Evaluating Culturally-targeted Fear Appeal Messages for HPV Self-Sampling among Jamaican Women: A Qualitative Formative Research Study.

Despite the disproportionate burden of cervical cancer among Caribbean women, evaluations of targeted communication interventions to increase screening behaviors are sparsely represented in extant literature. Informed by data on the cognitive, affective and sociocultural factors associated with low cervical screening in the English-speaking island of Jamaica, the current study aimed to explore how theory-based message design, coupled with innovative solutions, might increase screening. In this formative research study, we first described the process used to develop culturally-targeted fear appeal messages embedded within an HPV self-sampling kit developed by the researchers. Then, we shared the results of an evaluation of the kit, which was reviewed by 36 Jamaican women in 8 focus groups, to understand the potential impact of the messages and the utility of HPV self-sampling to increase screening behaviors in this population. The results provide data on effective messages for cervical cancer prevention among Jamaican women, which may be further applicable to underscreened women in the English-speaking Caribbean. Additionally, results from this research suggest support for HPV self-sampling to address salient cultural and structural barriers to screening, which provides an impetus for experimental research in message design to inform policy and practice.

Cultural factors influencing teenage pregnancy in Jamaica.

A literature review was undertaken to identify key factors associated with teenage pregnancy in Jamaica. Using the PEN-3 cultural model, we first categorised these factors to develop a theoretical taxonomy that can be used to help health intervention planners to understand and address the phenomenon. Next, we examined the validity of this initial taxonomy by comparing it with cultural factors identified in semi-structured focus group discussions with Jamaican teenage mothers. Cultural factors identified in the initial literature review - such as parental interaction and control, the intergenerational transmission of teenage pregnancy and experiences of sexual abuse - were largely confirmed and built upon. Results highlight promising opportunities for health communication among young women in Jamaica with a focus on self-efficacy, resilience and positive cultural factors.