Dissemination pilot of a culturally-tailored HPV educational website for Hmong adolescents and parents in clinics and schools

Context: Our community-based participatory research (CBPR) team previously developed and piloted a culturally- and linguistically-tailored human papillomavirus (HPV) eHealth website (https://hmonghpv.com) for Hmong adolescents and their parents that aimed to address low levels of HPV vaccine completion in this population.

Objective: To assess dissemination and implementation of the Hmong Promoting Vaccines website within primary care clinics and school settings.

Study Design and Analysis: CBPR process using a mixed-methods design with 8-week dissemination pilot and pre- and post-pilot interviews with participating organizations. Analyzed using template analysis, Google Analytics, and a Qualtrics website survey.

Setting: 2 primary care clinics, 2 school-based clinics, and 2 school health education classrooms in the Minneapolis/St. Paul metro area with large Hmong populations.

Population Studied: 8 organizational leads (clinicians, clinic staff, and educators).

Outcome Measures: Facilitators and barriers to dissemination (qualitative), website reach and utilization metrics (i.e., number of new users, mean time spent on website).

Results: The website was disseminated to approximately 580 Hmong individuals over 8 weeks, resulting in 300 new users who were on the website for an average of 12 minutes. Dissemination reach was most robust (n=117 individuals) in one participating Hmong charter school that integrated the website into their curriculum. Post-pilot interviews identified that dissemination fit well into clinic workflows and school curriculum and that the cultural tailoring of the website appealed to adolescents. Barriers to dissemination included time constraints in all settings, lower patient/parent receptivity to vaccine conversations at non-preventive clinic visits, preference for alternatives to paper handouts by adolescents, and other clinic factors such as staff turnover.

Conclusions: This pilot study demonstrated the feasibility of disseminating a culturally-tailored educational website tool for HPV education in clinics and schools with Hmong populations.

Health education curricula in culturally-specific schools appeared to be an especially robust modality for dissemination. Proactive outreach from both clinics and schools to adolescents and parents may be helpful in further disseminating this educational innovation. A dissemination toolkit containing strategies and materials to utilize the website in clinics and schools is available.