One of IRSN members/Immigrant Insight Scholar (Neelam Dehal) featured in the Sainth Elizabeth's Newsletter (January 2019). See belwo for more detail:


Helping CoDesign a Culturally Appropriate HPV Screening Program

Project Specialist, Brianna Croft, had the pleasure of interviewing research fellow Neelam Dehal to learn more about the amazing work she is contributing as a key partner on one of our SE Futures Health Technology Funded Projects with the women's health social enterprise Eve Medical. 

Neelam is an internationally educated researcher with more than eight years of experience in public health and research on health policy change in India. There, she had managed four national health programs and coordinated various research initiatives for policy advocacy in different areas such as proposing guidelines for alternative medicine and improving regulations for the advertisements related to beauty and health related products. She moved to Canada in 2017 and completed the Ryerson's Internationally Trained Medical Doctors (ITMD) Bridging Program. She is currently a fellow under the Immigrant Insight Scholars Initiative (IISI) at Access Alliance, a local, multicultural community health center in Toronto. Her current research fellowship focuses on designing and evaluating a culturally appropriate HPV (human papilloma virus) self-screening program with key underscreened/never-screened communities of immigrant and indigenous women, with the support of Eve Medical's elegant technology and service model. IISI is an initiative of Access Alliance that provides paid fellowship opportunities along with mentorship for internationally educated researchers to utilize and strengthen their skills, and to smoothen their transition to a successful research career in Canada

By building the needed evidence on community-based and culturally sensitive care pathways for promoting HPV self-sampling to screen for cervical cancer; Neelam and her project team have been conducting focus groups with women and families, as well as with healthcare providers in Toronto and in Sudbury. The key goal is to understand the extent to which at-home based HPV self-sampling based screening could overcome institutional and socio-cultural barriers associated with Pap test (administered by healthcare providers) and generate suggestions/recommendations for overcoming these barriers and challenges. The ultimate goal is to open up access to allow women to be screened in the comfort and privacy of their location of choice, such as the home.
When diving deeper into the project, Neelam shared that those who were not born in Canada or who are low income have lower rates in adherence to cervical cancer screening based on Pap test based screening.
"Cervical cancer screening is a private issue for some women" Dehal explains, "and this take- home solution in terms of HPV self-sampling kit may help to eliminate the embarrassment as well additional costs women encounter when going to get screened by a healthcare provider". This is a really good example of using new innovation and technology for improving health in marginalized communities. 
The study that Neelam is conducting is already generating some interesting findings about the perceptions, acceptability as well as barriers to the new technology (at home HPV based screening kit).  In terms of barriers, study results point to both institutional level barriers and concerns (for example, provider knowledge about the new technology; provider-patient communication related to the kit; integration into EMR; follow up process) and community/client level barriers and concerns (such as language barriers; privacy and modesty issues; cost concerns related to kit; and lack of familiarity with at home kits).  
Next steps for Neelam with the project are to conduct her last focus group and plan for the design phase of the study where the project team will develop interventions and solutions to overcome the barriers to HPV self-sampling documented in the study.
Neelam is on a very exciting journey in hopes of making a large systematic change in the Canadian Health Care system. Currently, self-screening for cervical cancer does not exist in our publicly funded system in Ontario. "We are working hard to make cervical cancer screening inclusive and equitable to all," Neelam explains, "it's really about working towards making healthcare affordable and accessible for everyone". 
Neelam expressed that it has been an extremely rewarding experience working on this project as the primary population is a group that she strongly connects with. We are lucky to have passionate people, like Neelam, to work with when creating the future of health.

Neelam Dehal, Research Fellow at Access Alliance  
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  • Great,  Congratulations Neelam  

  • Congratulations Neelam. We are proud of your achievements!

  • Congrats Neelam! Well done!

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