Improving Patient Education Materials for HPV Self-Collection: Insights from Women at High Risk of Developing Cervical Cancer

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Purpose: Women living with chronic conditions and/or living in poverty have a higher risk of developing cervical cancer compared to the general population due to lower rates of cervical cancer screening (CCS). Human papillomavirus (HPV) self-collection tests improve CCS rates in under-screened populations by reducing barriers. However, some women are concerned about the ability to adequately perform self-collected sampling for CCS. This study examined how existing HPV self-collection patient education materials can be enhanced to increase self-efficacy in self-collecting samples. Methods: We conducted three focus groups with 13 women living in zip codes associated with high poverty rates or chronic conditions in north central Florida. The Information-Motivation Behavioral Skills Model (IMB model) and the Patient Education Material Assessment Tool for Printable Materials (PEMAT-P) guided the focus group discussions. Focus group interviews were recorded and transcribed, and thematic analysis was used to analyze the data. Results: Opportunities for improvement included: (1) Information : Using simplified language, including HPV and cervical cancer information, clear explanations about mailing procedures, information on access and interpretation of results, and visual elements to increase user confidence in medical soundness and safety, (2) Motivation : offering the materials in various languages and balancing design for inclusion of all women, and (3) Behavioral Skills : enhancing visual aids through clear directions to instructional videos, use of zoomed-in images, and projecting variable female anatomy figure positions to illustrate proper device insertion to encourage actionability. Discussion: This study helps to bridge the gap in studies aimed at enhancing participation in HPV self-collection by examining opportunities to improve current HPV self-collection printed patient education materials and instructions among women with increased cervical cancer risk. Participants identified opportunities to enhance language, visual aids, and inclusivity – factors that may improve women’s confidence in self-collection and ultimately increase rates of CCS in underserved women. Keywords: HPV self-collection, cervical cancer screening, underscreened population, chronic diseases, patient education material

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