Overcoming barriers to HPV vaccination: A randomized clinical trial of a culturally-tailored, media intervention among African American girls

Abstract

Although genital HPV is the most prevalent STI in the US, rates of vaccination uptake among high-risk subgroups remain low. Investigations of vaccine compliance have mainly targeted mother-daughter dyads, which in some settings may prove difficult. This study examines an innovative culturally tailored, computer-delivered media-based strategy to promote HPV vaccine uptake. Data, inclusive of sociodemographics, sexual behaviors, knowledge, attitudes, and beliefs about HPV and vaccination were collected via ACASI from 216 African American adolescent females (ages 14-18 years) seeking services in family planning and STI public health clinics in metropolitan Atlanta. Data were obtained prior to randomization and participation in an interactive media-based intervention designed to increase HPV vaccination uptake. Medical record abstraction was conducted 7 month post-randomization to assess initial vaccine uptake and compliance. Participants in the intervention were more compliant to vaccination relative to a placebo comparison condition (26 doses vs. Seventeen doses; pD0.12). However, vaccination series initiation and completion were lower than the national average. Thorough evaluation is needed to better understand factors facilitating HPV vaccine uptake and compliance, particularly perceived susceptibility and the influence of the patient-provider encounter in a clinical setting.

Interventions to reduce inequalities in vaccine uptake in children and adolescents aged <19 years: a systematic review

“…An RCT evaluating an intervention targeting African-American females to increase HPV vaccine uptake (‘Girls on Guard’) found that only 12% of 216 participants initiated the vaccine course, with equal numbers in intervention and control groups 90. Another randomised study examined a computer-based health message intervention delivered in school-based clinics in a population of ethnically diverse parents of non-HPV vaccinated children (n=445) and found that rhetorical questioning message prompts increased vaccination intention, but not uptake 91…”

A Quality Improvement Project to Increase the Rate of HPV Vaccination Initiation in Adolescents

“…Interventions have been described in research to aid in increasing the rate of vaccinating adolescents eligible to receive the HPV vaccine. Increasing availability of educational resources were implemented in several studies through the use of an interactive and age-appropriate information via electronics on an iPad, culturally-sensitive and accessible media interventions, and by providing education materials and patient reminders via telephone, text, or e-mail [13,[21][22][23][24].…”

Reducing Cancer and Cancer Disparities: Lessons From a Youth-Generated Diabetes Prevention Campaign

“…93 However, an intervention among university students comparing the impact of gain-or loss-framed video messages found no effect on vaccine behavior, 94 and a recent culturally tailored, computer-delivered, media-based strategy among African-American adolescent females within public health clinics increased vaccination, though rates were lower than the national average. 95 Research suggests that messages to promote HPV vaccine uptake should be tailored to age and should be culturally and linguistically appropriate. Specifically, messages that integrate a positive youth development framework and build on youths' assets, strengths, and protective factors are likely to be more effective than messages that seek to isolate HPV as a health concern.…”