JMIR Publications

ABSTRACT

Background:

The high morbidity, mortality, and economic burden attributed to cancer-causing HPV call for researchers to address this public health concern through human papillomavirus (HPV) vaccination. Disparities of HPV-associated cancers in Vietnamese and Korean Americans (VA, KA) exist, yet their vaccination rates remain low. Evidence points to the importance of developing culturally and linguistically congruent interventions to improve their HPV vaccination rates. We adopted digital storytelling (DST) that combines oral storytelling with computer-based technology (digital images, audio recording, and music) as a promising approach for facilitating communication of culturally relevant health messages.

Objective:

This study aimed to (a) assess feasibility and acceptability, (b) conduct deep analysis of the cultural experience that shapes HPV attitudes, and (c) explore aspects of the DST workshop experience that could inform future formative and intervention work.

Methods:

Through community partner, social media and snowballing, we recruited two VA and six KA mothers (mean age = 41.4 years old; SD = 5.8) who had children vaccinated against HPV. Three virtual DST workshops were conducted between July 2021 and January 2022. Our team supported mothers to develop their own stories. Mothers filled out online surveys before and after the workshop and provided feedback on each other’s story ideas and the workshop experience. We used descriptive statistics to summarize the quantitative data and constant comparative analysis to analyze qualitative data collected in the workshop and field notes.

Results:

Eight digital stories were developed in the DST workshops. They were well accepted, shown in the mothers’ overall satisfaction and relevant indicators (i.e., would recommend it to others, would watch more stories and attend a similar workshop, it was worth their time and appropriate; mean = 4.6 - 4.8, range 1-5). They found the process rewarding and appreciated the opportunity to share their stories in group settings and learn from each other. The six major themes that emerged from the data, reflect the mothers’ rich personal experiences, attitudes, and perceptions about their child’s HPV vaccination included (1) showing parents’ love and responsibility; (2) HPV and related knowledge, awareness, and attitudes; (3) factors influencing vaccine decision-making; (4) source of information and information sharing; (5) response to children's being vaccinated; and (6) cultural perspectives on healthcare and HPV vaccination.

Conclusions:

Our findings suggest that a virtual DST workshop is a highly feasible and acceptable approach to engage VA and KA immigrant mothers in developing culturally and linguistically congruent DST interventions. Further research is needed to test the efficacy and effectiveness of the digital stories as an intervention for VA and KA mothers of unvaccinated children. This process of developing an easy-to-deliver, culturally and linguistically aligned, and holistic online DST intervention can be implemented with other populations in other languages.