and clients promoted attendance at forums. Additional funding sought from the Department of Human Services (DHS) to fund the Well Women's Health Day was successful, emphasising the importance of health issues for women with disabilities.

What did not work so well?

We experienced some difficulties in providing information to women with high levels of intellectual disability. In educating these women, it was difficult to assess the levels of comprehension and provide information that was clear, sensitive and understandable.

Unfortunately there was a low uptake of carers responding to the forum invitations. Therefore information was provided to this group through the use of program newsletters and displays.

What can others learn from this?

In delivering information on cervical screening, the issue of client embarrassment and apprehension should not be underestimated. It is very important to consider how to deliver the information in a non-confrontational, safe environment. Therefore, client education was incorporated within a well woman's health message, with the majority of information provided in written form to take away and read. The provision of information was always accompanied by the reassurance that a woman had a right to refuse the test, empowering choice.

It was also very important that Disability Support Providers and support workers received training. This training was very valuable in promoting cervical screening to the target group and raising awareness of many combined issues faced by these women that impact on a range of life and emotional health issues.

How was the project evaluated?

Evaluation formed an integral part of the development and implementation of our Pap Chat project model. As this was a new project, we found that the model evolved rapidly within the early stages and the importance of evaluating this process for the future benefit of the program was paramount.

Review and evaluation mechanisms included:

  • Informal liaison, discussions and consultation with program participants, including women with disabilities, carers, disability support workers and other relevant service providers.

  •  Formal evaluation of project activities, including surveys, interviews and focus groups with project stakeholders.

  • Regular consultation among program staff from EACH involved in the delivery of services to women with an intellectual disability or an Acquired Brain Injury.

How much did this project cost?

PapScreen Victoria funded the project to the value of $5,000 which included salaries and venue hire, transport and catering.

EACH provided in-kind funding for project management and contributed to the venue hire, transport and catering costs.

DHS contributed $1000 towards the cost of catering, promotional material and equipment used on the two Well Women's Health Days

On sustainability

The project outcomes will be sustained through regular updates for new staff. EACH is also investigating the possibility of repeating the Well Women's Forums.

At a policy level, EACH has developed and adopted new practice standards that embrace cervical screening as an important Public Health initiative. As a result, EACH has committed to ensure that these standards are included in all person-centred planning processes and that actions are clearly articulated in the Individual Development Plans of all relevant clients (including the client/carer's right to choose to take no action).

EACH's Supported Residential Service (SRS) project worker has facilitated links with Family Planning Victoria to address the sexual health needs of women with disabilities within these services.

EACH has also employed a project worker to investigate the viability, and establishment of a Disability Friendly Medical Clinic to service the region.

The GP involved in the project reference group has pledged ongoing assistance with any future initiatives, including the engagement of fellow GP's

Name of project worker/s

Eva Kalivas
Community Health Nurse
Eastern Access Community Health
46 Warrandyte Rd Ringwood 3134
Phone: (03) 9871 1800
Email: info@each.com.au


Lucy's story 

I've always been very aware of the importance of regular Pap tests, as my Mum had early-stage cervical cancer in her 30s.

She encouraged me to start having regular Pap tests when I turned 18 and I followed her advice, albeit begrudgingly!

Read more ...

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