Effect of a Brief Web-Based Educational Intervention on Willingness to Receive the Human Papillomavirus Vaccine in Japan: A Randomized, Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Yukio Suzuki ◽  
Akiko Sukegawa ◽  
Yutaka Ueda ◽  
Masayuki Sekine ◽  
Takayuki Enomoto ◽  
...  

BACKGROUND The human papillomavirus (HPV) vaccination rate in Japan has fallen to nearly zero since the suspension of governmental proactive recommendations in 2013, owing to the development of purported adverse events. This has resulted in an unfavorable situation that requires rectification. OBJECTIVE This study aimed to clarify the effects of a brief web-based educational intervention using the theory of behavioral insights on willingness to receive the HPV vaccine. METHODS We recruited 1,660 participants aged 20 years and older in March 2018 via a webpage and provided them with a 10-item questionnaire related to the following aspects: awareness regarding HPV infection and vaccine, willingness for immunization, and actions for prevention. We randomly stratified participants based on sex, age, and marital status with or without a brief educational intervention using scientific information presented in an easy-to-read format. RESULTS Only 29.2% of the respondents were aware of the benefits of HPV vaccination. Although only 21.2% of the respondents displayed a willingness toward immunization for their daughters, an additional 4.8% of the respondents in the intervention group reported affirmatively (adjusted odds ratio [aOR]=1.32, 95% CI 1.04-1.69). In a sub-analysis, the willingness of male participants significantly changed following intervention with fundamental scientific information (aOR=1.46, 95% CI 1.05-2.02). However, such a change was not observed among female participants (aOR=1.20, 95% CI 0.83-1.73). CONCLUSIONS This study suggests that a brief web-based educational intervention increases the willingness to receive the HPV vaccine, especially among male participants. Thus, providing adequate information to men may be a useful strategy to improve the currently low rates of HPV vaccination. CLINICALTRIAL The study protocol was approved by the Institutional Research Ethics Committee of Yokohama City University School of Medicine (A180200004). The institutional ethics committee ruled that a non-invasive brief educational intervention of this nature can be exempted from trial registration.

2021 ◽  
Author(s):  
Yukio Suzuki ◽  
Akiko Sukegawa ◽  
Yutaka Ueda ◽  
Masayuki Sekine ◽  
Takayuki Enomoto ◽  
...  

BACKGROUND Providing adequate information to parents who have children eligible for human papillomavirus (HPV) vaccination is essential to overcoming vaccine hesitancy in Japan, where the government recommendation has been suspended. However, prior trials assessing the effect of brief educational tools showed only limited effects on increasing the willingness of parents to vaccinate their daughters. OBJECTIVE The aim of this trial was to assess the effect of a cervical cancer survivor story on the willingness of parents to get HPV vaccination for their daughters. METHODS In this double-blinded, randomized controlled trial implemented online, we enrolled 2175 participants aged 30–59 years in March 2020 via a webpage and provided them with a questionnaire related to the following aspects: awareness regarding HPV infection and HPV vaccination, and willingness for HPV vaccination. Participants were randomly assigned (1:1) to see a short film of cervical cancer survivor story or nothing, stratified by sex (male vs. female) and willingness to HPV vaccination prior to randomization (Yes vs. No). The primary endpoint was the rate of parents who agreed to HPV vaccination for their daughters. The secondary endpoint was the rate of parents who agreed to HPV vaccination for their daughters and the HPV vaccination rate at 3 months. RESULTS Among 2175 participants, 1266 (58.2%) were men and 909 (41.8%) were women. A total of 191 (8.8%) participants were willing to consider HPV vaccination prior to randomization. Only 339 (15.6%) participants were aware of the benefits of HPV vaccination. In contrast, 562 (25.8%) patients were aware of the adverse events of HPV vaccination. Although only 476 (21.9%) of the respondents displayed a willingness to vaccinate their daughters for HPV, there were 7.5% more respondents in the intervention group with this willingness immediately after watching the short movie (odds ratio [OR] 1.55, 95% CI 1.27-1.91). In a sub-analysis, the willingness to vaccinate daughters for HPV was 10.9% higher in males in the intervention group (OR 1.75, 95% CI 1.36-2.25); however, such a difference was not observed among females (OR 1.25, 95% CI 0.86-1.81). Male participants were more likely to have willingness for HPV vaccination compared to female participants. In the follow-up survey at 3 months, 1807 (83.1%) participants responded. Of these, 149 (8.2%) responded that they had had their daughters receive vaccination during the 3 months, even though we could not see the effect of the intervention; 77 (7.9%) in the intervention group and 72 (8.7%) in the control group. CONCLUSIONS A cervical cancer survivor story increases immediate willingness to consider HPV vaccination, but the effect does not last for 3 months. Furthermore, this narrative approach to parents did not increase vaccination rates in children eligible for HPV vaccination. CLINICALTRIAL UMIN Clinical Trials Registry UMIN000039273; https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000043714.


Vaccines ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 31 ◽  
Author(s):  
Dingyun You ◽  
Liyuan Han ◽  
Lian Li ◽  
Jingcen Hu ◽  
Gregory D. Zimet ◽  
...  

Background: This study aimed to determine human papillomavirus (HPV) vaccine uptake and willingness to receive HPV vaccination among female college students, in China, and its associated factors. Methods: An online cross-sectional survey of female college students across the eastern, central, and western regions of China was undertaken between April and September 2019. Partial least squares structural equation modeling (PLS-SEM) was used to examine factors associated with the HPV vaccine uptake and willingness to receive the HPV vaccine. Results: Among the total 4220 students who participated in this study, 11.0% reported having been vaccinated against HPV. There are direct effects of indicators of higher socioeconomic status, older age (β = 0.084 and p = 0.006), and geographical region (residing in Eastern China, β = 0.033, and p = 0.024) on HPV vaccine uptake. Higher knowledge (β = 0.062 and p < 0.000) and perceived susceptibility (β = 0.043 and p = 0.002) were also predictors of HPV vaccine uptake. Of those who had not received the HPV vaccine, 53.5% expressed a willingness to do so. Likewise, social economic status indicators were associated with the willingness to receive the HPV vaccine. Total knowledge score (β = 0.138 and p < 0.001), both perceived susceptibility (β = 0.092 and p < 0.001) and perceived benefit (β = 0.088 and p < 0.001), and sexual experience (β = 0.041 and p = 0.007) had a positive and significant direct effect on the willingness to receive the HPV vaccine, while perceived barriers (β = −0.071 and p < 0.001) had a negative effect on the willingness to receive the HPV vaccine. Conclusions: Geographical region and socioeconomic disparities in the HPV vaccination uptake rate and willingness to receive the HPV vaccine provide valuable information for public health planning that aims to improve vaccination rates in underserved areas in China. The influence of knowledge and perceptions of HPV vaccination suggests the importance of communication for HPV immunization.


2003 ◽  
Vol 14 (5) ◽  
pp. 300-306 ◽  
Author(s):  
Jessica A Kahn ◽  
Susan L Rosenthal ◽  
Tara Hamann ◽  
David I Bernstein

Human papillomavirus (HPV) vaccines are under investigation, but little is known about attitudes regarding vaccination. The aims of this study were to identify attitudes about and intention to receive an HPV vaccine in young women using a theory-based model. Young women ( n=52, mean age 25 years, range 18-30 years, 35% Black/Non-Hispanic) completed a survey assessing knowledge, attitudes about HPV vaccination, and risk behaviours. Associations between attitudes and intention to receive the vaccine were assessed using Mann-Whitney U or chi-square tests. Subjects reported positive attitudes about receiving an HPV vaccine and high intention to receive the vaccine both for themselves and their daughters. Variables associated significantly with intention included knowledge ( P=0.004), personal beliefs about vaccination ( P=0.004), belief that others would approve of vaccination ( P=0.005), and higher number of sexual partners ( P=0.028). Information on attitudes about HPV vaccination and predictors of intention to receive a vaccine may guide immunization initiatives for young adults.


2019 ◽  
Author(s):  
Paul L. Reiter ◽  
Amy L. Gower ◽  
Dale E. Kiss ◽  
Molly A. Malone ◽  
Mira L. Katz ◽  
...  

BACKGROUND Gay, bisexual, and other men who have sex with men experience several disparities related to human papillomavirus (HPV) infection, including high incidence rates of anal cancer. HPV vaccine is currently recommended for young adults, yet HPV vaccine coverage is low among young gay, bisexual, and other men who have sex with men (YGBMSM). OBJECTIVE We describe the design and methods for a randomized controlled trial (RCT) to rigorously evaluate Outsmart HPV, a population-targeted, individually-tailored web-based HPV vaccination intervention for YGBMSM. The RCT is designed to determine the efficacy of the intervention, the mechanism by which the intervention has an effect (i.e., mediation), and whether efficacy varies by participant characteristics (i.e., moderation). METHODS Outsmart HPV was previously developed and pilot-tested. The current study is a three-arm prospective RCT that will enroll a projected 1995 YGBMSM who are ages 18-25, live in the United States, and have not received any doses of HPV vaccine. Participants will be recruited via paid advertisements on social media sites and randomized to receive either: (a) standard information online about HPV vaccine (control group); (b) Outsmart HPV content online with monthly unidirectional vaccination reminders sent via text message; or (c) Outsmart HPV content online with monthly interactive vaccination reminders sent via text message. Participants will complete online surveys at four time points during the study: baseline; immediately after engaging with online content; three months after randomization; and nine months after randomization. Primary outcomes will include both HPV vaccine initiation (i.e., receipt of one or more doses of HPV vaccine) and completion (receipt of all three doses recommended for this age range). We will examine constructs from the intervention’s theoretical framework as potential mediators, and we will examine demographic and health-related characteristics as potential moderators of intervention effects. RESULTS The Institutional Review Board at The Ohio State University has approved the study. Materials have been developed and finalized for all study groups. Recruitment for the RCT is scheduled to begin in Fall 2019. CONCLUSIONS If shown to be efficacious, Outsmart HPV has the potential to fill an important gap by promoting HPV vaccination among a population at increased risk of HPV infection and HPV-related disease. CLINICALTRIAL The trial is registered at ClinicalTrials.gov: NCT04032106 (available at: https://clinicaltrials.gov/ct2/show/NCT04032106).


2018 ◽  
Vol 57 (13) ◽  
pp. 1523-1531 ◽  
Author(s):  
Nora B. Henrikson ◽  
Weiwei Zhu ◽  
Lauren Baba ◽  
Matthew Nguyen ◽  
Heidi Berthoud ◽  
...  

This study evaluated the impact of health system–based outreach and reminders on human papillomavirus (HPV) vaccine series initiation and completion. Parents of 10 to 12 year olds (n = 1805) were randomized to receive either (1) an outreach letter and brochure recommending HPV vaccination followed by automated HPV vaccine reminders or (2) usual care. We interviewed a subset of 50 parents to assess program acceptability. Outcomes were HPV vaccine initiation during the study period and on-time series completion. Rates of HPV vaccine initiation during the study period (July 2015 to August 2016) were similar between the intervention and control groups, but initiation within 120 days of randomization was higher in the intervention group (23.6% and 18.8%, P = .04) as was completion during the study period (10.3% vs 6.8%, P = .04). Reminders for doses 2 and 3 did not affect completion. The program was acceptable to parents. This study provides evidence that health system–based outreach and reminders can improve HPV vaccination.


10.2196/16294 ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. e16294 ◽  
Author(s):  
Paul L Reiter ◽  
Amy L Gower ◽  
Dale E Kiss ◽  
Molly A Malone ◽  
Mira L Katz ◽  
...  

Background Gay, bisexual, and other men who have sex with men experience several disparities related to human papillomavirus (HPV) infection, including high incidence rates of anal cancer. Although the HPV vaccine is currently recommended for young adults, HPV vaccine coverage is modest among young gay, bisexual, and other men who have sex with men (YGBMSM). Objective We describe the design and methods for a randomized controlled trial (RCT) to rigorously evaluate Outsmart HPV, a population-targeted, individually tailored, Web-based HPV vaccination intervention for YGBMSM. The RCT is designed to determine the efficacy of the intervention, the mechanism by which the intervention has an effect (ie, mediation), and whether efficacy varies by participant characteristics (ie, moderation). Methods Outsmart HPV was previously developed and pilot-tested. This study is a 3-arm prospective RCT that will enroll a projected 1995 YGBMSM who are aged 18 to 25 years, live in the United States, and have not received any doses of the HPV vaccine. Participants will be recruited by means of paid advertisements on social media sites and randomized to receive (1) standard information on the Web about HPV vaccine (control group), (2) Outsmart HPV content on the Web with monthly unidirectional vaccination reminders sent via text messages, or (3) Outsmart HPV content on the Web with monthly interactive vaccination reminders sent via text messages. Participants will complete Web-based surveys at 4 time points during the study: baseline, immediately after engaging with Web-based content, 3 months after randomization, and 9 months after randomization. Primary outcomes will include both HPV vaccine initiation (ie, receipt of 1 or more doses of the HPV vaccine) and completion (receipt of all 3 doses recommended for this age range). We will examine constructs from the intervention’s theoretical framework as potential mediators and demographic and health-related characteristics as potential moderators of intervention effects. Results The institutional review board at The Ohio State University has approved the study. Materials have been developed and finalized for all study groups. Recruitment for the RCT began in fall 2019. Conclusions If shown to be efficacious, Outsmart HPV has the potential to fill an important gap by promoting HPV vaccination among a population at increased risk of HPV infection and HPV-related disease. Trial Registration ClinicalTrials.gov NCT04032106; http://clinicaltrials.gov/show/NCT04032106 International Registered Report Identifier (IRRID) PRR1-10.2196/16294


2021 ◽  
Vol 28 ◽  
pp. 107327482110328
Author(s):  
Mingyu Si ◽  
Yu Jiang ◽  
Xiaoyou Su ◽  
Wenjun Wang ◽  
Xi Zhang ◽  
...  

Background This study aimed to assess the awareness and attitudes toward human papillomavirus (HPV) vaccination among female college freshmen and explore their willingness and associated factors to receive the HPV vaccine based on the information–motivation–behavior skills (IMB) model. Methods From February 21 to April 30, 2020, a cross-sectional survey was conducted among female freshmen in seven colleges in mainland China. Socio-demographic characteristics, health-related awareness, knowledge of HPV, motivation, and behavioral skills toward HPV vaccination were assessed using questionnaires. Univariate and multivariate logistic regression analyses were performed to identify the influencing factors of willingness to receive the HPV vaccine in the next 6 months. Results Among the 3867 students invited to participate in this study, 102 (2.64%) reported having taken the HPV vaccine. Among the unvaccinated participants, 59.89% had previously heard of HPV, and 32.08% were willing to take the HPV vaccine in the next 6 months. Willingness to get the HPV vaccine was associated with sexual experience(s) (AOR = 1.96, 95% CI: 1.25–3.08), family or friends with cancer (AOR = 1.24, 95% CI: 1.04–1.48), having heard of HPV (AOR = 1.23, 95% CI: 1.03–1.47), and having actively searched for or having consulted on issues concerning HPV vaccine (AOR = 1.22, 95% CI: 1.02–1.45). In the dimensions of the IMB model, “perceived susceptibility” (AOR = 1.20, 95% CI: 1.09–1.31), “perceived severity” (AOR = 1.24, 95% CI: 1.11–1.39), “subjective norms” (AOR = 2.09, 95% CI: 1.75–2.49), and “self-efficacy” (AOR: 2.95, 95% CI: 2.44–3.58) were positively associated with HPV vaccination acceptance, while “perceived barriers” (AOR = .60, 95% CI: .52–.69) negatively affected intention to get HPV vaccination. Conclusion HPV vaccination rates and willingness to receive the HPV vaccine in the next 6 months were found to be poor among female college freshmen in mainland China. Having a positive attitude toward HPV vaccination, creating vaccine-friendly social norms, and removing related barriers are important measures to promote HPV immunization.


2019 ◽  
Vol 24 (8) ◽  
Author(s):  
Michael Edelstein ◽  
Nalini Iyanger ◽  
Nicola Hennessy ◽  
David Mesher ◽  
Marta Checchi ◽  
...  

Background: Opportunistic human papillomavirus (HPV) vaccination for men who have sex with men (MSM) was piloted in sexual health clinics (SHC) in England between 2016 and 2018. Aim: to evaluate the pilot’s first year (April 2016–March 2017) in terms of feasibility, acceptability, uptake, impact and equity and interpret the outcome in the context of wide HPV vaccination policy. Methods: Attendance and uptake data from routine SHC surveillance datasets and a cross-sectional survey administered to individuals receiving the vaccine were analysed. Results: Among 18,875 eligible MSM, 8,580 (45.5%) were recorded as having received one HPV vaccine dose, decreasing slightly with increasing age, and uptake was higher in rural than urban areas. Survey results suggested that of those receiving the first dose of HPV vaccine, 8% were new attendees and that among those, less than 11% attended just to receive the vaccine. Of those having their first HPV vaccination, 95% indicated they would like to receive the next vaccine doses at the same clinic and 85% of patients reported accessing other services when visiting SHC for the first dose of vaccine. Conclusion: An opportunistic HPV vaccination programme for MSM can be delivered in an acceptable and, as far as can be evaluated, equitable manner, without major disruption to SHC and HIV clinics.


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