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A Formal Evaluation of Existing Printed HPV Educational Materials A Formal Evaluation of Existing Printed HPV Educational Materials Heather M. Brandt,

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Presentation on theme: "A Formal Evaluation of Existing Printed HPV Educational Materials A Formal Evaluation of Existing Printed HPV Educational Materials Heather M. Brandt,"— Presentation transcript:

1 A Formal Evaluation of Existing Printed HPV Educational Materials A Formal Evaluation of Existing Printed HPV Educational Materials Heather M. Brandt, PhD, CHES 1 Donna H. McCree, PhD, MPH, RPh 2 Lisa L. Lindley, DrPH 3 Patricia A. Sharpe, PhD, MPH 1 1 University of South Carolina Prevention Research Center, Columbia SC USA 2 Centers for Disease Control and Prevention, Atlanta GA USA 3 Western Kentucky University, Department of Public Health, Bowling Green KY USA

2 Objective To formally evaluate existing, printed human papillomavirus (HPV) educational materials to determine (1) readability, (2) suitability, and (3) HPV content for women who have HPV or are at risk for HPV.

3 Background HPV is a common sexually transmitted infection Most women do not know they have high-risk HPV Abnormal Pap test and then HPV DNA test HPV is complex Test positive and then “clear” infection No critical evaluation of HPV educational materials has been published

4 Methods 21 HPV educational materials were identified for evaluation Content of educational materials included STD, abnormal Pap, cervical health materials that discussed HPV Sources of educational materials: American Academy of Family Physicians (AAFP), American College of Obstetricians and Gynecologists (ACOG), American Social Health Association (ASHA), American Society for Colposcopy and Cervical Pathology (ASCCP), Channing Bete, Digene Corporation, ETR, Krames, National HPV & Cervical Cancer Campaign, Navy Environmental Health Center, Planned Parenthood, Kaiser Family Foundation, National Cancer Institute, SC Dept. of Health and Environmental Control

5 Methods Three independent evaluators Familiar with HPV and tenets of designing health messages and materials development Scores from three evaluators were averaged Readability assessment Suitability Assessment of Materials (SAM) HPV content assessment

6 Methods Readability Assessment SMOG (Simplified Measure of Gobbledygoop) Formula to assess reading grade level of a written sample Fry formula Formula to assess reading grade level of a written sample Preferred method of Doak, Doak, & Root (1996)

7 Methods Suitability Assessment of Materials (SAM) Doak, Doak, & Root (1996) Structured approach to evaluating materials Each item is scored 2 = Superior, 1 = Adequate, 0 = Not suitable, NA = Not Applicable Scored items are totaled and divided by total possible (excluding NAs) SAM Rating 70-100% Superior material 40-69% Adequate material 0-39% Not suitable material Total scores for three reviewers were averaged

8 Methods Content Purpose Behavioral content Scope Review Literacy Demand Reading grade level Writing style Vocabulary Graphics Purpose Explanations Layout and Typography Subheadings Learning Stimulation/ Motivation Interaction Modeled behaviors Motivation Cultural Appropriateness Cultural images and examples Suitability Assessment of Materials

9 Methods HPV Content Assessment 12 important educational messages were identified Selected materials were reviewed for inclusion of this information and explanation Each of the 12 messages was scored 3 = Adequately explains, 2 = Somewhat explains, 1 = Does not explain, 0 = Information not included in brochure Total score divided by 36 Total scores for three reviewers were averaged

10 Methods HPV is sexually transmitted HPV is a virus HPV is common Two types: high-risk and low-risk HPV may cause cervical cancer HPV causes genital warts HPV may cause abnormal Pap test HPV may affect pregnancy HPV treatment HPV is spread via skin-to-skin contact Condoms do not always prevent Important to have regular Pap tests Content Assessment Messages

11 Results: Readability Grade LevelSMOGFRYAVE <7<7061 8134 9614 10432 11243 12403 13100 14000 15111 >16233 n=21 Range: SMOG8-16 FRY5-17 Ave7-17

12 Results: Suitability SAM scores 0-39% = Not suitable 40-69% = Adequate 70-100% = Superior Mean: 28% (Not suitable) Range: 14 - 49% Not Suitable AdequateSuperior 1560

13 Results: Suitability Content Lacked clear purpose Too limited or too broad of scope Lack of summary to reinforce important messages Literacy demands “Medical terms” often used and not explained Graphics Seemed out of place or irrelevant Did not add to the material

14 Results: Suitability Layout Detracted from messages Overall design not appealing Learning Stimulation / Motivation Lack of focus on behavior Limited interaction Cultural Appropriateness Not addressed in majority Lack of cultural images and examples

15 Results: HPV Content 12 important messages Mean: 63% Range: 32 – 93% Absent or not well explained messages Two types of HPV: High-risk and Low-risk Treat signs and symptoms not virus May affect pregnancy Transmission skin-to-skin contact Condoms not always effective

16 Results Not Suitable AdequateSuperior Number of Materials 1560 Average Readability 12 th 8 th N/A Ave. Readability Range 6 th – 17 th 5 th – 10 th N/A Ave. HPV Content Score 69%46%N/A SAM Score

17 Results Publications scored as “adequate” American Social Health Association A Practical Guide for the Tongue-Tied: How to talk with your health care provider about HPV and STDs Channing Bete Genital Warts and HPV: What you need to know Krames HPV and Genital Warts HPV: Understanding this common virus American Academy of Family Physicians Pap Smears: What they are and what the results mean STDs: Common symptoms and tips on prevention

18 Discussion Reading levels were too high Design not appealing Limited focus on behavior Increased HPV content = Decreased readability Lack of summary “Generic” information could be confusing

19 Recommendations Improvements to HPV educational materials are needed to improve readability, suitability, and HPV content Active involvement of target audience Enhance cultural diversity and relevance Women need access to materials that are appropriate and accurate with clear, simple language

20 Acknowledgment This project was supported under a cooperative agreement from the Centers for Disease Control and Prevention (CDC) through the Association of Schools of Public Health (ASPH). Grant Number U36/CCU300430-22. The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of CDC or ASPH.


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