Pre-implementation assessment of upstream domains on the uptake of HPV self-sampling in safety-net settings: a scoping review

Human papillomavirus (HPV) screening can be used as an early detector for cervical cancer. The newly US Food and Drug Administration-approved HPV self-sampling tests can be used by safety net practices in the USA to help mitigate the current screening disparities seen in patients. As patient acceptability and capability have already been established, this scoping review synthesizes the barriers and facilitators of implementing HPV self-sampling from the perspective of safety net providers and leadership, and the upstream factors not yet explored in current research. Following PRISMA-ScR guidelines, a literature search was conducted exploring peer-reviewed publications and grey literature to establish the current landscape of HPV self-sampling. Findings were organized using the Consolidated Framework for Implementation Research. From the 57 works included, it was found that safety net practices are capable of implementing HPV self-sampling by utilizing current workflows and team members. However, outer setting guidelines and policies heavily influence the implementation process, likely causing a delay in uptake by safety net practices. Recent guideline endorsements and forthcoming insurance coverage address several of these barriers, making post-approval implementation research in safety net settings an urgent priority.