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The Maison des adolescents of the Cochin Hospital in Paris is a multidisciplinary structure with a transcultural sensitivity. It welcomes young people, but also their families, and take into account their unique backgrounds. From the reception of the adolescent by the consultation nurse to the implementation of specific care in a transcultural group, the care pathway sometimes requires the mother-adolescent dyad to be carried along in order to achieve an appeasement of the sufferings of each., La Maison des adolescents de l’hôpital Cochin à Paris est une structure pluridisciplinaire dotée d’une sensibilité transculturelle z Elle a pour mission d’accueillir les adolescents, mais aussi leurs familles, et de prendre en compte leurs parcours singuliers z De l’accueil de l’adolescent par l’infirmière de consultation à la mise en place de soins spécifiques en groupe transculturel, le parcours de soins nécessite parfois de porter la dyade mère-adolescent pour parvenir à un apaisement des souffrances de chacun.

Additional file 1: Appendix A. Illustrative quotes.

This review will investigate previous and existing approaches and delivery strategies for shared decision-making and risk communication in the context of screening for women's cancers in low- and middle-income countries (LMICs). This review will address the following questions: 1. What risk communication and/or shared decision-making strategies have been used by health providers in screening programs for women's cancers in LMICs? Examples may include the following: - Is there a need for evaluation of risk communication and decision-making strategies or are they usually described, but not evaluated? - In cases where strategies have been evaluated for success (e.g., comprehension, acceptability, uptake of the intervention, etc.), how successful have they been? - What are measures of success for shared decision-making and risk communication strategies? - Are risk communication and decision-making strategies clearly defined? - What are potential recommendations for presenting clear and transparent information to ensure that patients’ values and preferences are incorporated in shared decision-making? (i.e. ensuring comprehension/understanding) - Are risk communication and decision-making strategies developed specifically for LMICs, or are they "imported" from other settings with little consideration for cultural norms, stigma, vulnerability, literacy, etc.? - What are key barriers to achieving a successful shared decision-making process in LMIC communities and populations? 2. What are the risk communication and shared decision-making information needs and preferences of women undergoing screening for women's cancers in LMICs?

Papua New Guinea has among the highest cervical cancer incidence and mortality rates globally and has been plagued by repeated unsuccessful cervical cancer screening, and treatment programs. The World Health Organization (WHO) recently recommended same-day (single visit) human papillomavirus (HPV) screen and treat for primary cervical screening in low- and middle-income countries (LMIC). The acceptability and experience of participation in same day HPV screen-and-treat programs has not previously been evaluated in Papua New Guinea or any other high-burden settings. As part of a larger field prospective single-arm intervention study, my doctoral research examines key social constructs that could impact the acceptability of a same day point-of-care HPV screen-and-treat program from the perspectives of women, health care workers, and policymakers in Papua New Guinea. Through this research, I identify the factors and expound on key stakeholders’ experiences to determine the requirements to successfully build an acceptable, sustainable, patient-centred, HPV diagnostic testing and treatment program in the country now and into the future. In the first study (chapter 3), I conducted a global qualitative meta-synthesis on the use of and acceptability of the use of self-collection for HPV-based screening. As part of a prospective field study in Papua New Guinea, I led a qualitative sub-study (chapters 4-6) using different qualitative data analysis methods to explore the acceptability of point-of-care HPV screening and same-day treatment. Using purposive sampling a total of 88 semi-structured interviews were conducted with women attending the screen-and-treat service (n=62), health care workers (n=20), and policymakers (n=6). Key findings in chapter 4 highlighted the socio-cultural factors positively impacting women’s engagement in the screening program. Chapter 5 expands on the narratives of women who have tested positive for oncogenic HPV and highlights how having access to same day treatment transformed these women’s experiences of diagnosis. Chapter 6 emphasizes critical perspectives of health care workers and key informants and their experiences with the provision of self-collected HPV-based screen-and-treat services and its impact on acceptability. In chapter 7 I discuss the implications of these novel findings for developing strategies and policies to ensure sustained acceptability of the program as well as sound financial, and human resources for health to increase the coverage of same day self-collected HPV-based screen-and-treat in Papua New Guinea. These findings and recommendations will inform practice and policies for the rollout of HPV-based screen-and-treat locally, and in similar high burden settings.

Additional file 1. Characteristics of Included Studies.

Additional file 4. Literature Search Results.

Additional file 3. GRADE-CERQual Assessment Results.

Additional file 2. Critical Appraisal Skills Program (CASP) Tool Results.

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