Reaching Latina Mothers of Preteens Developing a fotonovela on HPV and Cervical Cancer Prevention

A review of the literature reveals that in California, Latina women have the highest rate of cervical cancer incidence and are two times more likely than non-Latina white women to be diagnosed with cervical cancer. In addition, cultural influences contribute to barriers in getting routine pap screenings, including shame. Moreover, during initial focus groups, Latina mothers of preteens expressed concern that getting their daughters vaccinated against HPV might encourage early sexual promiscuity. Our key messages addressed getting women to seek a pap test and to get their preteens vaccinated against HPV.

Fotonovelas are a staple fixture in Latino communities. Their dramatic storylines mimic Spanish-language "telenovelas." Familiarity with this medium provides an optimum vehicle for transmitting education content, embedded in an approachable and entertaining format. Using guidance from the literature and preferences of our target population, photos (rather than illustrations) were used to appeal to a newer immigrant population. Important characters included "comadres" (close friends), a wise grandfather, a dubious husband, and authoritative pediatrician.

The publication was developed in consultation with an expert team of health educators and clinicians, the majority bilingual and bicultural. The team worked to incorporate key messages into the story, while ensuring a low reading level. Focus groups, held in English and Spanish, tested understanding of the messages and vocabulary. 100% of focus group participants reported knowledge gain using a pre- and post-test. Acquired knowledge included "what does the HPV vaccine prevent?," "how many shots are needed?," and "is the vaccine available for both boys and girls?".