Using a participatory four-step protocol to develop culturally targeted cancer education brochures
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Updated: Jul 6, 2026

E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Manny Kulukulualani1, Kathryn L Braun, JoAnn U Tsark
1Imi Hale-Native Hawaiian Cancer Network, program of Papa Ola Lōkahi, Honolulu, Hawai'i 96813, USA. mannyk@papaolalokahi.org
Abstract:
Native Hawaiians have a high cancer burden, but few culturally targeted cancer education brochures exist. The authors followed a participatory four-step protocol, involving more than 200 health providers and clients, to develop and test culturally targeted brochures on skin, oral, cervical, prostate, and testicular cancers. The final products featured Hawaiian faces, scenes, words, and activities. They proved more attractive than existing materials, in particular to younger Hawaiians, and posttests suggested good comprehension of intended messages. This protocol may have application in other communities that want to develop brochures that are attractive, acceptable, readable, and useful to minority clients and their providers.
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