Brief Client-Centered Motivational and Behavioral Intervention to Promote HPV Vaccination in a Hard-to-Reach Population

Abstract

Objective To evaluate the impact of a client-centered behavioral intervention (Brief Negotiated Interviewing) on mothers' human papillomavirus (HPV) vaccine knowledge and vaccination initiation for their adolescent daughters. Methods We randomized mothers to intervention (n = 100) and control (n = 100) groups, and followed them over 12 months. Electronic medical records were reviewed to determine vaccination status. The primary outcome was receipt of the first vaccine. The secondary outcome was HPV vaccine knowledge among mothers. Results Brief Negotiated Interviewing intervention mothers demonstrated increased knowledge about HPV (pre/post mean score of 5 to 10 out of a possible 11; P < .001) and significantly higher mean knowledge scores (10 vs 6, P < .001) than control mothers. However, initiation and completion rates of the vaccine were not significantly different between groups. Conclusions Increasing HPV vaccine knowledge did not translate into increased vaccine uptake or completion of vaccination series. Future intervention must explore vaccine reminders to increase HPV vaccination rates.

Predictors of Human Papillomavirus Vaccine Initiation and Completion Among Latino Mothers of 11- to 17-Year-Old Daughters Living Along the Texas-Mexico Border

“…Mothers who participated in the EMH program, compared to the brochure-only group, were also more likely to initiate and complete the vaccine series. Our findings were similar to those of Joseph and colleagues 34 , who found in their clinic-based intervention that increases in mothers’ HPV vaccine knowledge did not influence adolescent vaccination coverage in their study. Because mothers are the primary decision makers in vaccinating children younger than 18, limited HPV and vaccine knowledge among Hispanic mothers is a legitimate concern.…”

“…Negative attitudes among parents toward the HPV vaccine and a lack of information about the vaccine were negatively associated with initiation. Joseph and colleagues 34 found that HPV vaccine knowledge among mothers was not associated with increased vaccine initiation or completion. Tsui and colleagues 32 reported that neighborhood sociodemographic factors (e.g., the percentage of census tract residents living below poverty level, the percentage of unemployed census tract residents older than age 16, the percentage of census tract residents belonging to a minority race/ethnicity, and the percentage of census tract residents without access to a private vehicle) were not significantly associated with HPV vaccine initiation after controlling for individual-level factors (e.g., the daughter’s age, insurance type, usual source of care; and the mother’s race/ethnicity, age and level of HPV awareness).…”

“…Few studies have specifically assessed parent predictors of HPV vaccine initiation 30–34 and completion 33, 34 for their adolescent girl children. Brewer and colleagues 30 found increased HPV vaccine initiation among parents when few barriers to vaccination were perceived.…”

“…The aforementioned studies focused on rural and urban African American, 30, 33, 34 Haitian, 34 mixed urban Latino and African American, 31 and mixed urban Latino and Asian American 32 populations. Few of these studies controlled for individual level factors such as HPV and HPV vaccine knowledge, which are recognized by health promotion theories 35, 36 as contributing to the adoption and/or maintenance of HPV vaccination.…”

The Resurgence of Measles, Mumps, and Pertussis

“…40 Results showed that the MI group had significantly higher vaccine coverage at 3 months (91.3% vs 88.1%), 5 months (83.2% vs 78.3%), and 7 months (75.9% vs 68.6%) compared with the control group. 40 Joseph et al 41 performed a pilot study using mother-daughter dyads examining human papillomavirus (HPV) intent to vaccinate and knowledge gained through a brief MI behavioral intervention. There was no difference noted between dyads receiving their first HPV vaccine (56% vs 51%), although the intervention dyad mothers did significantly increase their knowledge of HPV by almost 2 times the standard deviation.…”