Cancer-salient messaging for Human Papillomavirus vaccine uptake: A randomized controlled trial |
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| Affiliation: | 1. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States;2. Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States;3. Emory Vaccine Center, Emory University, Atlanta, GA, United States;4. Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, United States;1. Department of Pediatrics, UCLA Mattel Children’s Hospital, University of California Los Angeles (UCLA), Los Angeles, CA, USA;2. Department of Pediatrics, Golisano Children’s Hospital, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA;3. Department of Clinical and Social Psychology, University of Rochester and Children’s Institute Rochester, NY, USA;4. Department of Public Health, Monroe County, NY, USA;5. Department of Ophthalmology, University of Rochester School of Medicine and Dentistry, USA;6. Department of Public Health Sciences, University of California at Davis, Davis, CA, USA;7. Department of Pediatrics, Children’s Mercy, Kansas City, MO, USA;8. Pop Health/Analytics Group, NextGen Healthcare, Fairport, NY, USA;1. Department of Pediatrics, University of Washington, Seattle, WA, United States;2. Seattle Children’s Research Institute, Seattle, WA, United States;3. Department of Pediatrics, Columbia University, New York, NY, United States;4. NewYork-Presbyterian Hospital, New York, NY, United States;5. Department of Psychiatry, Columbia University, New York, NY, United States;6. Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, United States;1. Department of Family and Community Health, University of Pennsylvania School of Nursing, 416 Fagin Hall, 435 Curie Blvd, Philadelphia, PA 19104, USA;2. Division of General Pediatrics, The Children''s Hospital of Philadelphia, CHOP North Room 1546, 34th & Civic Center Blvd, Philadelphia, PA 19104, USA;3. Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Blockley Hall 333, 423 Guardian Drive, Philadelphia, PA 19104, USA;4. Department of Family and Community Health, University of Pennsylvania School of Nursing, 416 Fagin Hall, 435 Curie Blvd, Philadelphia, PA 19104, USA;5. Division of Infectious Diseases, The Children''s Hospital of Philadelphia, 3535 Market Street, Room 1579, Philadelphia, PA 19104, USA;6. Massachusetts General Hospital, Harvard University School of Medicine, 15 Parkman Street, Boston, MA 02114-3117, USA;7. Division of Infectious Diseases, The Children''s Hospital of Philadelphia, CHOP North Room 1511, 34th & Civic Center Blvd, Philadelphia, PA 19104, USA;1. Adult and Child Consortium for Outcomes Research and Delivery Science Program (ACCORDS), Children’s Hospital Colorado, University of Colorado Denver, USA;2. Department of Pediatrics, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA;3. Department of Family Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA;1. Emory University, Department of Epidemiology and Laney Graduate School, Atlanta, GA, United States;2. Emory University, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, and Division of Infectious Diseases, Department of Medicine, Atlanta, GA, United States;3. Emory University, Rollins School of Public Health, Hubert Department of Global Health, Atlanta, GA, United States;4. Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA, United States;5. Emory University, School of Medicine, Department of Gynecology and Obstetrics, Atlanta, GA, United States;6. University of Kansas Medical Center, Department of Obstetrics and Gynecology, Kansas City, KS, United States;7. Emory University, Emory Vaccine Center and School of Medicine, Atlanta, GA, United States;8. Emory University, Department of Pediatrics, Atlanta, GA, United States;1. CVS Health, Woonsocket, RI, United States;2. OASH, HHS, Washington, DC, United States;3. UPMC Health Plan, Pittsburgh, PA, United States;4. St. George''s University, Grenada, West Indies |
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| Abstract: | Background and objectivesVaccination with Human Papillomavirus (HPV) vaccine is recommended for 11–12 years-old, but uptake is suboptimal. Current messaging focuses on HPV infection transmission and prevention. Parents and providers are often uncomfortable discussing sexual practices of adolescents, contributing to the delay/refusal of vaccine. We created a cervical cancer-salient message encouraging HPV vaccination, emphasizing disease salience and disease threat, while promoting self-efficacy. We hypothesized this message would have greater effects on vaccine confidence and intent to vaccinate compared to Centers for Disease Control and Prevention (CDC) and non-vaccine control messages.MethodsA 3-arm randomized trial was conducted. Parents of girls aged 9–17 were eligible for the study. We measured participants’ vaccine confidence and intent to vaccinate at baseline and post intervention message. Recruitment and surveys were administered online through Amazon Mechanical Turk.Results762 participants completed both surveys. We saw modest increases in vaccine confidence when comparing cervical cancer arm and control arm, and CDC arm and control arm; estimates were not statistically significant. The odds of reporting intent to vaccinate among the cervical cancer message arm were 1.13 times the odds of reporting intent to vaccinate in the control arm (95% CI: 0.30. 4.29). Intent to vaccinate was also not statistically significantly different between CDC message arm and control arm (OR = 1.25, 95%CI: 0.66, 2.37).ConclusionNeither message had effect on intent to vaccinate, highlighting need for research to identify successful messaging strategies for HPV. Exploratory analyses suggest among parents with ‘Low’ vaccine confidence at baseline, the cervical cancer framed message may be more effective in changing intention than the CDC message or non-vaccine control. Future work should target groups with ‘Low’ or ‘Medium’ vaccine confidence at baseline - they may be more amenable to change, and more receptive to disease-salient messaging.Clinical Trial Registration: Clinicaltrials.gov, Reference #: NCT03002324. |
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