Efficacy of an educational comic book for HPV vaccination information in Nigeria.

Abstract

e18577 Background: In Nigeria, cervical cancer is the second most common cancer in part due to disparities in education, access to screening, and access to treatment. In Nigeria, the HPV vaccine is planned for introduction into the public sector but will not be mandated. Given the preventable nature of the disease and need for public awareness, we developed an easy-to-understand teaching tool, the Global Oncology (GO) Comic Book focused on both general cancer education and about cervical cancer and HPV vaccination. Methods: The GO Comic Book is set in modern-day Lagos, Nigeria and aims to dispel myths and misconceptions associated with cancer in general and cervical cancer in particular. After developing the comic book, we developed a teaching guide and a plan for a pilot distribution of the comic book to students in Nigeria. In late 2019, GO and programmatic partners including the Clinton Health Access Initiative (CHAI), Cancer Education and Advocacy Foundation of Nigeria (CEAFON) and Panaramic Comics (based in Lagos, Nigeria) successfully conducted a pilot distribution of the GO Comic Book to nearly 5,000 students representing 18 junior secondary schools in Lagos and Rivers states. The comic books were distributed as part of 12 school assemblies which featured interactive, live-readings of the comic book by students and Nigerian physician volunteers. Pre-/post-tests with 9 questions were administered to a subset of the students (N = 202) to assess change in knowledge before and after the educational assemblies and data was analyzed using descriptive statistics. Results: The response rate of the 202 administered surveys was 98% (N = 198) with 193 female (97.5%) and 5 male (2.5%) respondents. Participants were an average of 11.2 years of age. All multiple-choice-type assessment items showed shifts to better-informed responses following the educational intervention. The item with the highest positive-percent change as assessed in the post survey queried: “what types of virus can cause cervical cancer?” (pre-test = 25.2%, post-test = 68.2%). The table below shows the cervical cancer related questions that were asked and the proportion of correct answers. Conclusions: The GO comic book in conjunction with school assemblies, improved the knowledge regarding cervical cancer causes and risk factors in Nigerian school children. Findings highlight the lack of knowledge regarding cervical cancer among the young population eligible for HPV vaccination, and describe an effective educational strategy in this setting.[Table: see text]