Banca de DEFESA: CANDIDA MIRNA DE SOUZA ALVES ALENCAR

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : CANDIDA MIRNA DE SOUZA ALVES ALENCAR
DATE: 24/02/2026
TIME: 16:00
LOCAL: Google Meet
TITLE:

Improving adherence to cytopathological screening in a municipality in northeastern Brazil.

KEY WORDS:

Pap smear; Cervical neoplasms; Primary Health Care; Quality Indicators, Health Care.

PAGES: 50
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

INTRODUCTION: An estimated 17,000 new cases of cervical cancer occur annually in Brazil between 2023 and 2025, with a risk of 15.38 cases per 100,000 women. Screening is recommended for women aged 25 to 64 years, annually, and after two consecutive negative results, every three years. However, achieving the agreed target for cytopathological screening remains a challenge, and the quality of records in the Citizen’s Electronic Health Record (Prontuário Eletrônico do Cidadão – PEC) is essential for case surveillance. OBJECTIVE: To improve adherence to cytopathological screening in a municipality in northeastern Brazil. Specifically, this study aimed to identify the main barriers to undergoing the cytopathological exam, analyze the completeness of exam records in the PEC, and evaluate the effect of interventions on adherence to screening. METHODS: This was an intervention study with a quasi-experimental before-and-after design, without a control group, using a quantitative approach. The intervention followed a quality improvement cycle and included the following stages: (a) identification of opportunities for improvement; (b) analysis of barriers using the Consolidated Framework for Implementation Research (CFIR); (c) baseline quality assessment; (d) planning and implementation of interventions; and (e) post-intervention quality reassessment. Data on exam performance and record completeness were extracted from the PEC of five Family Health Units. Descriptive analysis was performed using means, absolute and relative frequencies, and 95% confidence intervals. Absolute and relative improvements were calculated, and the McNemar test was used to compare preand post-intervention periods, adopting a 5% significance level. RESULTS: The identified barriers were related to the inner setting (lack of bathrooms in consultation rooms and the presence of male health professionals), the outer setting (delays in test results), and individual characteristics (fear and embarrassment). The interventions included educational activities and active outreach. The frequency of cytopathological screening among 276 women increased from 36.6% to 41.3% after the interventions (p < 0.001). The mean completeness of PEC fields related to the cytopathological exam was 26%, representing an absolute increase of 31%. The least completed field was “dietary intake markers” (0.4%), while the most completed field was “problems or conditions assessed during this visit” (42.5%). CONCLUSIONS: Active outreach proved to be an effective strategy to increase adherence to cytopathological screening; however, it requires strengthening teamwork to consolidate organized screening and overcome the opportunistic model. In addition, continuous health education actions are essential to increase women’s adherence, as well as training health teams to improve the quality of PEC records.

COMMITTEE MEMBERS:
Externa à Instituição - ARDIGLEUSA ALVES COELHO
Interna - ***.578.944-** - GRÁCIA MARIA DE MIRANDA GONDIM - Fiocruz - RJ
Presidente - 1674688 - TATYANA MARIA SILVA DE SOUZA ROSENDO