Each year, nearly 14 million Americans become infected with human papillomavirus (HPV), a sexually transmitted infection that can cause cancer. While there is a vaccine against the virus, vaccination rates in the United States are disappointingly low, particularly among Hispanics. To raise awareness about HPV vaccination, our research team created a fotonovela, or a photographic short story similar to a comic book. Particularly in Spanish-speaking communities, fotonovelas are popular sources of health information because they are educational, yet highly entertaining—in which educational messages are placed within dramatic “soap opera” scripts.

Fig. 1. Sample scenes from fotonovela about the diseases associated with HPV infection, information about the HPV vaccine, and the male burden of HPV disease.

Written in English and Spanish at a sixth-grade reading level, our fotonovela, “What You Don’t Know,” tells the story of a young Hispanic woman who learns the importance of being vaccinated against HPV while in a committed relationship. The fotonovela specifically targets female and male adolescents and young adults because a large proportion of this population remains unvaccinated due to missed opportunities.

To evaluate the fotonovela, 41 young adults, aged 18-26 years old, in Southern California, were enrolled in our study. Most of the participants were female (78%) and Latino/Hispanic (93%). The effectiveness of the fotonovela was evaluated based on the following criteria: entertainment value, educational quality, readability, changes in attitudes and intentions towards HPV vaccination after reading the fotonovela, and gains in knowledge.

Overall, the majority of participants, regardless of race and sex, found the fotonovela to be entertaining, educational and easy to read. After reading it, many realized their risk of getting the infection was significantly higher than they had originally anticipated. Nearly 82% of readers planned to get vaccinated themselves, and 90% would encourage others to get vaccinated too. The most commonly reported takeaway lessons from the fotonovela were the risk of HPV infection despite condom use and current relationship status, the 3-dose vaccine administration schedule, and the burden of infection among males.

In summary, the results were promising because they demonstrate that our fotonovela can be a powerful vehicle for HPV education, particularly among Hispanics. To our knowledge, there is no other narrative-based HPV vaccination educational intervention that target Hispanic young adults.

Alvin Chan, MDc, MPHc
University of California, Irvine School of Medicine
Irvine, USA

Publication

Evaluation of fotonovela to increase human papillomavirus vaccine knowledge, attitudes, and intentions in a low-income Hispanic community
Chan A, Brown B, Sepulveda E, Teran-Clayton L.
BMC Res Notes. 2015 Oct 29;8:615

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