University of Kentucky faculty from the College of Public Health, College of Communication and Information, and Rural Cancer Prevention Center collaborated on the development and implementation of a DVD intervention designed to promote the completion of the human papillomavirus (HPV) vaccination series among young women in Appalachian Kentucky. Their work is funded through the Prevention Research Centers program of the Centers for Disease Control and Prevention. Cervical cancer, a disease that is both preventable and screenable, remains a national public health concern, particularly for women in medically underserved communities, such as those in Appalachian Kentucky. The most common prevention strategy is the three-dose HPV vaccine. However, despite the availability of the HPV vaccine, evidence suggests young women are simply not completing the entire vaccination series as recommended for full cervical cancer prevention.
Dr. Robin Vanderpool, assistant professor in the department of health behavior and corresponding author for the project reported that, “Getting these young women in the door for the first [HPV vaccine] dose is only half the battle. The challenge is staying engaged with the patient through the six-month vaccination schedule. We wanted to focus on helping these women finish all three doses and follow-up with age-appropriate screening [Pap testing].” So, the idea of “1-2-3 Pap” was created. After talking with young women from the community to understand barriers to vaccination and Pap testing, Dr. Elisia Cohen, associate professor in the department of communication, developed a 13-minute DVD message using local ‘stars’ from Appalachian Kentucky. Young women, healthcare providers, and a local news reporter were recruited from the community to deliver salient messages throughout the video.
The video targeted women ages 18-26 years old, and encouraged them to make their own choice about completing the vaccination series. The research team partnered with nurses from local health departments and set up free vaccine clinics at popular locations, such as Wal-Mart, community colleges, and seasonal festivals. The video was shown to a randomized group of young women after receiving the first dose of the vaccine, and followed-up with standard reminder phone calls for the remaining doses.
The researchers were impressed to find that the DVD worked. Young women enrolled in the DVD intervention were 2.5 times more likely to complete the HPV vaccine series compared to women receiving standard-of-care (reminder phone calls only). More importantly, these results translate to fewer women being at risk for cervical cancer. The research team is looking forward to seeing this effect in similar campaigns. “These findings can be replicated for other populations, and scaled to fit statewide or even national campaigns,” said Dr. Vanderpool. “We are excited to see how this can impact the health of other communities.”
The “1-2-3 Pap” video is available on YouTube.
[Photo: Dr. Robin Vanderpool]