Why Women Don't Return: Nurse Perspectives on Follow-Up Care After Abnormal Cervical Cancer Screening Results in Mississippi's Public Health System.

OBJECTIVE: To explore public health nurses' perspectives on reasons women in Mississippi may fail to receive follow-up care after abnormal cervical cancer (CC) screenings. BACKGROUND: Mississippi's high cervical cancer mortality rate poses a significant public health challenge. Understanding public health nurses' perspectives on barriers to follow-up may help improve timely diagnostic care. METHODS: This qualitative descriptive study used focus groups to examine barriers and facilitators to follow-up care. Sixteen registered nurses who manage follow-up care in Mississippi public health clinics participated in five virtual focus groups. Participants represented diverse ages and experience levels (mean age 45.5 years; mean 10 years' experience). Semi-structured interviews elicited perspectives on patient, nursing, and system-level barriers and facilitators. Data was thematically analyzed. RESULTS: Three overarching barriers emerged: patient-level (limited health literacy, financial constraints, unreliable contact information), nursing-level (language differences, staffing shortages, declining motivation), and system-level (underuse of electronic health records, limited access to specialty care). Facilitators included early patient education, proactive communication, language resources, adequate staffing and training, and full utilization of electronic health record tools. CONCLUSION: Nurses identified multilevel barriers and facilitators influencing CC follow-up in Mississippi. These insights can inform strategies to improve follow-up care and reduce CC disparities in rural and underserved populations.