Developing a Bilingual Fotonovela to Encourage Human Papillomavirus Preteen Immunization in California: A Case Study

Abstract

Background. Cervical cancer affects Latinas disproportionately in the United States, especially in California. Fotonovelas are an entertaining educational medium within the Latino community. Purpose. The California Department of Public Health, Immunization Branch partnered with a fotonovela production company to develop a bilingual fotonovela to motivate Latina mothers of preteens to get their children vaccinated against human papillomavirus (HPV). This paper reviews the process of and lessons learned from creating and pilot testing the HPV fotonovela. Methods. We convened a 10-member advisory committee to guide the development of the fotonovela and field-tested the medium with three focus groups of Latina mothers of preteens (n=22). The focus group participants completed a pre- and post-survey to assess knowledge gain after reading the fotonovela on their own. After participants completed the post-survey, the moderator facilitated a discussion. Results. The advisory committee identified barriers and myths around HPV vaccination and suggested culturally appropriate messaging for the fotonovela. The pre-/post-survey showed statistically significant knowledge gain on the HPV vaccine among focus group participants. Conclusion. We found that the fotonovela is a well-accepted educational vehicle for Latinas. An intervention/control study to test the effectiveness of a fotonovela and/or webnovela in bringing about measurable behavior change is needed.