Table 1 Interview guide

1. I’d like to begin by hearing about a time when you needed a specific health care service and you had a positive experience. This could be a time when you went for health care of any kind, mental health services, help with substance use, help with the court system, housing services, or other services. Talk me through what you did and what happened.

• What did you need help with?

• How did you go about getting help?

• Where did you go?

• What steps did you take?

• What people do you remember talking with or interacting with?

• How were you treated?

• What were specific problems or barriers you ran into?

• How did the experience end?

• What made the experience a positive one?

2. Now can you tell me about a time when you needed a specific health care or other kind of service, but you could not get it for some reason or things did not go well. Please talk me through what happened.

• What did you need help with?

• How did you go about getting help?

• Where did you go?

• What steps did you take?

• What people do you remember talking with or interacting with?

• How were you treated?

• What were problems or barriers you ran into? How did the experience end?

• What made the experience a negative one?

3. Can you tell me about the kinds of places you go for routine sexual health care, such as Pap tests, STD tests, and birth control. How did you end up going to these places to get care? What kinds of health care do you get at each?

• Probe for Pap tests, STD tests, and birth control; if any are not obtained at the stated place, ask: Where do you go when you need a Pap test/STD test/birth control?

• How did you find this place to get care?

• How do get there?

• How you pay for care at the places where you go?

4. Thinking back to your last Pap test, what made you decide to go for the Pap test?

• How did you get to the place where you got the Pap test?

• How did you pay for the test or get health insurance to cover it?

5. What do you remember about the health care provider who gave you your last Pap test? Was it a doctor, nurse practitioner, midwife, or a physician’s assistant? What were your interactions with that person like?

• What, if anything, did the health care provider do that helped make you feel more comfortable?

• What, if anything, did the health care provider do that made you feel uncomfortable?

6. Can you describe the Pap test itself—what happened during the Pap test?

• Do you remember how the health care provider explained the reason for the Pap test?

• What did they say it was for?

• Were you able to ask questions?

• Did you see the speculum?

• What other instruments were used?

• Do you remember if the provider mentioned “HPV testing”?

• Did they say they were going to send cells to be analyzed for HPV types?

7. What did the health care provider say about how they would get your results to you? Can you remember how you actually ended up getting the results?

• What were the results?

• What did you do after getting the results?

• Did you follow-up?

8. What would you change about the experience of your last Pap test?

9. Sometimes women might need a Pap test, but they find it hard to get one. What are some of the things a person needs in order to get a Pap test?

• Ask about transportation, appointment scheduling/reminders, time off work, child care, health insurance, cash for co-payments, access to free or low-cost clinics; for each.

10. What do you remember about the last time you thought you needed to get a Pap test but you didn’t get one?

• Why did you think that you needed to get a Pap test?

• What were the things that got in the way of going to get the test?

11. What kinds of people in the community have helped you get Pap tests or other types of health care?

• Tell me about a time that you went for a Pap test and someone else encouraged you or helped you make that happen.

12. Tell me about a time when someone you knew or someone you didn’t know, like someone at an office or agency, got in the way of your getting a Pap test or other health care? What happened?

13. If you have ever been in jail or prison, did you get a Pap test while you were there? If so, can you tell me about the last time you got a Pap test in those places – what was it like? Walk me through what happened.

• Why did you get it?

• What were the health care providers like?

• How did the health care provider explain why you needed the Pap test or what the results were?

• Do you have anything to say about how that care compares to care you usually get in the community

14. If you do use or have used drugs or alcohol in the past, was there ever a time when drug or alcohol use got in the way of your getting health care? Again, I’m especially interested in Pap tests, but any kind of health care is fine, too.

15. What advice would you give to a woman who wanted to get a Pap test? What would you tell her to do?

• What advice would you give to a woman who hasn’t had a Pap test and doesn’t want to get one?