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Abstract Background Cervical screening rates have fallen in recent years in the UK, representing a health inequity for some under-served groups. Self-sampling alternatives to cervical screening may be useful where certain barriers prohibit access to routine cervical screening. However, there is limited evidence on whether self-sampling methods address known barriers to cervical screening and subsequently increase uptake amongst under-screened groups. Addressing this research gap, the study aims to understand experiences during and barriers to attending cervical screening for under-screened groups and; explore the views of individuals eligible for screening towards self-sampling (vaginal swabbing and urine sampling) as alternative screening methods and how this may address existing barriers to screening. Methods We draw on three integrated theoretical frameworks (access to primary care services, intersectional and feminist perspectives) to examine participants’ barriers to screening and views toward self-sampling methods. We undertook primary qualitative data collection (interviews and focus groups) with 46 participants, facilitated by collaborations with the VCSE sector which successfully enhanced reach to under-served communities. Results Known barriers to cervical screening persist for under-screened participant groups, but we also find numerous examples of good practice where some participants’ needs were met throughout the screening process. Both positive and negative experiences tend to centre around experiences with healthcare professionals, with negative experiences also centring around the use of the speculum. Self-sampling methods (vaginal swab and urine collection) were positively received by participants, and may address some existing barriers through the proponents of enhanced choice – between method and location (which also dovetailed with convenience) leading to greater empowerment. The removal of the speculum and lack of invasive examination by a healthcare professional was also positively received. Conclusions Whilst barriers to cervical screening remain for under-served groups, examples of good practice are prevalent. Such examples should be implemented more widely to ensure consistency in patient experience and to ensure needs are better met for under-served groups. The introduction of self-sampling alongside traditional methods may reduce barriers to screening, and may boost screening rates for under-screened groups but only if they are implemented with appropriate information and sufficient communication. Failure to implement self-sampling without these considerations may threaten to undermine the identified and important benefits of self-sampling methods.

Mental health issues are increasing in prevalence, particularly in adolescents. Many studies have linked parental divorce and separation to poor mental health outcomes among children and adolescents, but findings are mixed about whether the timing of divorce or separation matters and whether this impact varies by gender.We used panel data methods (pooled OLS with correlated random effects) to analyse the relationship between parental divorce occurring prior to or during adolescence on GHQ-12 mental health scores and alcohol consumption at ages 15, 17, and 25. We used data on 5155 males and 4960 females from the longitudinal Next Steps study in England.We found a clear difference by gender in the impact of the timing of parental divorce/separation on mental health. Parental divorce/separation occurring in childhood and early adolescence was negatively associated with female mental health at age 15 but not at ages 17 and 25. We found no consistent relationship between parental divorce/separation and male mental health. When using alcohol consumption as an alternative outcome, we found the same pattern of results for females, and also found that early parental divorce (before age 15) was associated with increased alcohol consumption at age 15 in males, but reduced consumption at age 25. Results remained robust when controlling for omitted variable bias.Our findings suggest there is scope for targeted mental health support in adolescence, by gender, to mitigate potential impacts of parental divorce and separation.