Persuasiveness of Statistics and Patients’ and Mothers’ Narratives in Human Papillomavirus Vaccine Recommendation Messages: A Randomized Controlled Study in Japan

Abstract

BackgroundThe human papillomavirus (HPV) vaccination percentage among age-eligible girls in Japan is only in the single digits. This signals the need for effective vaccine communication tactics. This study aimed to examine the influence of statistical data and narrative HPV vaccination recommendation massages on recipients’ vaccination intentions.MethodsThis randomized controlled study covered 1,432 mothers who had daughters aged 12–16 years. It compared message persuasiveness among four conditions: statistical messages only; narrative messages of a patient who experienced cervical cancer, in addition to statistical messages; narrative messages of a mother whose daughter experienced cervical cancer, in addition to statistical messages; and a control. Vaccination intentions to have one’s daughter(s) receive the HPV vaccine before and after reading intervention materials were assessed. Statistical analysis was conducted using analysis of variance with Tukey’s test or Games–Howell post hoc test, and analysis of covariance with Bonferroni correction.ResultsVaccination intentions after intervention in the three intervention conditions were higher than the control condition (p < 0.001). A mother’s narrative messages in addition to statistical messages increased HPV vaccination intention the most of all tested intervention conditions. A significant difference in the estimated means of intention with the covariate adjustment for baseline value (i.e., intention before intervention) was found between a mother’s narrative messages in addition to statistical messages and statistical messages only (p = 0.040).DiscussionMothers’ narrative messages may be persuasive when targeting mothers for promoting HPV vaccination. This may be because mothers can easily relate to and identify with communications from other mothers. However, for effective HPV vaccine communication, further studies are needed to understand more about persuasive differences in terms of statistics, narratives, and narrators. Directions for future research are also suggested.

Examining Long-Term Effects of Human Papillomavirus Vaccine Recommendation Messages: A 4-months Follow-up Survey of a Randomized Controlled Study in Japan

“…Thus, the answer to our research question 2 was also "no". Our previous study showed that vaccination intention increased significantly directly after reading intervention materials, and that statistical messages plus a mother's narrative increased vaccination intention the most [9]. However, the present findings revealed that those effects wore off during the 4 months following intervention.…”

“…This result indicated that exposure to messaging about efficacy and safety of HPV vaccine may increase vaccination intention of mothers with daughters directly after exposure to messaging, whether this includes only statistical messages, or narratives of experiences with cervical cancer in addition to statistical messages. Additionally, our previous study showed that the intention for the statistical messages plus mother's narrative was the highest among the intervention groups and was significantly higher than in the statistics-only group (p=0.040) [9]. This indicated that the narrative messages of a mother whose daughter experienced cervical cancer may be persuasive for audiences who are mothers with daughters.…”

“…Detailed information was reported in our previous study [9]. Briefly, in that study, participants were recruited from among individuals registered in a survey company database in Japan.…”

“…Therefore, we previously conducted a randomized controlled study to examine the types of persuasive messages to use when recommending HPV vaccination to mothers with daughters in September 2017 in Japan [9]. We compared message persuasiveness according to four conditions: messages including statistical information only; statistical messages plus narrative messages of a patient who experienced cervical cancer; statistical messages plus narrative messages of a mother whose daughter experienced cervical cancer; and a control condition [9]. Our previous study showed that messages containing statistics information only, as well as a narrative (of a patient or a mother) in addition to statistical messages, significantly increased participants' attitude and intention to have their daughter(s) receive the HPV vaccine, compared with prior to the intervention and with participants who received no messaging (p<0.001) [9].…”

“…We compared message persuasiveness according to four conditions: messages including statistical information only; statistical messages plus narrative messages of a patient who experienced cervical cancer; statistical messages plus narrative messages of a mother whose daughter experienced cervical cancer; and a control condition [9]. Our previous study showed that messages containing statistics information only, as well as a narrative (of a patient or a mother) in addition to statistical messages, significantly increased participants' attitude and intention to have their daughter(s) receive the HPV vaccine, compared with prior to the intervention and with participants who received no messaging (p<0.001) [9]. This result indicated that exposure to messaging about efficacy and safety of HPV vaccine may increase vaccination intention of mothers with daughters directly after exposure to messaging, whether this includes only statistical messages, or narratives of experiences with cervical cancer in addition to statistical messages.…”