Design and efficacy of a multilingual, multicultural HPV vaccine education intervention

Abstract

Background

The human papillomavirus (HPV) is the precursor and the single, most important risk factor for cervical cancer. It is also the most commonly sexually transmitted infection in the United States. An estimated 20 million persons are currently infected with the virus, with an estimated 6 million new infections occurring annually and 12 000 new cervical cancer cases and 4 000 cervical cancer deaths annually. The HPV vaccine is thus an especially important preventive measure for racial/ethnic groups who bear an unequal burden of cervical cancer mortality.

Purpose

This study aimed to develop a culturally and linguistically appropriate intervention to educate and empower Latino and Korean American parents to make an informed HPV vaccination decision for their minor children.

Methods

A parent-focused HPV vaccine education DVD was developed through focus groups and cognitive interviews with Latino and Korean American parents of children ages 11–17. A randomized controlled efficacy trial was subsequently conducted with 708 Latino and Korean American parents to assess knowledge gains, decisional conflict, decision self-efficacy, and informed decision-making resulting from viewing the intervention DVD.

Results

Differences between treatment and control groups for pre-post changes in knowledge, informed decision-making, and decisional conflict were statistically significant among the parents exposed to the education intervention DVD.

Conclusion

The study demonstrated that a culturally and linguistically appropriate intervention DVD designed to educate parents about the risks and benefits of the HPV vaccine promoted informed decision-making regarding HPV vaccination among at-risk populations.

Keywords:

• Ethnic groups
• Hispanic Americans
• Korean Americans
• Papillomavirus vaccine
• Parents
• United States
• Uterine cervical neoplasms
• Vaccination

Additional information

Notes on contributors

Armando Valdez

Armando Valdez is the corresponding author and principal investigator of the study. He is a health communication expert with considerable experience developing multilingual and multicultural health education interventions designed for communities of color, and subsequently conducting efficacy evaluations of those interventions. He previously taught at several California universities, directed a research center at Stanford University and managed HealthPoint Communications, a research institute devoted to developing and evaluating health promotion and health literacy education interventions.

Susan L. Stewart

Susan L. Stewart, a biostatistician and statistics professor assumed responsibility for the data analysis and interpretation of the study data.

Sora Park Tanjasari

Sora Park Tanjasiri, a behavioral scientist specializing in health promotion, provided advice and assisted with data analysis.

Alvaro Garza

Vivian Levy and Alvaro Garza, board-certified medical doctors and researchers, provided advice and vetted the intervention materials for medical accuracy; they also co-authored an animated (motion graphics) segment of the intervention that described in lay terms how human immunization works.