The participants were questioned about the types of HPV materials they would need or use in their practices. In addition to probing about the pocket guide tested during the interview, the moderators asked about a variety of other materials CDC could produce, such as a patient counseling tip sheet or memo pad.
The most requested items overall were a Web site, algorithm wheel/chart, tip sheet, memo pad, and patient materials. Nurse practitioners and registered nurses were also very interested in the toolkit option. The participants were very interested in materials to help them counsel patients, HPV Health Care Provider Materials Testing Report 46
as well as to give to patients to prompt a discussion or use during a discussion. Although the poster was not a popular item, many participants said they wanted a version of the algorithm to place on the wall or in an exam room. Several providers, particularly physicians, also requested a small, laminated version of the algorithms. Other suggestions for new materials from
registered nurses included a laminated pocket card with counseling tips and a videotape for patients.
The preferences for materials only varied slightly by provider type. The physicians generally preferred the Web site, algorithm wheel or chart for the wall, and a tip sheet; while the nurse practitioners preferred the patient materials, memo pad, Web site, algorithm wheel/chart, and tip sheet. The registered nurses were most interested in the algorithm wheel/chart, toolkit, and tip sheet.
1. Pocket Guide
Participants first were asked whether they would use the information they just evaluated in a pocket guide format, and what qualities the guide would need to encourage them to keep the material rather than discard it. Most participants said they would keep and use the material tested, and were enthusiastic about having it. Only a few physicians stated they would not be interested in keeping it due to the large amount of materials they already have. However, the pocket guide format was one of the least popular material options among all participants, who were more interested in using the material as a reference guide or keeping it in exam rooms than carrying it around in their pockets.
A few physicians and nurse practitioners liked the idea of the pocket guide. None of the registered nurses requested it, but said they would keep the material and use it as a reference piece. In particular, several registered nurses said they would keep it if it contained patient counseling information or other information to share with patients.
➢ “Our pockets are only so big. There’s too many pocket-sized things. So, no, I wouldn’t use
it.” (Physician, Caucasian patient population) 2. Other Materials
i. Algorithm/Decision-tool Wheel or Chart. The participants were asked whether they would
use an algorithm or a decision-tool wheel or chart in their practice. Most participants (26 of 27) said they would use this type of material, particularly if they could post it on the wall in the patient exam rooms. As mentioned above, several providers requested a small, sturdy, laminated pocket card with the algorithms. The respondents expressed a need for a durable tool that could also be used to share information with patients.
➢ “…[algorithm charts] would be better if they were flowcharts that were able to be put on a
chart for the wall in the exam room.” (Physician, Asian American patient population)
➢ “I like the idea of the laminated algorithms. Those are really helpful.” (Nurse Practitioner,
Hispanic patient population)
ii. Patient Brochures. The participants were asked if they would use patient brochures, and
whether the brochures would need to take into account literacy levels or cultural issues. The patient brochures were extremely popular, with 28 participants requesting them. The participants noted that they are always looking for useful patient materials. In particular, several nurse
practitioners requested shorter, one-page brochures for patients that contain a bullet-point format and are easier to read than a typical patient brochure.
Low-literacy Materials: Almost all participants noted a need for low-literacy materials.
Although the exact level of literacy requested varied considerably both across and within
provider types – and ranged from elementary school to high school – all agreed that it should be at or below high school-level.
One Hispanic nurse practitioner requested separate materials for her lower-literacy Hispanic populations than for higher-income patients, noting that the higher-income patients would want more statistical, complex information.
Culturally sensitive Materials/Languages: Many participants acknowledged a need for materials
translated in other languages. Spanish was the language most requested, when one was specified. Other specific requested languages were Chinese, Hmong (Cambodian), Farsi, and Hebrew.
In addition, physicians serving Native Americans and Asian Americans specifically noted a need for culturally sensitive and multilingual materials. One registered nurse, who works with an African-American population, said she’d like to see more races represented in the material, especially Native Americans, African Americans, and Hispanics.
➢ “…we’d like to see different races in anything we get. There’s not that many brochures or
literature that are out that are mainly specific to Native Americans. So, if there’s some way to develop these brochures that are specific to Native Americans and for African Americans or the Hispanics that would really help us out.” (Registered Nurse, African-American patient population)
➢ “It should be in a variety of different languages. The literacy level should be fairly simple –
an elementary education.” (Physician, Asian American patient population)
iii. Patient Counseling Tip Sheet/Guide. The participants were asked if they would use a
patient counseling or interpersonal relationship tip sheet or guide. Many participants (23) across provider types were interested in this type of material. As mentioned previously, one registered nurse requested a laminated card with counseling tips to carry around and use during patient interactions. In addition, one physician raised concerns about offending patients with cultural beliefs or practices that conflict with the recommendations being given and asked for that issue to be addressed within the counseling materials. In general, the respondents were encouraged at the prospect of receiving materials that would “be helpful” in assisting them with patient
counseling on HPV-related subject matter.
➢ “I know my patients who come in and say, well, I think we’re supposed to do this and this
and this, I’m more apt to go get the rest of the information and [use the tools to] make sure I’m not missing anything.” (Nurse Practitioner, Caucasian patient population)
iv. Memo Pad. The participants were asked if they would use a memo pad with key points
about HPV or clinical algorithms printed on it. Overall, the providers were interested in the memo pad material, with 21 saying they would find it useful. The nurse practitioners and registered nurses were more enthusiastic about this idea, while the physicians generally were not as interested in it.
➢ “That might be helpful. I’m always interested in any kind of educational material that I can
share with my patients and anything that might be helpful. So, that might work out. A tear- off sheet might work out well and help with documentation also in the patient record in terms of what the plan is.” (Nurse Practitioner, Hispanic patient population)
v. Web Site or CD-ROM. The participants were asked whether they would use a Web site or CD-ROM in their practice. Most participants preferred the Web site to the CD-ROM, with 25 saying they would use the Web site and 12 wanting to use the CD-ROM. One physician
commented that a Web site is no longer optional – it is a requirement. Most participants said that a Web site would be quicker and easier to access, and has an additional advantage because it can be updated regularly. A few providers liked the idea of receiving a CD-ROM, however, because they could use it with patients.
➢ “More information and more accessible information is always easier. Especially if you
could put it on the computer. You could pull it up immediately rather than look for something.” (Physician, Caucasian patient population)
➢ “Something that we could go to immediately would be fine. So, either one.” (Registered
Nurse, African-American patient population)
vi. Toolkit. The participants were asked whether they would use a toolkit containing some or all
of the pieces listed above. Many participants (18) liked the idea of a toolkit and having a variety of materials available to them. All of the registered nurses said they would use a toolkit, while about half of the nurse practitioners agreed. One nurse practitioner requested that the toolkit include reproducible materials for patients. Only a few physicians were interested, however, in part because of storage and practicality issues.
➢ “[With a toolkit]… you get into too much stuff. I’d rather have it all in one thing.”
(Physician, Caucasian patient population)
➢ “I would [use a toolkit]. I personally would use [a toolkit or a combination of multiple
pieces about HPV] if they were available.” (Nurse Practitioner, Hispanic patient population)