Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.
Introduction: Graphic medicine, the utilization of comics to communicate medical information, is an emerging approach aimed at increasing health literacy. The effectiveness of this strategy in promoting HPV vaccination literacy within pediatric populations has not yet been studied. Despite the increase in the incidence of HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) over recent decades, public awareness regarding the association of HPV with head and neck cancer remains low. Bridging this knowledge gap through targeted graphic medicine educational interventions for parents and caregivers may increase HPV vaccination rates among children and adolescents. In this study, we introduced a concise graphic medicine-based educational intervention during routine pediatric otolaryngology clinic visits, to enhance awareness of the link between HPV and oropharyngeal cancer. Our objective was to assess the feasibility of this intervention and to evaluate its efficacy in improving caregiver and patient understanding of the role of HPV in head and neck cancer.
Methods: Participants for the study included patients from the ages of 8 to 18 years who visited the Pediatric Otolaryngology Clinic at Yale New Haven Hospital from 3/5/2024 to 10/29/2024. Upon arrival to the clinic, patients and/or their caregivers completed a pre-intervention questionnaire. An educational graphic poster was hung on the door of the exam room. Before the visit with the otolaryngologist, participants were also provided with a comic pamphlet in the exam room that outlined HPV exposure risks and the association between HPV and oropharyngeal cancer. After the visit, participants completed a post-intervention questionnaire designed to assess knowledge and attitudes toward HPV vaccination. The pre- and post-intervention scores for knowledge and attitude were analyzed using mean and standard deviation calculations in Microsoft Excel.
Results: 100% of participants read the graphic medicine pamphlet that was left in the exam room. Before reading the handout, 76.9% of patients’ caregivers had heard about the HPV vaccine, but only 30.8% were able to state what kind of cancer(s) HPV was associated with. When the pamphlet was in the room during the patient’s visit, 76.9% of participants said they learned something new about HPV, despite only 7.7% of participants stating that HPV was discussed during the otolaryngology visit.
Discussion: Our study demonstrates an opportunity for improvement in patient and caregiver education regarding HPV vaccination in the pediatric population. The findings suggest that a simple intervention, involving an educational graphic medicine pamphlet regarding HPV vaccines, may increase patient awareness of HPV’s role in oropharyngeal squamous cell carcinoma (OPSCC), even if this topic is not discussed directly with the otolaryngologist during the otolaryngology visit. Additionally, this is the first study to date to validate the role of graphic medicine in patient education in this domain. Pediatric and adult otolaryngologists should consider integrating similar educational strategies into their routine practice to boost public understanding of HPV and its association with oropharyngeal cancer, promote HPV vaccination, and ultimately lessen the prevalence of HPV-related diseases.