JMIR Publications

ABSTRACT

Background:

Human papillomavirus is a common and preventable sexually transmitted infection but vaccination rates in the U.S. among the target age group, 11-12 years old, are lower than national goals. Interventions that address the barriers and facilitators to vaccination are important in improving HPV vaccination rates. Online text-based focus groups are becoming a promising method that may be well-suited for conducting formative research to inform the design of digital behavior change intervention content and features that address HPV vaccination decision making.

Objective:

This study explores parental HPV vaccination decision-making processes using an online text-based focus group protocol in order to inform content and feature recommendations for an HPV prevention digital behavior change intervention.

Methods:

We conducted four online text-based synchronous focus groups via Skype with parents of 11-13-year-old patients within a large urban U.S. pediatric clinic network.

Results:

The 22 parents were majority female, white non-Hispanic, had a graduate or professional degree and had private health insurance for their children. Fifty-six percent of the parents’ 11-13-year-old children had initiated HPV vaccination. Most parents had experience using Skype (82%). Parents requested a text-only chat format (47%) over an audio-visual call format (6%) for their focus group. The three main themes from the qualitative data were (1) HPV vaccination misinformation and confusion; (2) HPV beliefs and attitudes; and (3) facilitators to vaccination. Eleven intervention content and feature recommendations emerged from the themes including: address HPV knowledge barriers using trusted sources; design for a family audience; focus on the framing of messages; report reputable HPV research in a digestible format; and expand the clinic visit experience.

Conclusions:

Synchronous text-based focus groups are feasible for conducting formative research on HPV vaccination decision making. Among well-educated and well-resourced parents, there is misinformation about HPV and knowledge barriers that influence HPV attitudes and beliefs. Parents want to conduct their own HPV research as well as receive relevant HPV vaccination advice from their child’s pediatrician. In addition, parents want an enhanced clinic visit experience which lets them access and connect to tailored information before and after clinic visits. The results gathered provide guidance for content and features that may inform a more responsive digital behavior change intervention to address HPV vaccination decision making among parents.