Health workers’ perceptions of the quality of print IEC materials for Cancer patient education at the Uganda Cancer Institute

Abstract

Background: Print Information, Education, and Communication (IEC) materials serve as invaluable resources in cancer patient education in low-resource settings, providing patients with information, educational content, and communication tools to support their journey through diagnosis, treatment, and survivorship. However, challenges such as language barriers, literacy levels, cultural sensitivities, and material accessibility may limit their effectiveness. Objectives: This study aimed to determine the perceptions of health workers regarding the quality of Print Information, Education, and Communication (IEC) materials and to assess their quality using the Patient Education Materials Assessment Tool for Print Materials (PEMAT-P). Methods: This was a multiple methods study design that employed qualitative and quantitative methods of data collection and analysis. It was carried out among Health workers and IEC materials used in cancer patient education at the Uganda Cancer Institute. Qualitative data was collected through in-depth interviews using an interview guide. The data was transcribed, coded into themes and analysed using thematic analysis. The Patient Education Materials Assessment Tool (PEMAT-P) for print materials was utilized to collect and analyze data on the quality of the Print IEC materials. Results: Interviews with 20 health workers revealed that while IEC materials are valued as important educational aids, their impact is hindered by limited language options, predominantly English and Luganda, excluding many patients from diverse linguistic backgrounds. Low literacy levels further reduced patient engagement with the text-heavy materials. Cultural and religious beliefs affected acceptance, with some images and recommendations causing discomfort or rejection. Inconsistent availability, outdated content, and poor placement also compromised usage. The PEMAT-P evaluation showed high Understandability scores between 59–94% (81% Avg.) but lower Actionability scores between 20–100% (59% Avg.), indicating a lack of practical guidance for patients. More than half (71%, n=10) of the materials met the AHRQ threshold of ≥70% for Understandability while more than half (64%, n=9) of the materials scored below this threshold in Actionability. Conclusion and recommendations: Health workers perceived Print IEC materials as valuable tools for standardizing information and supporting patient education, but their utility was diminished by limited accessibility, language and literacy barriers, cultural and religious mismatches, and outdated content. The materials were effective in conveying knowledge but less effective in empowering patients to translate that knowledge into actionable health decisions. Efforts should be made to improve accessibility, ensure language and literacy appropriateness, align content with cultural and religious contexts, and regularly update materials to maximize their effectiveness. The materials should be redesigned to not only convey information clearly but also provide practical guidance that enables patients to take specific health actions.