Development of a Tailored Mobile Phone-Based Intervention to Facilitate Parent-Child Communication and Build Human Papillomavirus Vaccine Confidence: Formative Qualitative Study.
Development of a Tailored Mobile Phone-Based Intervention to Facilitate Parent-Child Communication and Build Human Papillomavirus Vaccine Confidence: Formative Qualitative Study.
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DOI：
10.2196/43041
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发表时间：
2023-04-04
影响因子：
2.2
通讯作者：
Hull, Pamela C.
中科院分区：
文献类型：
--
作者：
Cunningham-Erves, Jennifer;Wilkins, Consuelo H.;Dempsey, Amanda F.;Jones, Jessica L.;Thompson, Chris;Edwards, Kathryn;Davis, Megan;Mayberry, Lindsay S.;Landsittal, Douglas;Hull, Pamela C.
关键词：
人乳头瘤病毒（HPV）疫苗犹豫正在上升，提供者沟通是解决父母担忧的一线策略。由于提供者的时间、自我效能和执行这些战略的技能有限，提供者使用假定方法和动机性面谈可能不足以影响父母的决策。加强提供者沟通和建立父母HPV疫苗信心的干预措施尚未得到充分测试。在父母访问医疗保健提供者之前，通过移动的电话向他们提供量身定制的患者教育，可以解决诊所访问期间的时间限制问题，并对疫苗接种产生积极影响。本研究旨在描述一种基于移动的电话的、以家庭为中心的干预方法的发展并评估其可接受性，该方法以理论为指导，在诊所就诊前解决HPV疫苗犹豫不决的父母的担忧，并探索干预方法的使用，以促进亲子沟通。健康信念模式与理性行动理论指导的介入内容发展。一个多层次的利益相关者参与过程被用来迭代开发HPVVaxFacts干预措施，包括社区咨询委员会审查，由HPV疫苗犹豫不决的父母组成的咨询小组的审查，健康传播专家审查，与HPV疫苗犹豫不决的父母（n=31）和供应商（n=15）的半结构化定性访谈，以及内容专家审查。归纳主题分析被用来确定主题的访谈数据。定性访谈产生了4个主题：对移动终端用于健康信息的总体看法、HPVVaxFacts的可接受性、HPVVaxFacts使用的促进因素和HPVVaxFacts使用的障碍。在审查HPVVaxFacts原型后的家长访谈中，几乎所有家长（29/31，94%）表示他们打算让孩子接种疫苗。大多数家长表示，他们喜欢增加青少年角，以进行可选的亲子沟通（即选择与孩子分享和讨论信息; 27/31，87%），并在某些情况下分享决策（8/31，26%）。在整合所有输入后，最后的干预措施包括一项10项调查，以确定父母最关心的3个问题，然后针对以下每个问题进行量身定制的教育：证据信息、图像或图形，以提高理解力和解决识字率低的问题，链接到可信的网站，提供者视频，建议向孩子的医生提问，以及一个可选的青少年角，以教育病人和支持父母与孩子的沟通。用于迭代开发这种针对HPV疫苗犹豫家庭的新型干预措施的多层次参与者参与过程可以用作开发未来移动的健康干预措施的模型。这项干预措施目前正在进行中试，为一项随机对照试验做准备，旨在增加诊所环境中对疫苗犹豫不决的父母的青少年儿童的HPV疫苗接种。未来的研究可以使HPVVaxFacts适应其他疫苗，并在其他环境中使用（例如，卫生部门和药房）。
Human papillomavirus (HPV) vaccine hesitancy is on the rise, and provider communication is a first-line strategy to address parental concerns. The use of the presumptive approach and motivational interviewing by providers may not be enough to influence parental decision-making owing to the providers’ limited time, self-efficacy, and skills to implement these strategies. Interventions to enhance provider communication and build parental HPV vaccine confidence have been undertested. Delivering tailored patient education to parents via mobile phones before they visit the health care provider may address time constraints during clinic visits and positively affect vaccine uptake. This study aimed to describe the development and evaluate the acceptability of a mobile phone–based, family-focused intervention guided by theory to address concerns of HPV vaccine–hesitant parents before the clinic visit, as well as explore intervention use to facilitate parent-child communication. The health belief model and theory of reasoned action guided intervention content development. A multilevel stakeholder engagement process was used to iteratively develop the HPVVaxFacts intervention, including a community advisory board review, a review by an advisory panel comprising HPV vaccine–hesitant parents, a health communications expert review, semistructured qualitative interviews with HPV vaccine–hesitant parents (n=31) and providers (n=15), and a content expert review. Inductive thematic analysis was used to identify themes in the interview data. The qualitative interviews yielded 4 themes: overall views toward mobile device use for health information, acceptability of HPVVaxFacts, facilitators of HPVVaxFacts use, and barriers to HPVVaxFacts use. In parent interviews after reviewing HPVVaxFacts prototypes, almost all parents (29/31, 94%) stated they intended to have their child vaccinated. Most of the parents stated that they liked the added adolescents’ corner to engage in optional parent-child communication (ie, choice to share and discuss information with their child; 27/31, 87%) and shared decision-making in some cases (8/31, 26%). After incorporating all input, the final intervention consisted of a 10-item survey to identify the top 3 concerns of parents, followed by tailored education that was mapped to each of the following concerns: evidential messages, images or graphics to enhance comprehension and address low literacy, links to credible websites, a provider video, suggested questions to ask their child’s physician, and an optional adolescents’ corner to educate the patient and support parent-child communication. The multilevel stakeholder-engaged process used to iteratively develop this novel intervention for HPV vaccine–hesitant families can be used as a model to develop future mobile health interventions. This intervention is currently being pilot-tested in preparation for a randomized controlled trial aiming to increase HPV vaccination among adolescent children of vaccine-hesitant parents in a clinic setting. Future research can adapt HPVVaxFacts for other vaccines and use in other settings (eg, health departments and pharmacies).
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