Online narrative video as an effective tool to increase Pap test completion among Latinas along the border

BY Jessica Calderón-Mora

Although rates of cervical cancer and related deaths have decreased drastically over the past 80 years, rates are still higher among Latinas compared to non-Hispanic white women. This is a result of Latinas having lower cervical cancer screening completion rates because of difficulty accessing healthcare (i.e. lack of transportation, inability to take time off from work, or finding childcare), fear of being diagnosed with cancer, language differences with provider, and embarrassment. Cervical cancer screening, also known as the Pap test, not only detects cervical cancer, but can also prevent cervical cancer by detecting abnormalities before they become cancerous. Narrative videos with relatable cultural storylines, infographics with statistical information, and motivational messages have been found to be effective at increasing knowledge about cervical cancer and motivating women to complete their Pap smear.

Most narrative videos related to cervical cancer have been delivered in-person and mostly among non-minority groups. Therefore, our study evaluated the effect of a cervical cancer-focused narrative video delivered online in a Texas-Mexico border county that is predominantly Latinx.

We recruited women who were at least 18 years old, were not enrolled in our Evidence-Based Cancer Control Program, De Casa en Casa, could read and understand either English or Spanish, and had internet access. Participants were provided a link and QR code to our study, which was completely online. The participant first chose their preferred language – either English or Spanish, then they completed the pre-test. The 74-item survey had items related to previous Pap smears, knowledge about cervical cancer and Pap smears, and attitudes (e.g. how serious they think cervical cancer is, if they think are susceptible to developing cervical cancer, barriers and benefits to being screened, and if they think people important to them would want them to be screened). Once they completed the pre-test, they were then shown the 17-minute narrative video that begins with a conversation between two young Latina friends discussing their sexual relationships and having a Pap test. Infographics then appear with narration discussing how cervical cancer develops. One of the friends then talks about how a Pap test is done and the infographics and narration explain how many women get cervical cancer and how many survive. The two friends continue their conversation and one of friend’s mother and grandmother joins them. They discuss myths surrounding Pap smears and reasons why women do not get screened. This is followed by another infographic on current screening guidelines. The video ends with one of the friends recognizing the importance of the Pap test and agreeing to schedule her appointment. As soon as the video ends, the participant was asked to complete the post-test. This 59-item survey asked the participants to rate their satisfaction with the video and then to answer the knowledge and attitude questions again to see if anything changed after watching the video.

We had 227 women complete both the pre- and post-test. Most of the women had heard about cervical cancer before and had completed a Pap test in the past. Our analysis found that their knowledge did increase slightly after watching the video, but not significantly. All of the attitude scores did change significantly in the direction we hoped after watching the video, so women reported cervical cancer being serious, found Pap tests to be beneficial, and reported less barriers to getting a Pap test. The vast majority of the participants rated all satisfaction items as good or excellent and reported that information was easy-to-understand, useful, and helped to lower their anxiety about getting a Pap test.

Implications for future interventions and studies promoting cervical cancer screening.

Our study found that narrative videos delivered online are an effective tool at increasing awareness of cervical cancer and the the Pap test and can improve the screening completion rates in areas with high cervical cancer rates. Findings from our study suggest that these types of videos can be shown in community clinic waiting rooms to provide widespread education and ultimately reduce cervical cancer in the Latina population.

Article details

Evaluation of a Narrative Video to Promote Prevention and Early Detection of Cervical Cancer Among Latinas
By Jessica Calderón-Mora, Adam Alomari, Theresa L. Byrd and Navkiran K. Shokar
First Published: September 22, 2021
DOI:10.1177/15248399211038943
Health Promotion Practice

About the Author

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Jessica Calderón-Mora, DrPH, is an Assistant Professor in the Department of Population Health and Director of Operations for the Cancer Prevention and Control Research Program within the Livestrong Cancer Institutes at the University of Texas at Austin Dell Medical School. Her work focuses on health disparities related to cancer prevention, the development of interventions, and community-engaged research investigating colorectal and cervical cancer and HPV vaccination in underserved communities, namely the Latinx population. She is a Certified Community Health Worker Instructor and has worked with promotores, or community health workers, for the past 20 years. Dr. Calderón-Mora also has extensive experience in diversity, equity and inclusion, notable work in this area incudes service as an implicit bias training instructor.