The human papillomavirus (HPV) is the most common sexually transmitted disease in the United States. There are over forty types of HPV affecting genital regions, including the cervix, and it can lead to cervical cancer. Vaccination against high-risk HPV types is crucial in preventing cervical cancer, yet disparities persist in vaccination uptake, particularly among low-income groups, further widening health inequalities.

Professor Jennifer Warren, the Qualitative Research Director from George Mason University, worked together with Dr. Suellen Hopfer and Emilia Fields from University of California, Sahana Natarajan from Center for African American Health Disparities Education and Research, Dr. Rhonda Belue from University of Texas, Professor Francis McKee from St. Andrew Development, Dr. Michael Hecht from REAL Prevention and Dr. Joel Lebed from Planned Parenthood Southeastern Pennsylvania to design a study aimed at revolutionizing HPV prevention and vaccination uptake among low-income women. The results are published in the peer-reviewed journal, PEC Innovation.

In an effort to enhance patient education and engagement, Professor Warren and colleagues sought to gather valuable insights into the design and communication strategies of a health kiosk stationed within Planned Parenthood facilities. Their mission was clear: to delve into women’s readiness to embrace such a kiosk as a source of HPV prevention information, alongside their willingness to receive QR codes and vaccine reminder text messages. By understanding these preferences, the study aims to adapt the design of the kiosk to effectively spread crucial information about HPV risks and vaccination benefits.  

To gain insight into the women’s preferences, Professor Warren and her team conducted semi-structured interviews at a Planned Parenthood center in Philadelphia’s Northwest suburbs. Adult participants, aware of their HPV vaccination status, were sampled from the center’s waiting room. The goal of the interviews was to probe the participants’ experiences with HPV vaccination and their perceptions of kiosk use and design, using open-ended questions.

“The study revealed high receptivity among low-income women who utilize Planned Parenthood services to using a kiosk to deliver HPV-related health information as well high receptivity to using QR codes to deliver vaccine text message reminders on smartphones and additional information via a website link. This is encouraging especially given that 100% of unvaccinated women participants were receptive to the health kiosk,” said Professor Warren. Ease of access, interest in health information and boredom alleviation were cited by the participants as the key motivators to use the health kiosk.

While participants supported various aspects of kiosk design and information presentation, they also offered some valuable suggestions for improvement, such as creating visually appealing designs and strategically placing the kiosk within the waiting room. They emphasized the importance of relatable narratives in kiosk videos, along with interactive features and transparent information curation. To address concerns about privacy and discomfort, participants proposed practical solutions like staff guidance, disposable earbuds, and privacy screens. QR codes were familiar to participants, which offers a promising avenue for reaching underserved communities beyond the health setting.

While the study provided crucial insights into designing the health kiosk to better HPV education and vaccine uptake among low-income women at Planned Parenthood, limitations included the lack of socioeconomic status disclosure and the study’s single-site nature. Professor Warren conclude: “This study highlights an example of how underserved, low-income populations visiting safety net health centers such as Planned Parenthood in the U.S. can be engaged in efforts that use digital health tools,” and that “digital health is a supplemental resource to traditional medical care, and can be optimized to reduce reproductive and cancer-related health disparities.” While privacy concerns and logistical barriers were acknowledged, overall reaction to the kiosk and digital features was promising, suggesting the potential of this innovative approach to bridge gaps in HPV education, awareness and vaccination uptake among low-income women accessing reproductive health services.

JOURNAL REFERENCE

Jennifer R. Warren, Suellen Hopfer, Emilia J. Fields, et al. “Digital HPV education to increase vaccine uptake among low income women.” PEC Innov., 2022.

DOI:  https://doi.org/10.1016/j.pecinn.2022.100111