Presentation on theme: "A Formal Evaluation of Existing Printed HPV Educational Materials Heather M. Brandt, PhD, CHES1 Donna H. McCree, PhD, MPH, RPh2 Lisa L. Lindley, DrPH3."— Presentation transcript:
1 A Formal Evaluation of Existing Printed HPV Educational Materials Heather M. Brandt, PhD, CHES1 Donna H. McCree, PhD, MPH, RPh2 Lisa L. Lindley, DrPH3 Patricia A. Sharpe, PhD, MPH1 1University of South Carolina Prevention Research Center, Columbia SC USA 2Centers for Disease Control and Prevention, Atlanta GA USA 3Western Kentucky University, Department of Public Health, Bowling Green KY USA
2 ObjectiveTo formally evaluate existing, printed human papillomavirus (HPV) educational materials to determine(1) readability,(2) suitability, and(3) HPV contentfor 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 HPVAbnormal Pap test and then HPV DNA testHPV is complexTest positive and then “clear” infectionNo critical evaluation of HPV educational materials has been publishedCDC estimates about 5 million men and women acquire a genital HPV infection each yearHigh-risk types – higher risk for cervical cancerLow-risk types – visible genital wartsPersistent HPV infection is greatest concern for progression to cervical cancerImmune system can “clear” infectionImportant information that women need to know…complexities of HPV may not be able to be explained during brief patient-provider encounter, so supplementary materials are important for women to have access to reliable and appropriate information
4 Methods 21 HPV educational materials were identified for evaluation Content of educational materials included STD, abnormal Pap, cervical health materials that discussed HPVSources 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 developmentScores from three evaluators were averagedReadability assessmentSuitability 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 sampleFry formulaPreferred method of Doak, Doak, & Root (1996)
7 Methods Suitability Assessment of Materials (SAM) Doak, Doak, & Root (1996)Structured approach to evaluating materialsEach item is scored2 = Superior, 1 = Adequate, 0 = Not suitable, NA = Not ApplicableScored items are totaled and divided by total possible (excluding NAs)SAM Rating70-100% Superior material40-69% Adequate material0-39% Not suitable materialTotal scores for three reviewers were averaged
8 Methods Suitability Assessment of Materials Content Literacy Demand PurposeBehavioral contentScopeReviewLiteracy DemandReading grade levelWriting styleVocabularyGraphicsExplanationsLayout and TypographySubheadingsLearning Stimulation/ MotivationInteractionModeled behaviorsMotivationCultural AppropriatenessCultural images and examples
9 Methods HPV Content Assessment 12 important educational messages were identifiedSelected materials were reviewed for inclusion of this information and explanationEach of the 12 messages was scored3 = Adequately explains, 2 = Somewhat explains, 1 = Does not explain, 0 = Information not included in brochureTotal score divided by 36Total scores for three reviewers were averaged
10 Methods Content Assessment Messages HPV is sexually transmitted HPV is a virusHPV is commonTwo types: high-risk and low-riskHPV may cause cervical cancerHPV causes genital wartsHPV may cause abnormal Pap testHPV may affect pregnancyHPV treatmentHPV is spread via skin-to-skin contactCondoms do not always preventImportant to have regular Pap tests
13 Results: Suitability Content Literacy demands Graphics Lacked clear purposeToo limited or too broad of scopeLack of summary to reinforce important messagesLiteracy demands“Medical terms” often used and not explainedGraphicsSeemed out of place or irrelevantDid not add to the materialThese are some of the reasons, in general, why a material scored low on these items.
14 Results: Suitability Layout Learning Stimulation / Motivation Detracted from messagesOverall design not appealingLearning Stimulation / MotivationLack of focus on behaviorLimited interactionCultural AppropriatenessNot addressed in majorityLack of cultural images and examples
15 Results: HPV Content 12 important messages Mean: 63% Range: 32 – 93% Absent or not well explained messagesTwo types of HPV: High-risk and Low-riskTreat signs and symptoms not virusMay affect pregnancyTransmission skin-to-skin contactCondoms not always effective
16 Results SAM Score Not Suitable Adequate Superior Number of Materials 156Average Readability12th8thN/AAve. Readability Range6th – 17th5th – 10thAve.HPV Content Score69%46%Increasing scores on HPV content assessment were at the expense of readability in some cases
17 Results Publications scored as “adequate” American Social Health AssociationA Practical Guide for the Tongue-Tied: How to talk with your health care provider about HPV and STDsChanning BeteGenital Warts and HPV: What you need to knowKramesHPV and Genital WartsHPV: Understanding this common virusAmerican Academy of Family PhysiciansPap Smears: What they are and what the results meanSTDs: Common symptoms and tips on preventionASHA: Ave RL 8.5, SAM 46%, Content 60%Channing Bete: Ave RL 7, SAM 44%, Content 46%Krames (1): Ave RL 7.5, SAM 49%, Content 65%Krames (2): Ave RL 8, SAM 41%, Content 40%AAFP (1); Ave RL 8, SAM 40%, Content 32%AAFP (2): Ave RL 9, SAM 43%, Content 35%
18 Discussion Reading levels were too high Design not appealing Limited focus on behaviorIncreased HPV content = Decreased readabilityLack of summary“Generic” information could be confusing
19 RecommendationsImprovements to HPV educational materials are needed to improve readability, suitability, and HPV contentActive involvement of target audienceEnhance cultural diversity and relevanceWomen need access to materials that are appropriate and accurate with clear, simple language
20 AcknowledgmentThis 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/CCU The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of CDC or ASPH.