Developing patient-centered educational material to improve colposcopy adherence

To assess acceptability, appropriateness and feasibility of implementing the American College of Obstetrics and Gynecology (ACOG) colposcopy pamphlet among patients with low socioeconomic status. We then aimed to create new educational material with input from community stakeholders to effectively improve colposcopy knowledge.

We conducted a multi-phase pilot study at a university-based colposcopy clinic that serves patients with low income who are under- or uninsured. In Phase 1, 25 new patients assessed the ACOG pamphlet with validated measures of Acceptability, Appropriateness, and Feasibility. In Phase 2, we consulted 12 community stakeholders to create Tailored Education to Advance Cervical Health (TEACH). In Phase 3, 25 new patients completed pre-post knowledge tests alongside viewing TEACH and assessed implementation as in Phase 1. One-tailed Wilcoxon signed rank test was used to compare pre- and posttest knowledge scores.

Among 50 patients enrolled in Phases 1 and 3, median age was 37.6 (IQR = 19.5) and 74% identified as non-White. 76% of Phase 1 participants found the ACOG pamphlet acceptable, appropriate, and feasible. They suggested elaborating on colposcopy's steps and clinical indications. In Phase 2, stakeholders improved TEACH's content and delivery. In Phase 3, 88% of participants found TEACH to be acceptable, appropriate (92%), and feasible (96%). Participants' understanding of colposcopy significantly increased after reading TEACH (median_pre = 8, median_post = 11, p = 0.00011).

When designed with patient and community input, educational materials can positively impact patients' understanding of colposcopy. TEACH should be tested longitudinally in diverse samples to determine its impact on colposcopy adherence.