Barriers to prevention and early detection of cancer among the socioeconomically disadvantaged are important areas for public health focus. A community coalition was established in North York, Ontario, to identify a suitable primary prevention initiative, cervical screening among young women of lower economic status. Two pilot communities were selected for the project. Community members, key informants and service providers participated in a series of individual and focus group meetings to identify barriers that impede cervical screening. The benefits and challenges of such a project will be importance to practitioners eager to work collaboratively on primary prevention initiatives. This article will be of interest to nurses wanting to foster a community coalition approach to program design, planning, implementation and evaluation. It will also assist nurses with utilizing needs-based assessment in their work. Although the findings relate to a population of women in a large urban centre, the results will be useful for nurses and other health professionals planning to engage in work related to cervical screening.