Table 2.

Summary of suggestions and changes at each phase of HPVVaxFacts development.

Phase	Title	Suggestions	Changes
2	MVTCPa CABb Review	Modify literacy level Make language understandable to lay persons Diversity in images regarding sexual orientation, sex, and race	Lowered literacy level to grade 7 using simple terms Substituted scientific words or added definitions Updated images to be more racially diverse and more male oriented
3	Parental Advisory Panel Review	Need diversity in images (ie, in terms of race, age, and sex) Add images of physicians reflective of all races in white coats Add videos to complement content Add adolescents’ corner (images, messages, and testimonials for adolescents)	Updated more images to reflect diversity in age, race, and sex for children, parents, and physicians Developed videos from providers belonging to different racial groups Added videos that reinforced content of each concern Adolescents’ corner added with images and messages
4	CEHCc Content Review	Reorder or remove information Remove manipulative or contradictory language	Removed problematic language (eg, “as a good parent”) Revised misleading statements (eg, how HPVd is spread) Reordered and revised content
5
	Semistructured Interviews With Parents	Modify content to increase clarity Add images for diversity Add sources for content Add more research-based studies Tailor content to adolescents’ medical condition Introduce research team Increase font size and white space Add guidance on navigation	Updated 3 infographics to increase clarity on content (eg, impact of HPV vaccine on cancer rates) Updated links to go to visuals (eg, genital warts) Updated 2 images to reflect sex and diversity Substituted, added, or removed content from each concern (eg, edited language on rationale for age recommendation) Identified and added sources for content to increase credibility Added About Us tab of research team members with pictures and bio Shortened sentences, added white space, and increased font size Updated instructions on web page
	Semistructured Interviews With Providers	Give providers information on content to prepare for discussion with parents	Developed 1-page summary for providers on vaccine concerns Offered demonstration for providers
6	Expert Review	Edit content to improve accuracy and clarity Change 1 image to be more content appropriate	Edited content for all concerns (eg, updated explanation of natural immunity vs vaccine immunity) We did not change the picture for genital wart content because parents wanted the option to click a link that would lead to a picture of genital warts

^aMVTCP: Meharry-Vanderbilt–Tennessee State University Cancer Partnership.

^bCAB: community advisory board.

^cCEHC: Center for Effective Health Communication.

^dHPV: human papillomavirus.