JMIR Publications

ABSTRACT

Background:

Human papillomavirus (HPV) vaccine hesitancy is on the rise and use of the presumptive approach and motivational interviewing by providers may not be enough to influence parental decision-making. Tailored, patient education supporting parent-child communication is promising, yet untested. Delivering such an intervention via mobile phone, before a visit with a healthcare provider may address time constraints within clinic visits and positively impact vaccine uptake.

Objective:

To describe the development and evaluate acceptability of a mobile phone-based, family-focused intervention guided by theory to address concerns of HPV vaccine hesitant (HPV VH) parents; and explore the use of this intervention in parental-child communication.

Methods:

The Health Belief Model and Theory of Reasoned Action guided the development of the intervention content. A multi-level stakeholder engagement process was used to iteratively develop the HPVVaxFacts intervention: 1) community advisory board (CAB) reviews; 2) HPV VH parental advisory panel (PAP) review; 3) Health Communications expert review; 4) HPV VH parent and provider semi-structured qualitative interviews; and 5) a content expert review. Inductive, thematic analysis was used to identify emerging themes in the interview data.

Results:

Qualitative interviews yielded four themes: 1) Overall Views towards Mobile Device Use for Health Information; 2) Acceptability of HPVVaxFacts; 3) Facilitators to HPVVaxFacts Use; and 4) Barriers to HPVVaxFacts Use. The final intervention included a 10-item survey to identify the top 3 concerns of parents. Each concern was mapped to: 1) evidential messages, 2) images/graphics to enhance comprehension and address low literacy, 3) links to credible websites, 4) a video from a provider, 5) suggested questions to ask their child’s doctor; and 6) an adolescent corner to educate the patient and support parent-child communication.

Conclusions:

We demonstrated application of a multi-level stakeholder-engaged process to iteratively develop a novel intervention for HPV VH families, which can be used as a model to develop future interventions related to hesitancy with HPV or other vaccines. This intervention is currently being tested in a pilot study in preparation for a randomized controlled trial aiming to increase HPV vaccination among adolescents with VH parents.