The Three Step Model for Health Literacy - Information for the Auckland Metro Website

A health literacy approach to cervical screening involves using the Three Step Model for Health Literacy. (Link to HQSC resource developed by Workbase)

Step 1 Ask

Use questions to find out what a woman already knows and feels about cervical screening. Acknowledge what is known and felt.Whether a woman has experienced a cervical test is likely to significantly change what is felt and known. Finding out what a woman already knows will help you identify a starting point for a conversation as it is much more effective to provide new information that connects to and extends what a woman already knows, than to spend your time telling her things she already understands. (Link to schema theory)

Step 2 Build

Build new knowledge and understanding starting from what woman a woman already knows and feels. This may include unpacking past bad experiences to empathise and provide assurance that this can be remedied. This is an opportunity to build an accurate understanding of screening and ensure informed consent is achieved. It is important to discuss both why screening matters and what screening involves.

Step 3 Check

At the end of the discussion check that a woman has the information she needs and feels able to make a decision. This may include agreeing what will happen next.

Here are some questions you could ask (for Step 1) to find out what a woman already knows about cervical screening

Have you had a cervical smear in the past – or it may have been called a pap smear or smear?
I understand that you’ve never had a cervical test before and you are the right age to have one. Has anyone talked to you about cervical screening before – a doctor or maybe your mother or sister - what did they say?
What have you heard or seen on TV about cervical screening?
Have you heard of cervical cancer?
What have you heard about HPV or HPV immunisation?
Do you know what we are looking for when we do a cervical test?
Did you know that cervical tests are quite unusual because they actually help prevent cervical cancer? (by picking up changes in your cervix that can be fixed before they cause cancer)
I can see from our records you’ve had a cervical test before. Can you remember what happened during the test?
You are part of the National Cervical Screening Programme – can you remember being told about the Programme the last time you had a smear test?
What worries you about having a cervical test?
What’s stopped you from having a cervical test in the past?
What do you think the benefits might be of having a cervical test?
What would you like to know about cervical screening?