Development of culturally appropriate educational materials on HPV and Pap tests for American Indian women

Background: Culturally appropriate educational materials regarding human papillomavirus (HPV) and cervical health are an important part of patient education for cervical cancer prevention.

Purpose: The purpose was to develop patient education materials in partnership with clinicians at an American Indian women's clinic and to pretest the materials among women attending the clinic for content, appearance, format, and suitability.

Methods: Clinic staff of the Cherokee Women's Wellness Center and the researchers developed interview questions and reviewed existing materials on cervical health. Based on interview results with women patients and results of materials review, content was drafted for a brochure on HPV, Pap tests, and cervical health. In partnership with the Eastern Band of Cherokee Indians' (EBCI) graphic artist, three trial brochures were created. Brochures were pretested via in-depth interviews.

Results: Clinic staff interviewed 32 women regarding their understanding of HPV and Pap test results and cervical cancer. Key themes focused on women's feelings about and reactions to abnormal Pap tests and HPV and desire to learn more regarding cause, effects, and treatment. Nine or the 32 women completed a second interview to critique the brochure's meaning, clarity, format, appearance, appeal, comfort level, and cultural relevance. Brochures were revised based on patients' and clinicians' input. Content from the brochure was used to create a matching poster.

Discussion: A research partnership among university and CDC researchers and the EBCI resulted in culturally appropriate educational materials that will support patient-clinician communication.