A Vax4HPV Mobile Application for Parents of Human Papillomavirus Vaccine–Eligible Children

Abstract

Although the human papillomavirus vaccine is efficacious, 40% of 13-year-old adolescents have been vaccinated for human papillomavirus. Implementing theory-based, user-centered applications can address this suboptimal coverage. This formative usability test aimed to develop a theory-based, user-centered interface to stimulate and inform parents' decision making on human papillomavirus vaccination and to help them act upon that decision. Iterative formative assessments were conducted through four focus groups of parents of children aged 9 to 14 years (N = 15). Participants discussed the desired content and features of a vaccine for human papillomavirus smartphone application while reviewing application prototypes. The discussions were recorded, transcribed verbatim, and then underwent qualitative content analysis. Four of the discovered themes were related to the content desired by parents: sources of information, facilitators of human papillomavirus vaccination, addressing the reasons for vaccine hesitancy, and gender-neutral content. The remaining three themes concerned the application's desirable designs and features: clear and descriptive interfaces, accessibility to broad groups of end users, and closing the intention-behavior gap. The need for adolescent human papillomavirus vaccination was generally well received by participants. This study found that theory-based, user-centered applications offering directions to appropriate clinics and human papillomavirus vaccine recommendations offered by nurses, can mitigate hesitancy by providing information via preferred routes and closing intention-behavior gaps.

Digital Health Interventions to Improve Adolescent HPV Vaccination: A Systematic Review

“…Among the 24 articles selected for analysis, four studies focused on text messaging [ 30 , 31 , 32 , 33 ], four studies pertained to mobile apps [ 34 , 35 , 36 , 37 ], eight studies were social media and website-based interventions [ 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ], four studies were game-based interventions [ 46 , 47 , 48 , 49 ], and four studies were video-based interventions [ 50 , 51 , 52 , 53 ]. Thirteen studies (54%) targeted parents, seven studies (29%) targeted both parents and adolescents, and four studies (17%) targeted only adolescents.…”

“…The main outcome measures examined in these studies were categorized as knowledge about HPV and HPV vaccination, vaccination intention, vaccine uptake, and qualitative feedback for those that tested a prototype of their interventions. Knowledge about HPV and HPV vaccination was measured in ten studies [ 31 , 36 , 37 , 38 , 39 , 40 , 46 , 47 , 49 , 51 ], vaccination intention in nine studies [ 36 , 37 , 38 , 42 , 44 , 50 , 51 , 53 ], vaccine uptake in 13 studies [ 30 , 31 , 32 , 33 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 52 ], and eight studies focused on qualitative user feedback of the interventions [ 34 , 35 , 39 , 42 , 46 , 47 , 48 , 49 ]. Common features across the interventions were dissemination of HPV and HPV vaccine information, tailored feedback or personal stories about vaccinating children against HPV, vaccine reminders, HPV discussion forums or Frequently Asked Questions (FAQ), scheduling assistance or clinic locator, and guidance on how to initiate conversations with children about HPV ( Figure 2 ).…”

“…Four studies pertained to mobile apps developed to provide parents with information regarding adolescent HPV vaccination and promote uptake and completion of the HPV vaccine series [ 34 , 35 , 36 , 37 ]. Two of the studies focused on the formative assessment of a prototype HPV vaccine app, Vaccipack and Vax4HPV [ 34 , 35 ].…”

“…Four studies pertained to mobile apps developed to provide parents with information regarding adolescent HPV vaccination and promote uptake and completion of the HPV vaccine series [ 34 , 35 , 36 , 37 ]. Two of the studies focused on the formative assessment of a prototype HPV vaccine app, Vaccipack and Vax4HPV [ 34 , 35 ]. Distinct features of Vaccipack included a vaccine checklist, inspirational stories about parents drawing on common parental beliefs, and an active discussion forum about HPV vaccination.…”

“…Users of this app were also provided an exemplar script to help them facilitate parent-child communication about the vaccine. In addition to acknowledging that the app closed the intention-behavior gap by offering scheduling appointments and locating clinics, parents suggested that the app provide gender-neutral information to eliminate vaccine hesitancy [ 35 ]. Education about adolescent vaccination and parent-adolescent communication about the HPV vaccine were the most cited anticipated benefits for both apps.…”