Vaccine Hesitancy, Communication, Papilloma Viral Infection
Conditions
Brief summary
This research aims to identify communication strategies to improve the uptake of vaccines using an experimental design, focusing on the Human Papillomavirus (HPV) vaccine, which is highly effective in preventing HPV-related cancers. However, low HPV vaccination rates among adults remain a significant public health challenge. Although randomized controlled trials (RCTs) have demonstrated that interventions can increase vaccine uptake in children, few RCTs have been conducted among adults. To address this gap, a multidisciplinary investigative team with expertise in communication, medicine, nursing, and behavior-change intervention research will conduct a survey experiment and a cluster randomized controlled trial. First, a national sample of adults ages 18 to 45 who have not received the HPV vaccine or are unsure of their vaccination status will participate in a survey experiment to identify the most promising theory-based messages to strengthen HPV vaccine intentions. The two messages associated with the largest increases in vaccination intentions will then be selected for further testing. Next, 16 Penn Medicine primary care clinics will participate in a factorial cluster randomized controlled trial to test patient-level and clinic-level interventions designed to increase HPV vaccine uptake. Patient-level interventions will include theory-based text messages and a reminder-only message condition. The clinic-level intervention will provide healthcare providers with feedback on missed opportunities for HPV vaccination and a toolkit to support strong HPV vaccine recommendations. The study will evaluate whether these interventions increase receipt of the first HPV vaccine among eligible adult patients and whether combining patient-directed messages with the clinic-level intervention further increases HPV vaccination. HPV vaccination will be assessed using Penn Medicine electronic health records and, when needed, patient self-report.
Interventions
BEHAVIORALHPV Message 1
A patient-directed text-message intervention promoting HPV vaccination, selected from the Aim 1 survey experiment based on its effect on HPV vaccination intentions.
BEHAVIORALHPV Message 2
A patient-directed text-message intervention promoting HPV vaccination, selected from the Aim 1 survey experiment based on its effect on HPV vaccination intentions.
BEHAVIORALHPV Message 3
A patient-directed text-message intervention promoting HPV vaccination, selected from the Aim 1 survey experiment based on its effect on HPV vaccination intentions.
BEHAVIORALControl Message
An attention-matched control text-message condition that does not contain the theory-based HPV vaccination messages being evaluated.
BEHAVIORALProvider Strong-Recommendation Toolkit
A clinic-level intervention providing primary care providers with a toolkit supporting strong HPV vaccine recommendations.
Sponsors
Abramson Cancer Center at Penn Medicine
University of Pennsylvania
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
The study consists of two randomized components. In Aim 1, participants are randomly assigned to one of five theory-based HPV vaccine message conditions or an attention-matched control condition. The messages associated with the largest increases in HPV vaccination intentions are then selected for testing in Aim 2. In Aim 2, 16 primary care clinics are randomized in a 4 × 2 factorial design to one of four patient-level conditions (three patient-directed intervention text-message conditions or a control text-message condition) and, independently, to either receive or not receive a clinic-level provider intervention.
Eligibility
Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
* 18-45 years old
Exclusion criteria
* Under 18 and over 45 years old * Received HPV vaccine or unsure about receipt
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Aim 1 - Intention to Vaccinate | Immediately after exposure to the assigned message | Validated 3-item likert scale assessing HPV vaccination intention. |
| Aim 2 - Receipt of HPV Vaccine | From intervention initiation through 9 months of follow-up | Receipt of HPV vaccine during the follow-up period, determined from HPV vaccination documentation in the electronic health record or patient self-report. |
Countries
United States
Outcome results
None listed