A recent Catalysts for Change project has received recognition for the development of a trauma-responsive cervical screening programme for women in NHS Forth Valley who have experienced sexual trauma. Project Lead and Gender-Based Violence & Sexual Assault Nurse Hazel Somerville talks about winning the Innovations in Improving Physical Health & Wellbeing and Overall Winners award by the Mental Health Nursing Forum means for the project.
This project is about women who’ve experienced trauma reclaiming power over their lives, their bodies and their choices. Through support from the Queens Nursing Institute (QNIS) Catalysts for Change community project and the National Lottery Community Fund, the NHS Forth Valley Gender-Based Violence Team and Psychological Therapies are working in collaboration with Resilience Learning Partnership to develop a trauma-informed cervical screening programme across primary care. This collaboration also provides specialist services for women who have experienced sexual trauma.
Cervical cancer is the fourth most common cancer in women worldwide. The most effective strategy for detecting, and therefore treating it, is through cervical screening. Public Health Scotland reports that in 2019-20, 318,727 cervical screening tests were processed. However, the uptake rate was 71.2% of eligible women aged 25-64 years.
Women who have experienced sexual violence have lower levels of cervical screening uptake than the general population due to barriers such as the fear that the cervical screening will trigger traumatic memories (Cadman et al, 2012; Madden, 2018) and there is evidence that a broad range of childhood adversities negatively impact cervical screening programmes, with strong correlation with loss of repeat screening or follow up for women who have experienced childhood sexual abuse (Alcala et al, 2017). .
Trauma informed practice, which aims to avoid retraumatisation, aims to address this barrier to uptake rates of cervical smears (Kohler et al, 2021).
The project is about women reclaiming power over their lives, their bodies and their choices by:
- Introducing routine enquiry of all women, of their cervical smear status currently involved in the trauma clinic. These women require a higher level of support and joint working between smear taker and specially trained trauma therapists to ensure safety before, during and after the procedure. Developing a trauma informed plan of care to enable cervical screening at The Meadows. This involves staff at the Trauma clinic working with women in developing grounding and containment skills and coping strategies for intimate examination and when ready, visiting The Meadows, desensitising to the environment, meeting staff member to develop a fully personalised co-produced trauma responsive process plan and procedure centred by the core principles of Safety, Trust, Choice, Collaboration and Empowerment. Developing trauma informed training for health professionals in who undertake cervical screening. This will increase their knowledge and skills through dedicated training around trauma informed principles increasing confidence and competence in delivering cervical screening to this potentially complex population. Included in the training would be a short film produced by women with lived experience of sexual violence, talking about their experience.
In December 2021, we were awarded Innovations in Improving Physical Health & Wellbeing and the Overall Winners award by the Mental Health Nursing Forum for this project. Whilst, the initial focus was on delivering training with healthcare professionals who undertook cervical screening, following from winning this award we are now looking develop training for community mental health and learning disability nurses as they have a unique position in the promotion of attendance for preventative health screening, improving facilitation and identifying barriers. We are motivated by the recognition of how important this work is and look forward to assessing the impact of the project.