Parents Experience with an mHealth Intervention to Influence HPV Vaccination Decision-Making: Mixed Methods Feasibility Study (Preprint)

2021 ◽  
Author(s):  
Elisabeth R.B. Becker ◽  
Ross Shegog ◽  
Lara S. Savas ◽  
Erica L. Frost ◽  
Sharon P. Coan ◽  
...  
Keyword(s):  
Decision Making ◽  
Mixed Methods ◽  
Hpv Vaccine ◽  
Rating Scales ◽  
Controlled Trial ◽  
Hpv Vaccination ◽  
Future Research ◽  
Mhealth Intervention ◽  
Pediatric Clinic ◽  
Vaccination Decision

BACKGROUND HPV-attributed cancers are preventable, yet HPV vaccination rates severely lag other adolescent vaccinations. HPVcancerFree is an mHealth intervention developed to influence parental HPV vaccination decision making by raising awareness of HPV, reducing HPV vaccination barriers and enabling HPV vaccination scheduling and reminders through a smartphone. Evaluating the feasibility and user experience of mHealth interventions are vital components in assessing their quality and success. OBJECTIVE We aimed to evaluate the feasibility of HPVcancerFree using mixed methods data collected from log files, survey measures and qualitative feedback METHODS Study data was evaluated from parents in a large U.S. pediatric clinic network using HPVcancerFree in the intervention arm of a group randomized controlled trial. Log data captured HPVcancerFree retention and use. Post intervention rating scales and items, including the uMARS survey (reflecting engagement, functionality, aesthetics and information), assessed HPVcancerFree utility, usefulness, understandability, appeal, credibility, perceived impact and overall quality. Open-ended responses assessed patient recommendations for HPVcancerFree enhancement. RESULTS The 98 parent participants were mainly female (96%), 41±5.67 years of age, college educated (56%), white, non-Hispanic (56%) and had private health insurance for their children (77%). Parents used HPVcancerFree 197 times with average visit duration approximating 3.5 minutes. The uMARS app quality score was positively skewed (4.2/5). Mean ratings were highest for information (4.46±0.53) and lowest on engagement (3.74±0.69). Forty-seven percent of parents rated HPVcancerFree as helpful in HPV vaccination decision making and 17% attributed HPV vaccine initiation to HPVcancerFree. Parents reported that HPVcancerFree increased their awareness (89%), knowledge (89%) and HPV vaccination intentions (68%). Most parents rated the four HPVcancerFree components as useful (74-94%). Parents agreed that HPVcancerFree was clear (91%), accurate (91%), and more helpful than other HPV vaccine information they had received (94%), and that they would recommend it to others (85%). Parents suggested increasing awareness about the app, incorporating a tailored reminder system and creating opportunities to engage with adolescents about HPV and sexual health as enhancements for future iterations. CONCLUSIONS HPVcancerFree is a feasible mHealth intervention to support regular pediatric clinic HPV vaccine education. HPVCF was well received by parents. Future research is indicated to determine its efficacy to persuade parents to vaccinate and best promotional strategies to motivate parents to use HPVcancerFree.

scholarly journals Parents Experience with an mHealth Intervention to Influence HPV Vaccination Decision-Making: Mixed Methods Study (Preprint)

10.2196/30340 ◽  
2021 ◽  
Author(s):  
Elisabeth R.B. Becker ◽  
Ross Shegog ◽  
Lara S. Savas ◽  
Erica L. Frost ◽  
Sharon P. Coan ◽  
...  
Keyword(s):  
Decision Making ◽  
Mixed Methods ◽  
Hpv Vaccination ◽  
Mixed Methods Study ◽  
Mhealth Intervention ◽  
Vaccination Decision

scholarly journals Vaccination Decision-Making and HPV Knowledge: How Informed and Engaged Are Young Adult HPV Vaccine Recipients in Australia?

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Rebekah C. Laidsaar-Powell ◽  
Kirsten J. McCaffery ◽  
Tanya Mather ◽  
Ilona Juraskova
Keyword(s):  
Decision Making ◽  
Sexual Health ◽  
Hpv Vaccine ◽  
Sexual Attitudes ◽  
Population Based ◽  
Future Research ◽  
Decision Making Process ◽  
Post Vaccination ◽  
Hpv Knowledge ◽  
Vaccination Decision

Objectives. To date, there has been limited research on the decision-making process of HPV vaccine recipients. This study aimed to explore HPV-related knowledge, vaccination decision-making, and post vaccination attitudes about sexual behaviour in women who participated in the Australian school- and population-based HPV vaccine program. Materials and Methods. 102 female university students who had received the HPV vaccine (<27 years) completed scales on knowledge, vaccination decision-making, and post vaccination sexual attitudes. Results. HPV-related knowledge was low (M=57%), and women felt moderately involved in the vaccination decision (M=62%). Most women had not changed their sexual attitudes as a consequence of vaccination; however, some reported that since vaccination they feel less concerned about sexual health (19%). There were no significant differences between school- and population-based recipients on HPV knowledge (P=.559) or post vaccination sexual attitudes (P=.709). School-based recipients were significantly less autonomous in their decision-making (P=.001). Conclusion. Poor knowledge indicates a need for provision of information about HPV and post vaccination sexual health. Additionally, policy makers and health professionals may benefit from reiterating the importance of continued sexual health practices to HPV vaccine recipients. Future research should assess whether young women need to be more involved in the informed decision-making process for HPV vaccination.

scholarly journals Effectiveness of a Web-Based Tailored Intervention With Virtual Assistants Promoting the Acceptability of HPV Vaccination Among Mothers of Invited Girls: Randomized Controlled Trial

2017 ◽  
Vol 19 (9) ◽  
pp. e312 ◽  
Author(s):  
Mirjam Pot ◽  
Theo GWM Paulussen ◽  
Robert AC Ruiter ◽  
Iris Eekhout ◽  
Hester E de Melker ◽  
...  
Keyword(s):  
Decision Making ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Hpv Vaccination ◽  
Decisional Conflict ◽  
Future Research ◽  
Tailored Intervention ◽  
Web Based ◽  
Vaccination Uptake ◽  
Randomized Controlled

Background In 2010, the human papillomavirus (HPV) vaccination was introduced in the Dutch National Immunization Program for 12-year-old girls, aiming to reduce the incidence of cervical cancer in women. HPV vaccination uptake turned out to be lower than expected: 61% versus 70%, respectively. Mothers were shown to play the most important role in the immunization decision about this vaccination. They had also expressed their need for interactive personal information about the HPV vaccination over and above the existing universal general information. To improve the effectiveness of the existing education about the HPV vaccination, we systematically developed a Web-based tailored intervention with virtual assistants providing mothers of girls to be invited with tailored feedback on their decision making about the HPV vaccination. Objective The aim of this study was to evaluate the effectiveness of the Web-based tailored intervention for promoting HPV vaccination acceptance by means of a randomized controlled trial (RCT). Methods Mothers were recruited via the Dutch vaccination register (Praeventis) (n=36,000) and three Web-based panels (n=2483). Those who gave informed consent (N=8062) were randomly assigned to the control (n=4067) or intervention condition (n=3995). HPV vaccination uptake, as registered by Praeventis once the HPV vaccination round was completed, was used as the primary outcome. Secondary outcomes were differential scores across conditions between baseline (before the provided access to the new tailored intervention) and follow-up (just before the first vaccination) regarding the mothers’ degree of informed decision making (IDM), decisional conflict, and critical determinants of HPV vaccination uptake among which are intention, attitude, risk perception, and outcome beliefs. Results Intention-to-treat analysis (N=8062) showed a significant positive effect of the intervention on IDM, decisional conflict, and nearly all determinants of HPV vaccination uptake (P<.001). No effect was found on uptake (P=.60). This may be attributed to the overall high uptake rates in both conditions. Mothers evaluated the intervention as highly positive, including the website as well as the virtual assistants that were used to deliver the tailored feedback. Conclusions This computer-tailored intervention has the potential to improve HPV vaccination acceptability and IDM and to decrease decisional conflict among mothers of invited girls. Implications for future research are discussed. Trial Registration Trialregister.nl NTR4935; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4935 (Archived by WebCite at http://www.webcitation.org/6srT7l9EM)

The impact of patient narratives on medical students’ perceptions of shared decision making: A randomized controlled trial

2020 ◽  
Author(s):  
Martina Bientzle ◽  
Marie Eggeling ◽  
Simone Korger ◽  
Joachim Kimmerle
Keyword(s):  
Decision Making ◽  
Medical Students ◽  
Shared Decision Making ◽  
Medical Training ◽  
Controlled Trial ◽  
Future Research ◽  
Shared Decision ◽  
Randomized Controlled ◽  
Information Text ◽  
The Impact

BACKGROUND: Successful shared decision making (SDM) in clinical practice requires that future clinicians learn to appreciate the value of patient participation as early as in their medical training. Narratives, such as patient testimonials, have been successfully used to support patients’ decision-making process. Previous research suggests that narratives may also be used for increasing clinicians’ empathy and responsiveness in medical consultations. However, so far, no studies have investigated the benefits of narratives for conveying the relevance of SDM to medical students.METHODS: In this randomized controlled experiment, N = 167 medical students were put into a scenario where they prepared for medical consultation with a patient having Parkinson disease. After receiving general information, participants read either a narrative patient testimonial or a fact-based information text. We measured their perceptions of SDM, their control preferences (i.e., their priorities as to who should make the decision), and the time they intended to spend for the consultation.RESULTS: Participants in the narrative patient testimonial condition referred more strongly to the patient as the one who should make decisions than participants who read the information text. Participants who read the patient narrative also considered SDM in situations with more than one treatment option to be more important than participants in the information text condition. There were no group differences regarding their control preferences. Participants who read the patient testimonial indicated that they would schedule more time for the consultation.CONCLUSIONS: These findings show that narratives can potentially be useful for imparting the relevance of SDM and patient-centered values to medical students. We discuss possible causes of this effect and implications for training and future research.

scholarly journals Health Care Providers’ Knowledge of HPV Vaccination, Barriers, and Strategies in a State With Low HPV Vaccine Receipt: Mixed-Methods Study

JMIR Cancer ◽  
2017 ◽  
Vol 3 (2) ◽  
pp. e12 ◽  
Author(s):  
Echo L Warner ◽  
Qian Ding ◽  
Lisa Pappas ◽  
Julia Bodson ◽  
Brynn Fowler ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Care Providers ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Mixed Methods Study ◽  
Care Providers ◽  
Vaccination Barriers

scholarly journals “THOSE WHO LOVE, VACCINATE”: PARENTAL PERCEPTIONS OF HPV VACCINATION

2015 ◽  
Vol 25 (3) ◽  
pp. 341 ◽  
Author(s):  
Ellen Dias De Oliveira Chiang ◽  
Misha L. Baker ◽  
Daniella Figueroa-Downing ◽  
Maria Luiza Baggio ◽  
Luisa Villa ◽  
...  
Keyword(s):  
Decision Making ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Explanatory Power ◽  
Parental Knowledge ◽  
Specific Factors ◽  
Knowledge Levels ◽  
Parental Decisions ◽  
Context Specific ◽  
Vaccine Decision Making

Introduction: In March 2014, Brazil began its national HPV immunization campaign targeting girls ages 9-13. Objective: Describe determinants of parental decisions to vaccinate their daughters against HPV.Method: In this qualitative study, thirty semi-structured interviews were conducted at five health posts in São Paulo, Brazil. Interview questions explored parental opinions of disease prevention methods, vaccines in general, and the HPV vaccine. Interviews were analyzed using grounded theory. Results: Overall, parental knowledge about HPV and the vaccine was low, yet most eligible daughters had been vaccinated. Parents perceived the HPV vaccine to be normal, preventative, and protective. Parents viewed themselves as accountable for their children’s health, and saw the vaccine as a parenting tool for indirect control. Trust in healthcare professionals and an awareness of the dangers of “nowadays” (uncertainties regarding disease and sexual behavior) were also important in vaccine decision-making. These factors held more explanatory power for decisions to vaccinate than parental knowledge levels. This was the first study to qualitatively examine the perception of publically provided HPV vaccination among parents with eligible daughters in Brazil. The findings help interpret the greater than 90% coverage for the first HPV vaccine dose in Brazil. The results indicate that attempts to understand, maintain, or modify vaccination rates require the consideration of context specific factors, which influence both parent perspectives and vaccination decisions. Conclusion: HPV knowledge levels are not predictive of parental decisions to vaccinate daughters. Context specific factors from the sociocultural dimensions of parenting, sexuality, gender, and the healthcare system are more influential in vaccine decision-making.

scholarly journals Fathers’ participation in the HPV vaccination decision-making process doesn’t increase parents’ intention to make daughters get the vaccine

2020 ◽  
Vol 16 (7) ◽  
pp. 1653-1658 ◽  
Author(s):  
Tomomi Egawa-Takata ◽  
Ruriko Nakae ◽  
Mariko Shindo ◽  
Ai Miyoshi ◽  
Tsuyoshi Takiuchi ◽  
...  
Keyword(s):  
Decision Making ◽  
Hpv Vaccination ◽  
Decision Making Process ◽  
Vaccination Decision

scholarly journals Does electronic consent improve the logistics and uptake of hpv vaccination in adolescent girls? A mixed methods theory informed evaluation of an intervention

2020 ◽  
Author(s):  
Tracey Chantler ◽  
Ellen Pringle ◽  
Sadie Bell ◽  
Rosie Cooper ◽  
Emily Edmundson ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Adolescent Girls ◽  
Hpv Vaccine ◽  
Information Needs ◽  
New Technologies ◽  
Hpv Vaccination ◽  
Vaccine Uptake ◽  
Consent Form ◽  
Proxy Consent ◽  
Hpv Vaccine Uptake

Abstract Background Technological solutions may improve the logistics of obtaining parental consent in school-based immunisation programmes. In 2018/19 a health care organisation in London, England, piloted an electronic consent intervention in the adolescent girls’ HPV vaccination programme. We conducted a mixed-methods evaluation to examine the usability and acceptability of the intervention and assess its impact on consent form returns and HPV vaccine uptake. Methods The intervention was implemented in 14 secondary schools in seven South London boroughs. Each e-consent school was matched with a school that used standard paper consent. Matching was based on location and the proportion of students: i. with English as a second language, ii. receiving free school meals (socio-economic status proxy). Consent form return rates and HPV vaccine uptake were compared quantitatively between intervention and matched schools. Data from immunisation session observations (n=7), school feedback forms (n=14), individual and group interviews with implementers (n=8), parents and adolescents (n=12) and a focus group discussion with adolescents was analysed thematically to document user’s experiences investigate the implementation of the intervention. Results HPV vaccination uptake did not differ between e-consent and matched paper consent schools, but timely consent form return was significantly lower in the e-consent schools (73.3% (n=11) vs 91.6% (n=11), p=0.008). The transition to using the system was not straightforward, whilst schools and staff understood the potential benefits, they found it difficult to adapt to new ways of working which removed some level of control from schools. Part of the reason for lower consent form return in e-consent schools was that some parents found the intervention difficult to access and use. Adolescents highlighted the potential for e-consent interventions to by-pass their information needs. Conclusions The e-consent intervention did not improve consent form return or vaccine uptake due to challenges encountered in transitioning to a new way of working. New technologies require embedding before they become incorporated in everyday practice. The intervention is undergoing further iterative development to improve its usability, ensure schools are appropriately involved and adolescents receive tailored immunisation information. A re-evaluation once stakeholders are accustomed to e-consent may be required to understand its impact.

scholarly journals Obstacles to Implementing the HPV Vaccine: Is it Worth Pursuing or Not?

2019 ◽  
Vol 4 (4) ◽  
pp. 165-169
Author(s):  
Mastura Mohd Sopian ◽  
Sharifah Azdiana Tuan Din ◽  
Hasmah Hussin
Keyword(s):  
Lung Cancer ◽  
Cervical Cancer ◽  
Decision Making ◽  
Literature Review ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Vaccination Program ◽  
Extensive Literature ◽  
Younger Women ◽  
Vaccination Acceptance

Cervical cancer, along with breast, colorectal, and lung cancer, has become increasingly problematic in Malaysia. The prevalence of cervical cancer in Malaysia is projected to rise in younger women, and Malaysia views this prediction with concern and awareness of the need to take action to prevent the illness among those who are currently healthy. Providing free HPV vaccination is a way to lower the risk of developing cervical cancer among women in Malaysia. However, while Malaysia has been able to provide this vaccination at minimal or no cost, changes in socio-economic circumstances have stretched the demand. This review aims to highlight the probability of HPV vaccination acceptance and the reasons for it. An extensive literature review of acceptance, knowledge, attitude, practice, and decision making about HPV vaccination was performed to describe issues related to vaccination. The evidence presented herein can help identify ways to improve the HPV vaccination program in Malaysia.

scholarly journals Understanding How Adolescents Think about the HPV Vaccine

Vaccines ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 693
Author(s):  
Robyn A. Pennella ◽  
Katherine A. Ayers ◽  
Heather M. Brandt
Keyword(s):  
Decision Making ◽  
Thematic Analysis ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
The United States ◽  
The Body ◽  
Decision Making Process ◽  
Vaccination Rates ◽  
Qualitative Thematic Analysis ◽  
Adolescent Attitudes

Despite educational efforts, Tennessee human papillomavirus (HPV) vaccination rates are 43%, among the lowest in the United States. This study examined how adolescents think about the HPV vaccine to identify patterns and misconceptions to enhance educational efforts. Adolescents (ages 11–12) (N = 168) responded to open-ended questions regarding their thinking about the HPV vaccine. Data were analyzed and interpreted using qualitative thematic analysis. Three domains of themes emerged from responses: (1) characteristics of HPV vaccination, (2) knowledge-related themes, and (3) beliefs-related themes. Prevention of HPV and cancer was the most referenced characteristic of HPV vaccination followed by HPV vaccine rates and HPV vaccine efficacy. Student inquiries were mostly centered on HPV vaccine composition, administration, duration and how the vaccine interacts with the body. Some responses indicated a desire for more information about HPV not specific to the HPV vaccine. Overall, adolescent attitudes were positive towards the HPV vaccine. This study highlights specific questions adolescents have about the vaccine that can be used to tailor future HPV educational efforts, empowering adolescents with the knowledge to be more active students in the decision-making process. In addition, the potential for adolescents to serve as community advocates for the vaccine should be considered for future interventions.

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