Evaluation of a patient educational brochure to increase knowledge of cervical cancer screening among women living with HIV in La Romana.

backgroundCervical cancer is among the most preventable human malignancies, yet it’s the second leading cause of cancer death among women in the Dominican Republic. Among those who are most at risk for cervical cancer are women living with HIV (WLH) who face a six-fold increased risk compared to the general population. Given patient barriers to uptake of cervical cancer screening, we created a patient-facing brochure on cervical cancer to be distributed within a clinic, Clínica de Familia, which serves WLH in La Romana, Dominican Republic. The goals of this paper are to summarize the findings of cognitive interviews conducted with women evaluating the brochure to assess the acceptability and perceived usefulness of this approach and provide recommendations for future educational materials on cervical cancer that can adequately address knowledge gaps among WLH and facilitate patient self-advocacy in a clinical setting.

methodsWe conducted cognitive interviews with 30 WLH at Clinica de Familia La Romana to examine the clarity of language, emotional reactions, and visual design, as well as the cultural adaptation of an educational brochure on cervical cancer screening and prevention. Interviews were analyzed through thematic analysis. Findings were guided by Health Information Technology Evaluation Model and Patient Education Materials Assessment Tool.

resultsParticipant age ranged from 20 to 59 years with an average of 41 years (SD ± 11). The highest proportion of women (N = 9; 31%) reported that elementary school was their highest education level. Key qualitative findings included preference for different colors and styles, the need for more graphics to promote understanding and retention of information, and requests for further details about prevention methods. Positive feedback indicated printed learning materials in a clinical setting are a feasible way to share crucial information to support clarity, reactions, and design of patient educational material.

conclusionsThese findings will help guide future iterations of this brochure for distribution to WLH to promote cervical cancer screening. Future research should assess whether educational brochures lead to sustained health literacy about cervical cancer. Providers’ perspectives should be explored to understand how educational materials can be integrated into routine clinical practice and patient education. CLINICAL TRIAL NUMBER: Not applicable.