JMIR Publications

ABSTRACT

Background:

mHealth interventions offer the potential to facilitate provider-parent communication on HPV vaccination to reduce concerns and increase intention and uptake. HPVVaxFacts is a novel, mobile web app delivered to a parent's phone before clinic visits, offering education tailored to their concerns based on the Health Belief Model and Theory of Planned Behavior.

Objective:

This study aimed to assess the feasibility, acceptability, and preliminary efficacy of this mobile web app HPVVaxFacts among parents of adolescents aged 9-17 representative of the continuum of vaccine hesitancy.

Methods:

We conducted a pilot, 2-arm randomized control trial comparing two groups: tailored education via HPVVaxFacts (n=27) (intervention) compared to nutrition education via a mobile web app offering children’s nutrition information (n=30) (attention control) in two urban clinics in Tennessee from June to September 2023. Eligible parents had or were a caregiver to a child aged 9 to 17 years who were unvaccinated against HPV, had a mobile phone, had an upcoming clinic visit, and spoke English. Participants were recruited using patient intake software- Phreesia and eClinicalWorks. We assessed feasibility, acceptability, and preliminary efficacy to increase knowledge, attitudes, intentions, and vaccination rates. Parents were assessed at baseline and immediately post-education program via surveys and follow-up interviews, along with a provider consultation. Vaccination rates were assessed at 12 months post-intervention. Staff consultation was 1-month post-intervention, and parent interviews up to 9 months post-intervention.

Results:

HPV vaccination initiation rates were significantly greater in the intervention arm compared to the attention control arm. Furthermore, the mobile web app was feasible and parents found this mobile web app acceptable. Next steps include conducting a well-powered efficacy trial to determine the impact of HPVVaxFacts on HPV initiation vaccine rates and parental hesitancy factors, as well as to explore an interaction, effect modification, and mediation among different variables.

Conclusions:

Key indicators showed within-group and across- group improvements from baseline to immediate post-intervention for HPV vaccination rates in the HPVVaxFacts arm, suggesting potential efficacy of HPVVaxFacts. Furthermore, parents found this mobile web app acceptable. Next steps include conducting a well-powered efficacy trial to determine the impact of HPVVaxFacts on HPV initiation vaccine rates and parental hesitancy factors, as well as to explore an interaction, effect modification, and mediation among different variables. Clinical Trial: Clinical trial is registered under protocol number NCT04380623.