Fishman, PaulTolessa, Ayantu2025-08-012025-08-012025-08-012025Tolessa_washington_0250O_28137.pdfhttps://hdl.handle.net/1773/53308Thesis (Master's)--University of Washington, 2025Background: Cervical cancer is preventable through regular screening, yet Somali American women face significant barriers that contribute to low screening rates and delayed diagnoses. These barriers include limited knowledge, stigma, language barriers, and cultural norms. Human Papillomavirus (HPV) self-sampling is an emerging alternative to in-clinic screening, offering privacy and convenience that may help overcome these challenges. This study explores Somali Americans’ experiences with HPV self-sampling using the Socio-Ecological Model to identify factors at the individual, interpersonal, and community levels that influence screening participation. Findings aim to inform culturally relevant strategies to increase screening uptake and reduce health disparities. By understanding barriers and facilitators through the socio ecological lens, this research supports the development of more equitable cervical cancer prevention efforts. Methods: We conducted a secondary analysis of qualitative data from the Isbaar Study, a 2022 NIH funded project led by the University of Minnesota. The study held 6 focus groups with 44 Somali American women aged 30-65 in Minnesota to explore knowledge, experiences, and decision making around HPV self-sampling. Discussions were audio recorded and transcribed. NVivo software was used to apply deductive coding guided by the Socio-Ecological Model across individual, interpersonal, and community levels. Thematic analysis identified key barriers and facilitators to screening. Additionally, the analysis guided the creation of personas and empathy mapping to capture recurring patters in participants’ experiences by organizing responses into five categories: says, thinks, does, and environment. Results: Thematic analysis revealed four key themes shaping Somali Americans women’s perspectives on cervical cancer screening and HPV self-sampling: 1) limited knowledge and varying attitudes toward screening, 2) preferences shaped by personal experiences with Pap smears and interest in self-sampling, 3) the influential role of healthcare providers and peer support, and 4) cultural and societal norms impacting screening behavior. To further capture participant experiences, six personas were developed using empathy mapping, capturing the behaviors and needs related to HPV self-sampling. These ranged from individuals unfamiliar of screening to proactive screeners and peer advocates to highlight the variation in screening decision making. Conclusion: This study highlights the experiences and barriers Somali American women face regarding cervical cancer screening. Using the Socio-Ecological Model, personas, and empathy mapping, key factors influencing screening behavior were identified. Findings shown the importance of community informed strategies and expanding access to HPV self-sampling to reduce screening disparities.application/pdfen-USnonePublic healthHealth servicesThesis