Vacteens.org: A Mobile Web app to Improve HPV Vaccine Uptake

Abstract

U.S. HPV vaccine uptake remains below the Healthy People 2030 goal of 80% series completion. Parental concerns and misinformation about the efficacy and safety of the Human Papillomavirus (HPV) vaccine remain, and may be addressed by digital interventions tailored to their concerns. Reported here are results from a small scale randomized trial testing a mobile web app for parents and their adolescent daughters (ages 11–14 years) encouraging HPV vaccination in New Mexico, an ethnically-diverse U.S. state.Methods: A clinic-cluster randomized trial where pediatric clinics (n = 9) were recruited and randomized, and parent-adolescent pairs (n = 82) within clinics received either the Vacteens.org/Vacunadolescente.org mobile web app or Usual and Customary (UC) HPV Vaccination information. Parents completed online surveys at baseline and 3-months. Daughters' HPV vaccine data were collected from the New Mexico State Immunization Information System 1 year post baseline.Results: Three month survey results found Vacteens.org/Vacunadolescente.org parents to have higher positive HPV vaccine beliefs, informed decision making, intent to vaccinate and vaccine confidence outcomes than UC parents. HPV vaccine data found higher first dose HPV vaccination (Pearson χ2 = 6.13, p = 0.013, Vacteens.org/Vacunadolescente.org group 59.4%, UC group 40.6%), and higher HPV vaccination series completion (Pearson χ2 = 6.49, p = 0.011, Vacteens.org/Vacunadolescente.org group 68.4%, UC group 31.6%).Conclusions: The small trial results showed the Vacteens.org/Vacunadolescente.org web app prompted positive vaccine-related attitudes and beliefs, and more HPV vaccination initiation and series completion. Mobile web apps can make decision-making tools for HPV vaccination widely available on digital platforms, reducing vaccine hesitancy, and confusion and increase HPV vaccine uptake.

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.…”

“…Thirteen studies (54%) targeted parents, seven studies (29%) targeted both parents and adolescents, and four studies (17%) targeted only adolescents. Fifteen of the studies [ 30 , 31 , 32 , 33 , 36 , 37 , 41 , 43 , 44 , 45 , 46 , 51 , 52 , 53 ] were RCTs and four studies [ 38 , 42 , 49 , 50 ] were non-randomized pre-post designs without a control group. Selected studies did not represent various geographical settings as most of the studies (18/24, 75%) were conducted in the United States.…”

“…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 ].…”

“…Two studies evaluated HPV vaccination intention and vaccine initiation behavior following the use of the apps [ 36 , 37 ]. HPV CancerFree (HPVCF) comprised various educational contents including debunking misinformation, functioned as a medium to facilitate parent-provider communication, and operated as an assistant to schedule HPV vaccination appointments.…”