May Rose Dela Cruz, DrPH,
Jo Ann Tsark, MPH,
John Chen, PhD.,
Kathryn Braun, DrPH
â€˜Imi Hale Native Hawaiian Cancer Network and University of Hawaiâ€˜i at MÄnoa, John A. Burns School of Medicine and Department of Public Health Sciences
No localized brochure for the HPV vaccine exists for parents in Hawaiâ€˜i. The objectives of this study were to develop a local HPV vaccine brochure for parents and test it locally for attractiveness, comprehension, and impact on vaccination status.
As part of a Hawaiâ€˜i study to better understand how parents make decisions about vaccinating their children with the HPV vaccine, a brochure for parents was developed. A participatory four-step protocol was used to develop and test attractiveness, acceptability, messenger effectiveness, personal relevancy, and readability. Steps include: 1) Draft a brochure using information from a literature review and parent interviews, 2) Ensure accuracy of health information through physicians review, and request endorsement of physicians regarding their intent to use/distribute, 3) Test the brochure with the target population, 4) Finalize and seek endorsement from medical associations and identify venues for dissemination. A sample of 20 parents participated in step 1, eight physicians in step 2, and 52 parents in step 3. Currently, step 4 is being conducted with local physician organizations.
In step 1, interviews with 20 parents revealed that they felt a physicianâ€™s recommendation and health materials about the vaccine were important to assist parents with deciding to vaccinate their children with the HPV vaccine. Feedback from eight physicians in step 2 was positive overall and led to the inclusion of a section on the importance of the vaccine for boys. In step 3, 52 parents with 11-18 year olds participated in a mailed survey to evaluate the brochure. In that group, 36 parents (69% of 52) had children that were vaccinated and 16 parents (31% of 52) had no children who had been vaccinated with the HPV vaccine. Nearly all parents (over 90% of 52) responded positively to the brochure. Parents found the brochure easy to read, felt it was appropriate for parents, and, liked the testimonies, especially the testimony of a family with vaccinated children. Respondentsâ€™ feedback on recommended changes included comments on the brochureâ€™s color and format.Based on learner verification measures, nearly all parents (over 90% of 52) in this group were able to articulate the importance of the HPV vaccine for both girls and boys and that the vaccine prevented some cancers. All parents stated that they would share the brochure with their provider and other parents.
The developed brochure filled a gap in HPV vaccine education for Hawaiâ€˜iâ€™s parents of adolescents. The four-step protocol led to extensive participation from the intended audiences (parents and physicians) and assured the brochureâ€™s attractiveness, acceptability, messenger effectiveness, personal relevancy, and readability.