Evaluating the understandability and actionability of Japanese human papillomavirus vaccination educational materials on cervical cancer

Educational materials about human papillomavirus (HPV) vaccination must be easy to understand and must support recommended behaviors regardless of readers' health literacy levels. The purpose of this study was to evaluate the understandability, actionability, and comprehensiveness of HPV vaccination educational materials in Japan. From August to September 2023, we obtained HPV vaccination educational materials from the central government, local governments, and websites. We assessed the understandability and actionability of the materials using the Patient Education Materials Assessment Tool for Printed Materials (PEMAT-P), Japanese version. We also evaluated the comprehensiveness of the content. Ratings of understandability, actionability, and comprehensiveness were compared by material type and source. We evaluated 164 eligible materials. The mean understandability and actionability of all materials were 60.5% (standard deviation [SD] = 12.5) and 42.0% (SD = 20.5), respectively. Many materials lacked definitions of medical terms, clear explanations of numbers, content summaries, explicit steps of action, and the use of visual aids to improve understanding and actionability. The mean comprehensiveness score was 73.5% (SD = 14.7%). A few materials included all the necessary information content. The highest understandability score and actionability score were for local government mailings, and the highest comprehensiveness score was for academic materials. Most Japanese HPV vaccination educational materials were insufficiently understandable and actionable. Such materials need to be improved, especially regarding the use of numbers, medical terms, and visual aids. In terms of content, the importance of vaccination before sexual debut and the benefits of vaccination for men should be emphasized.