Department of Behavioral Science, UTHealth School of Public Health, Houston, TX, USA.
Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Hum Vaccin Immunother. 2022 Nov 30;18(5):2087430. doi: 10.1080/21645515.2022.2087430. Epub 2022 Jun 14.
Parent hesitancy contributes to reduced HPV vaccination rates. The HPVcancerfree app (HPVCF) was designed to assist parents in making evidence-based decisions regarding HPV vaccination. This study examined if parents of vaccine-eligible youth (11-12 yrs.) who use HPVCF in addition to usual care demonstrate significantly more positive intentions and attitudes toward HPV vaccination and greater HPV vaccination rates compared to those not using HPVCF. Clinics (n = 51) within a large urban pediatric network were randomly assigned to treatment (HPVCF + usual care) or comparison (usual care only) conditions in a RCT conducted between September 2017 and February 2019. Parents completed baseline and 5-month follow-up surveys. Participant-level analysis determined 1) change in HPV vaccination initiation behavior and related psychosocial determinants and 2) predictors of HPV vaccine initiation. Parents (n = 375) who completed baseline and 5-month follow-up surveys were female (95.2%), 40.8 (±5.8) yrs. married (83.7%), employed (68.3%), college educated (61.9%), and privately insured (76.5%). Between-group analysis of HPVCF efficacy demonstrated that parents assigned to receive HPVCF significantly increased knowledge about HPV and HPV vaccination ( < .05). Parents who accessed content within HPVCF significantly increased knowledge about HPV & HPV vaccine ( < .01) and perceived effectiveness of HPV vaccine ( < .05). Change in HPV vaccine initiation was not significant. A multivariate model to describe predictors of HPV vaccine initiation demonstrated an association with Tdap and MCV vaccination adoption, positive change in perceived effectiveness of the HPV vaccine, and reduction in perceived barriers against HPV vaccination. HPVCF appears to be a feasible adjunct to the education received in usual care visits and reinforces the value of apps to support the important persuasive voice of the health-care provider in overcoming parent HPV vaccine hesitancy.
家长的犹豫导致 HPV 疫苗接种率降低。HPVcancerfree 应用程序 (HPVCF) 的设计目的是帮助家长在 HPV 疫苗接种方面做出基于证据的决策。本研究考察了在常规护理的基础上使用 HPVCF 的疫苗合格青少年 (11-12 岁) 的父母是否与未使用 HPVCF 的父母相比，对 HPV 疫苗接种表现出更积极的意向和态度，并且 HPV 疫苗接种率更高。在 2017 年 9 月至 2019 年 2 月期间进行的 RCT 中，大型城市儿科网络内的诊所 (n=51) 被随机分配到治疗 (HPVCF+常规护理) 或比较 (仅常规护理) 条件。父母完成了基线和 5 个月的随访调查。参与者水平分析确定了 1) HPV 疫苗接种启动行为及相关心理社会决定因素的变化，以及 2) HPV 疫苗接种启动的预测因素。完成基线和 5 个月随访调查的父母 (n=375) 为女性 (95.2%)，40.8(±5.8) 岁，已婚 (83.7%)，有工作 (68.3%)，大学学历 (61.9%)，私人保险 (76.5%)。HPVCF 疗效的组间分析表明，接受 HPVCF 的父母对 HPV 和 HPV 疫苗接种的知识显著增加 ( < .05)。访问 HPVCF 内容的父母对 HPV 和 HPV 疫苗的知识显著增加 ( < .01) 和 HPV 疫苗的有效性感知 ( < .05)。HPV 疫苗接种的启动变化不显著。描述 HPV 疫苗接种启动预测因素的多变量模型表明，与 Tdap 和 MCV 疫苗接种的采用、对 HPV 疫苗有效性的感知变化以及对 HPV 疫苗接种障碍的感知减少相关。HPVCF 似乎是常规护理就诊时接受的教育的一种可行补充，并且强调了应用程序的价值，以支持医疗保健提供者在克服家长 HPV 疫苗犹豫方面的重要说服声音。
