Peer-reviewed article
Effect of a comic book-based educational intervention on human papillomavirus vaccine knowledge and safety perception among girls aged 9-14 in Nigeria.
James C Dickerson, Praise Adeyemo, Nicole Kim, Edoghogho Ighodaro, Paulette Ibeka et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study tested a comic book-based educational intervention about HPV vaccine and cervical cancer with girls aged 9-14 across four Nigerian states. The intervention included a school assembly, distribution of culturally tailored comic books, and community leader focus groups. Knowledge of HPV improved significantly after six weeks, and perception of vaccine safety increased from 62% to 81%, though increased knowledge did not translate into higher vaccination rates.
Key points
- HPV vaccine knowledge improved significantly across all four states (p < 0.01)
- Girls with lower baseline knowledge gained more from the intervention than those with higher baseline knowledge (p < 0.01)
- Perception of vaccine safety increased from 62% to 81% following the intervention (p < 0.01)
- Increased knowledge was not associated with higher vaccination receipt rates (p = 0.16)
- Comic books are proposed as a low-cost, scalable, and culturally adaptable health education tool
Limitations
This was a single-arm study without a comparison group, so we cannot attribute changes solely to the intervention or rule out other factors. The study did not measure whether awareness gains persisted beyond six weeks or had long-term effects on vaccination uptake.
Abstract
BACKGROUND: Cervical cancer is a leading cause of death for women and is preventable with the human papillomavirus (HPV) vaccine and regular screening. However, awareness of vaccines and screenings is poor in many low- and middle-income countries. In 2023, Nigeria sought to deliver 15 million doses of the HPV vaccine to girls aged 9-14. Within this vaccination campaign, we studied the effect of a comic book educational intervention on knowledge and perception of HPV, cervical cancer, and vaccine safety in girls eligible for the vaccine. METHODS: This single-arm study evaluated the effect of a bundled educational intervention on HPV knowledge and safety perception. The three-part intervention was a schoolwide assembly and lecture for children using a culturally tailored comic book as a guide, distribution of the comic book to all the children at the school and then separate focus groups with adult community leaders. The primary outcome was the change in the HPV knowledge score in girls aged 9-14 six weeks post-intervention. Exploratory outcomes were the differential effect of low versus high baseline knowledge, vaccine safety perception, and change in vaccine receipt status at the class level. RESULTS: We found significant gains in knowledge across all four states (n = 396; p < 0.01). Classes with lower baseline knowledge gained more from the intervention (p < 0.01). Perception of vaccine safety increased from 62% to 81% (p < 0.01). We did not find a relationship between increased learning and vaccination receipt (p = 0.16). CONCLUSION: Awareness and positive perception of the safety of the HPV vaccine increased following an educational comic book intervention in girls aged 9-14 across Nigeria. Comics may be a low-cost, scalable, and culturally adaptable tool for health education.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Bundled educational intervention comprising: schoolwide assembly and lecture using a culturally tailored comic book; distribution of comic books to all children; separate focus groups with adult community leaders
- Population
- Girls aged 9-14 across four Nigerian states (n=396)
Key finding
HPV knowledge improved significantly across all four states (p < 0.01)
Dickerson et al. · PubMed (US National Library of Medicine) · 5 Oct 2026