Communication Strategies for Increasing HPV Vaccination

Overseen By Florence Momplaisir

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Pennsylvania

Disqualifiers: Under 18, Over 45, Received HPV vaccine

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

3689 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to identify the most effective ways to communicate and encourage adults to receive the HPV vaccine, which prevents cancers caused by the Human Papillomavirus. Researchers are testing various message strategies to determine which ones increase the likelihood of vaccination. Participants will receive one of several message types to identify the most effective approach. Adults aged 18-45 who have not received the HPV vaccine and are certain about it might be suitable for this study. As an unphased trial, this study provides a unique opportunity to contribute to significant research on public health communication strategies.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these communication strategies are safe for increasing HPV vaccination rates?

Research has shown that the messages tested in this study are generally safe. Previous studies have explored various ways to discuss the HPV vaccine and found these methods can encourage vaccination without causing harm. For example, one study used texts and messages to promote the HPV vaccine, and participants did not report any negative effects from these messages.

This trial focuses on communication methods, not a new drug or vaccine. The messages aim to encourage vaccination against HPV, a virus linked to certain cancers. As these are just messages, there are no physical side effects like those associated with medications. The focus is on how these messages can increase the likelihood of vaccination. Therefore, the safety of these messages is not a concern as it might be with new drugs. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores new ways to boost HPV vaccination rates using theory-based messages. Unlike standard approaches that might rely heavily on general public health campaigns or reminders, these messages are crafted specifically to resonate with different psychological theories, aiming to connect more deeply with individuals’ motivations and concerns. The trial involves six different message conditions, each uniquely tailored to test which communication strategy is most effective at increasing vaccination uptake. This innovative approach could pave the way for more personalized and effective public health strategies, potentially leading to higher vaccination rates and better prevention of HPV-related diseases.

What evidence suggests that this trial's communication strategies could be effective for increasing HPV vaccination rates?

This trial will compare different theory-based message conditions to determine their effectiveness in increasing HPV vaccination rates. Research has shown that clear communication can greatly boost HPV vaccination rates. Studies have found that messages emphasizing cancer prevention, rather than the transmission of HPV, are more persuasive. Other research indicates that digital messages can enhance people's willingness to get vaccinated and their trust in the vaccine's safety. Additionally, when healthcare providers receive training to confidently recommend vaccines, they tend to view and suggest the HPV vaccine more positively. These findings suggest that well-designed messages could encourage more adults to choose vaccination. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for adults aged 18-45 who may be hesitant about getting the HPV vaccine. It aims to find effective communication strategies that encourage vaccination.

Exclusion Criteria

I have received the HPV vaccine or I am not sure if I have.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive theory-based messages to strengthen HPV vaccine intentions

1 day

1 visit (virtual)

Follow-up

Participants are monitored for changes in HPV vaccination intention immediately after the intervention

Immediately after intervention

What Are the Treatments Tested in This Trial?

Interventions

• Messages

Trial Overview The study tests different messages designed to increase intentions to get vaccinated against HPV. Over 3,689 adults will participate in a survey experiment as part of this research.

How Is the Trial Designed?

Group I: Theory-Based Message Condition 5 Experimental Treatment 1 Intervention

Group II: Theory-Based Message Condition 4 Experimental Treatment 1 Intervention

Group III: Theory-Based Message Condition 3 Experimental Treatment 1 Intervention

Group IV: Theory-Based Message Condition 2 Experimental Treatment 1 Intervention

Group V: Theory-Based Message Condition 1 Experimental Treatment 1 Intervention

Group VI: Theory-Based Message Condition 6 Active Control 1 Intervention

Who Is Running the Clinical Trial?

University of Pennsylvania

Lead Sponsor

Trials

2,118

Recruited

45,270,000+

Published Research Related to This Trial

In a national survey of 501 mothers of adolescent girls, only 51.1% reported that their daughters received the HPV vaccine, and only 38.3% completed all three doses, highlighting a significant public health issue.

Common reasons for not vaccinating included concerns about vaccine safety and lack of recommendation from healthcare providers, indicating that addressing these fears and improving provider communication could enhance vaccination rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A national study of HPV vaccination of adolescent girls: rates, predictors, and reasons for non-vaccination. Kester, LM., Zimet, GD., Fortenberry, JD., et al.[2021]

Mothers are the primary decision-makers for HPV vaccination, with a strong emphasis on prevention messages about cervical cancer being the most effective way to motivate parents across five countries.

Television is the preferred source of information about HPV vaccination in most countries surveyed, highlighting the importance of effective communication strategies by providers to enhance vaccination uptake.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Persuasive messaging for human papillomavirus vaccination by adolescent providers in a five-country multi-site study. Rwamwejo, J., Ramos, S., Morgan, K., et al.[2020]

A quality improvement initiative successfully increased HPV vaccine completion rates among adolescents from 50.9% to 61.7%, with significant improvements for both males and females.

The study demonstrated that enhancing provider recommendations and ensuring consistent vaccine availability at visits led to a notable rise in vaccination rates, with one-dose rates reaching 88.4% for males and 91.5% for females.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Increasing HPV Vaccination Coverage Through Provider-Based Interventions. Krantz, L., Ollberding, NJ., Beck, AF., et al.[2019]

The implementation of a strategic toolkit at Johns Hopkins University significantly increased HPV vaccination rates among college students from 12.2% to 20.8%, demonstrating an effective intervention in a population of 2,479 students.

The toolkit included educational presentations, visual messaging, and prompts in electronic medical records, which not only improved overall vaccination rates but also showed notable increases in vaccination rates among male students.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Strategies to improve human papillomavirus (HPV) vaccination rates among college students. Kessler, R., Auwaerter, P.[2023]

Text message reminders significantly improved the completion rates of the HPV vaccine series among adolescents, with a hazard ratio of 2.34, leading to an average of 71 days earlier receipt of the third dose compared to controls.

Phone reminders were only effective for those who had just started the vaccine series, showing a hazard ratio of 1.91 for those enrolling at dose 1, but did not significantly impact overall completion rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Phone and Text Message Reminders on Completion of the Human Papillomavirus Vaccine Series. Rand, CM., Vincelli, P., Goldstein, NPN., et al.[2022]

Gardasil-9, the only HPV vaccine available in the U.S., is nearly 100% effective at preventing precancers caused by oncogenic HPV types, yet only about half of adolescents are fully vaccinated.

Strong and presumptive recommendations from healthcare clinicians significantly improve HPV vaccine uptake, highlighting the importance of effective communication strategies in increasing vaccination rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinician communication strategies associated with increased uptake of the human papillomavirus (HPV) vaccine: A systematic review. Constable, C., Ferguson, K., Nicholson, J., et al.[2022]

From 2015 to 2018, the percentage of caregivers citing safety concerns as the main reason for not vaccinating their adolescents against HPV increased significantly from 13.0% to 23.4%, indicating a growing hesitancy related to vaccine safety.

Despite the rise in safety concerns among parents, the actual reporting of adverse events (AEs) following HPV vaccination decreased, suggesting that public fears may not align with the safety data, which shows stable serious AE rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Trends in Human Papillomavirus Vaccine Safety Concerns and Adverse Event Reporting in the United States. Sonawane, K., Lin, YY., Damgacioglu, H., et al.[2022]

Healthcare providers are less likely to recommend the HPV vaccine if they feel uncomfortable discussing sexual health, perceive parental hesitance, or view patients as low risk, which can negatively impact vaccination rates.

Patients, particularly younger individuals, males, and those from racial/ethnic minorities, are less likely to receive strong recommendations for the HPV vaccine, highlighting the need for clearer communication strategies from providers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Provider communication about HPV vaccination: A systematic review. Gilkey, MB., McRee, AL.[2023]

The introduction of the Zathu mini magazine significantly increased awareness and positive attitudes towards the HPV vaccine among 9-year-old girls and their caregivers in Malawi, demonstrating the effectiveness of girl-centered communication strategies.

Consumption of the Zathu mini magazine was positively correlated with an increase in HPV vaccine uptake among girls, indicating that targeted educational materials can effectively drive vaccination rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using branded behaviour change communication to create demand for the HPV vaccine among girls in Malawi: An evaluation of Girl Effect's Zathu mini magazine. Jones, A., Kawesa-Newell, N.[2022]

A clinical trial involving 7,718 young adults aged 18-26 tested different outreach methods to encourage HPV vaccination, revealing that personalized messages and mailed letters increased vaccination rates compared to no additional outreach.

Despite the increase in vaccination rates (from 3.5% with no outreach to 5.1% with mailed letters), the overall gains were not clinically significant, indicating a need for more effective strategies to improve HPV vaccination among young adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Learning Health System Approach to Increasing Human Papillomavirus Immunizations Among Young Adults. Khan, AA., Tran, HN., Lai, JA., et al.[2023]

The HPV vaccine is safe and effective in preventing cancer, yet only 37% of US adolescents aged 13-17 have completed the vaccination series, highlighting a significant gap in uptake due to misinformation and ineffective messaging.

Qualitative interviews with 34 stakeholders in South Carolina identified effective messaging strategies, such as emphasizing cancer prevention over sexual transmission, and using trusted messengers like medical professionals and cancer survivors to improve vaccine acceptance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

HPV Vaccination Communication Messages, Messengers, and Messaging Strategies. Cartmell, KB., Mzik, CR., Sundstrom, BL., et al.[2022]

A study of HPV vaccine information documents from all 13 Canadian jurisdictions revealed significant discrepancies in the physical risks listed, indicating a lack of consistency and accuracy across the board.

These inconsistencies in risk communication could undermine parental trust and informed consent regarding the HPV vaccine, highlighting the need for improved standardization and clarity in educational materials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ill-informed consent? A content analysis of physical risk disclosure in school-based HPV vaccine programs. Steenbeek, A., Macdonald, N., Downie, J., et al.[2013]

A systematic review of 12 randomized controlled trials involving 38,945 participants found that communication technology interventions significantly improve the initiation and completion rates of HPV vaccinations compared to control groups.

Various methods such as text messaging, automated phone calls, and electronic health record prompts were effective in increasing vaccination coverage, suggesting that these technologies can play a crucial role in future HPV vaccination efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Communication technologies to improve HPV vaccination initiation and completion: A systematic review. Francis, DB., Cates, JR., Wagner, KPG., et al.[2022]

Despite strong evidence supporting the safety of the HPV vaccine, vaccination rates in the U.S. remain low due to parental concerns about safety, with safety being the second most common reason for not vaccinating adolescents.

The study by Yih et al. confirms the low occurrence of adverse events following HPV vaccination, emphasizing the need for effective communication strategies to translate this evidence into public health initiatives that can increase vaccine uptake.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Invited Commentary: Moving From Evidence to Impact for Human Papillomavirus Vaccination-The Critical Role of Translation and Communication in Epidemiology. Rositch, AF., Krakow, M.[2019]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9673969/

HPV Vaccination Communication Messages, Messengers ... Recommended HPV vaccine messages included focusing on cancer prevention rather than sexual transmission, routinizing the vaccine, and highlighting risks/costs ...

2. sciencedirect.com sciencedirect.com/science/article/pii/S0264410X25006243

Impact of digital communication message on HPV vaccine ... Outcomes were willingness to vaccinate, confidence in vaccine safety and effectiveness, message trust, and concern about HPV-related diseases.

3. formative.jmir.org formative.jmir.org/2024/1/e59087

eHealth Communication Intervention to Promote Human ... This study aims to investigate the feasibility and usability of an eHealth communication intervention for HPV vaccination in middle-school girls.

4. implementationscience.biomedcentral.com implementationscience.biomedcentral.com/articles/10.1186/s13012-018-0743-8

Why is announcement training more effective than ... Both announcement and conversation trainings improved providers' HPV vaccine-related perceptions. However, providers viewed announcements as ...

5. researchprotocols.org researchprotocols.org/2025/1/e60790

Web-Based Human Papillomavirus Education and ... Objective: This study aims to compare HPV educational and professional skills intervention effectiveness on improving provider recommendations ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9210795/

Immunize the HPV Vaccine Rumors: Effects of Inoculation ... The present study identifies two message factors to help parents' HPV vaccine decision making: inoculation message and tone of voice.

7. tandfonline.com tandfonline.com/doi/full/10.1080/10810730.2025.2552492?src=

Conditional Effect of Need for Affect and Perceived Prior ... Abstract. This study examines the role of need for affect (NFA) and perceived prior knowledge about HPV in processing messages about the ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8025080/

Results from a Pilot Randomized Controlled Trial - PMC Findings suggest that txt2protect is an acceptable and potentially promising intervention for increasing HPV vaccine initiation among young sexual minority men.

9. sciencedirect.com sciencedirect.com/science/article/pii/S2211335519300646

Interventions to increase uptake of the human ... This review finds that interventions that engage both peers and medical professionals may be the most effective way to increase uptake.

10. clinicaltrials.gov clinicaltrials.gov/study/NCT02994108

txt2protect: Using Text Messaging to Increase HPV ... Human Papillomavirus (HPV) is a common sexually transmitted infection that can cause cancer (anal, penile, oropharyngeal) and genital warts in men.