An Educational Intervention to Improve HPV Vaccination: A Cluster Randomized Trial

Abstract

BACKGROUND: Human papillomavirus (HPV) infection can lead to serious health issues and remains the most common sexually transmitted infection. Despite availability of effective vaccines, HPV vaccination rates are suboptimal. METHODS: In a cluster randomized trial, an intervention used to target parents of adolescents (11-17 years) eligible for a dose of HPV vaccine, was tested in pediatric clinics part of an urban health system. Parents watched a digital video outlining the risks and benefits of vaccine using a tablet in the examination room. The primary outcome was change in HPV vaccine status 2 weeks after the clinic visit. An intention-to-treat analysis for the primary outcome used generalized estimating equations to accommodate the potential cluster effect of clinics. RESULTS: A total of 1596 eligible adolescents were observed during the 7-month trial. One-third of adolescents visited an intervention clinic. Adolescents who attended an intervention clinic were more likely to be younger (11-12 years) than those who attended a control clinic (72.4% vs 49.8%; P < .001). No differences in race or sex were observed. The proportion of adolescents with an observed change in vaccine status was higher for those attending an intervention clinic (64.8%) versus control clinic (50.1%; odds ratio, 1.82; 95% confidence interval, 1.47-2.25; P < .001). Adolescents whose parents watched the video had a 3-times greater odds of receiving a dose of the HPV vaccine (78.

Improvement of Parent’s awareness, knowledge, perception, and acceptability of human papillomavirus vaccination after a structured-educational intervention

“…A randomized cluster trial, parents of 11-17 years old girls watched a digital video outlining the risks and benefits of the vaccine was conducted in Indiana, United States. It showed that adolescents whose parents watched the video had a 3-times higher odds of receiving a dose of the HPV vaccine [31].. Another study assessing the effect of a school-based HPV vaccination program used video presentation, and a website for girls 9-14 years old and their parents was conducted in Hongkong. The program resulted in a higher uptake of the HPV vaccine [17].…”

Relative contributions of parental intention and provider recommendation style to HPV and meningococcal vaccine receipt

“…Though educational interventions aimed at parents have generally shown limited impact, 24 one recent study indicated benefit to educating parents through tailored videos during medical visits. 25 Culturally tailored interventions also show promise, though more research is needed. [26][27][28] In the era of social media, respected public health organizations with an online presence aimed at parents are also important for changing perceptions.…”

Waiting Room Videos for Increasing HPV Vaccination: Promise and Pitfalls

“…As the authors aptly point out, the logistics of delivering such an intervention were substantial. 5 Only 1 of 4 patients who were eligible to receive the intervention actually did so. This low level of engagement arose from difficulties in integrating an iPad-based intervention into the clinics' workflow, a challenge that has been reported by many others attempting to integrate mobile health technologies into primary care.…”