Development and Production of a Theory-Based, Audience Centered HPV Vaccine Promotion Comic Book for East African Adolescents

Abstract

HPV vaccine uptake is suboptimal among East African adolescents. We describe the development and production of a theory-based, audience centered HPV vaccine comic book for East African adolescents. We held three focus groups with East African immigrant mothers in King County, Washington (n=30) to identify themes and suggestions to inform comic book production. We conducted message mapping to bridge focus group themes, theoretical constructs, message objective, and message appeal. Finally, we embedded the theory-based messages into the story script and gathered input from community members on cultural appropriateness. The comic book incorporated emerging themes from the focus groups including mothers’ preference that comic book characters resemble members of their community; resonance with the social connections between the adolescent main character and her social network including adolescent-teacher, adolescent-peers, adolescent-mother, and adolescent-grandmother; integration of emotion through humor; and information needs. The story highlighted information about HPV infection and transmission, vaccine benefits, and risks. The story consisted of three scenes: 1) adolescent HPV vaccine education by a health professional at school; 2) discussion of HPV vaccine beliefs and experiences among a group of adolescent peers; and 3) communication with their mothers about HPV vaccine and intent for vaccination. Through this formative research process we identified suggestions linked to larger established themes regarding HPV vaccine and used them to produce a comic book for East African adolescents. Ongoing testing will assess acceptability and impact of the comic book on HPV vaccine knowledge, vaccination intention, and vaccine uptake.