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This mixed-design study identifies barriers and facilitators to follow-up adherence among women with human papillomavirus (HPV) infection and premalignant cervical lesions, conducted in Mexico between February and April 2019. Quantitative evidence draws on information-system data and questionnaires, complemented by semi-structured interviews, content analysis, and process risk evaluation to support strategies for the Early Detection Program.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/barriers-and-facilitators-for-adherence-to-follow-up-by-hr-hpv-positive-women-with-premalignant-cervical-lesions-a-mixed-design-study-in-mexico/331358/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/barriers-and-facilitators-for-adherence-to-follow-up-by-hr-hpv-positive-women-with-premalignant-cervical-lesions-a-mixed-design-study-in-mexico/331358.png","ImageObject",300,407,{"name":92,"@type":93},"Riley","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-23","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the study’s primary aim in Mexico?","Question",{"text":112,"@type":113},"To identify barriers and facilitators affecting follow-up adherence among women with HR-HPV infection and premalignant cervical lesions.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which barriers to follow-up adherence were identified?",{"text":117,"@type":113},"Barriers included low income, limited appointment time due to family provider roles, long waits for testing and results, distant facilities, insufficient communication about service hours, inadequate staff training, lack of systematic counseling, shame or fear, and limited knowledge of cervical cancer and screening.",{"name":119,"@type":110,"acceptedAnswer":120},"What strategies or factors supported follow-up adherence?",{"text":121,"@type":113},"Facilitators included respectful treatment by CAPASAM staff, no-cost services, health campaigns, and positive user attitudes.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},331358,1790467310,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},1374391975076,"https://ap-avatar.wpscdn.com/avatar/14000253ca4ec9f6853?x-image-process=image/resize,m_fixed,w_180,h_180&k=1783305029341752051","Aguilar‑Linares et al. BMC Women’s Health (2024) 24:550 [https://doi.org/10.1](https://doi.org/10.1) 186/s12905‑024‑03379‑3  \nBMC Women’s Health  \n RESEARCH Open Access  \nBarriers and facilitators for adherence to follow‑up by HR‑HPV‑positive women with premalignant cervical lesions: a mixed‑design study in Mexico  \nGengly Aguilar-Linares1, Margarita Márquez-Serrano2, Sergio Meneses-Navarro2,3,  \nBlanca Estela Pelcastre-Villafuerte2, Lorena E. Castillo-Castillo4, Jesús A. Estévez-García5,  \nTania O. Valadez-George6, Margarita Bahena-Román7, Vicente Madrid-Marina7 and Kirvis Torres-Poveda3,7*  \nAbstract  \nBackground Mexico reports low follow-up completion rates among women with abnormal cervical cancer screenings. This study aimed to identify barriers and facilitators to follow-up adherence among women with human papillomavirus (HPV) infection and premalignant cervical lesions in Mexico.  \nMethods A mixed-methods study was conducted from February to April 2019. Participants included women undergoing follow-up care for high-risk human papillomavirus (HR-HPV) and premalignant lesions, along with health personnel from the Women’s Healthcare Center (CAPASAM) in Mexico. Quantitative data were obtained from the Women’s Cancer Information System and through a questionnaire about factors affecting follow-up adherence. Additionally, the health personnel involved completed a compliance checklist regarding care regulations. Descriptive statistics were used for analysis. Qualitative data were collected via semi-structured interviews with both groups, followed by a content analysis based on identified categories. The Hazard Analysis and Critical Control Point System confirmed care process risks. Proposals to enhance the Early Detection Program for Prevention and Control of Cervical Cancer were collected from a CAPASAM health personnel nominal group.  \nResults Identified barriers to follow-up included low income among CAPASAM users, family provider roles limiting time for appointments, long waits for testing and results delivery, distant facilities, insufficient service hour communication, inadequate health personnel training, and a lack of systematic counseling. Hesitation toward follow-up was also linked to shame, apprehension, uncertainty, test aversion, fear of positive results, and limited cervical cancer and screening knowledge. Patriarchal attitudes of partners and limited access to the now-discontinued PROSPERA government program further discouraged follow-up. Facilitators comprised respectful treatment by CAPASAM staff, no-cost services, health campaigns, and positive user attitudes.  \nConclusions The study found more barriers than facilitators to follow-up adherence, highlighting the need for strategies to bolster the Early Detection Program. Future strategies must address the comprehensive array offactors and incorporate stakeholder perspectives.  \nKeywords Barriers, Facilitators, Adherence, HPV, Uterine cervical neoplasia, Secondary prevention, Mexico, Women  \n*Correspondence: Kirvis Torres-Poveda [kjtorres@insp. mx](kjtorres@insp. mx)  \nFull list of author information is available at the end of the article  \n© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by st","cbCaieK0SISq8XJk","https://ap.wps.com/l/cbCaieK0SISq8XJk","pdf",1297534,13,"English","# Abstract\n# Background\n## Cervical cancer burden in Mexico\n## Early detection program and limitations\n# Methods\n# Results\n# Conclusions","[{\"question\":\"What was the study’s primary aim in Mexico?\",\"answer\":\"To identify barriers and facilitators affecting follow-up adherence among women with HR-HPV infection and premalignant cervical lesions.\"},{\"question\":\"Which barriers to follow-up adherence were identified?\",\"answer\":\"Barriers included low income, limited appointment time due to family provider roles, long waits for testing and results, distant facilities, insufficient communication about service hours, inadequate staff training, lack of systematic counseling, shame or fear, and limited knowledge of cervical cancer and screening.\"},{\"question\":\"What strategies or factors supported follow-up adherence?\",\"answer\":\"Facilitators included respectful treatment by CAPASAM staff, no-cost services, health campaigns, and positive user attitudes.\"}]","Barriers and facilitators for adherence to follow-up by HR-HPV-positive women with premalignant cervical lesions - a mixed-design study in Mexico | PDF",1789992899,33]