Participant selection. Twenty-nine VCWs provided census
lists of females from 290 villages in half of the Shamva’s
district population. Using a proportionate allocation methodology,
a total of 700 women were identified: 121 from farm
villages, 50 from mine villages, 350 from traditional rural reserve
villages, and 179 from resettlement villages. A random
numbers table was used to draw names of potential subjects
from a total population of 3,043 females who met the inclusion
research criteria in the district. First, informed consent was
obtained from each village head man to conduct this research
among his villagers. A second informed consent was obtained
from the individual potential subjects; they received an explanation
of the research and were told they were free to
decline or discontinue participation at any time without being
disadvantaged in any way.
Study instrument. The instrument used in this study was
adapted from those previously used with other populations.
Yu et al.33 adapted the standard California Behavioral Risk
Factor Surveillance System questionnaire for use with Asian
Americans. We further adapted items for the Zimbabwean
population. The questionnaire itself covered a range of issues,
including (1) demographic and socioeconomic data, (2) cervical
screening tests knowledge, (3) beliefs and attitudes toward
cervical screening tests and cervical cancer, (4) reasons
for accessing cervical screening, (5) health practices, and (6)
perceptions of healthcare services.
Study procedures. To begin the study, six focus group
discussions were conducted to refine the study questionnaire.
With each focus group consisting of 8 participants, 48 of the
700 women participated in the focus group phase. The focus
group responses were used to assess cultural appropriateness
and understanding about clarity of the questionnaire. The
questionnaire was revised and administered to the remaining
514 females. Based on whether they had ever heard of cervical
cancer screening, the participants were divided into two
groups. Group A included 98 (19%) participants who had an
understanding of and actual experience of cervical cancer
screening, and group B included 416 (81%) participants who
had not heard about cervical cancer screening tests and lacked
appreciable knowledge and experience about cervical
screening tests and cervical cancer (Tables 2, 3, and 4). In order
to administer the rest of the questionnaire to group B participants,
it was necessary to provide onsite education. Using an
educational pamphlet developed by the University of Zimbabwe
Medical School at the department of obstetrics and
gynecology in collaboration with the Ministry of Health and
Child Welfare, supplemented with a plastic pelvic model,
participants were updated. All participants were black Afri