Promoting HPV Vaccination among Young Adults in Texas

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Project summary Human papillomavirus (HPV) vaccine is important because it protects against cancers caused by HPV infection. Nearly 79 million people are currently infected in the United States and about 14 million people become infected with HPV each year. HPV infection can cause cancers in both women and men and the financial burdens of these HPV-related diseases cost more than $8 billion per year in the US. The most recently approved HPV vaccination can prevent up to 74% of HPV-associated invasive cancers. Thus, HPV vaccination is one of the most profound opportunities in cancer prevention today. The Centers for Disease Control and Prevention (CDC) recommends HPV vaccines through age 26. Among adults18–26 years, HPV vaccination completion is unacceptably low whereas HPV infection rates are unacceptably high. There is also a lack of interventions to improve HPV vaccination rates among young adults who were not vaccinated during childhood. In the area of HPV vaccination uptake, males have disproportionately low rates and minorities have lower rates of completing the vaccinations compared to non-Hispanic whites. This study aims to fill in the important gaps by using a 2 by 3 factorial design to test the independent and combined effects of a multilevel intervention: school-based HPV vaccine administration (no access vs. access) at the system level and web- based narratives (no access vs. video vs. written) at the individual level. This intervention is developed based on pilot studies and socio-ecological models that recognize the impact multiple levels of influence have on behaviors. The 2 by 3 factorial design results in six groups: ) standard CDC information about HPV vaccination (control); 2) video narratives about HPV vaccination; 3) written narratives about HPV vaccination; 4) access to HPV vaccine at school combined with standard CDC information, 5) access to HPV vaccine at school combined with video narratives, or 6) access to HPV vaccine at school combined with written narratives . This design allows us to investigate the independent and combined effects of tailored narratives and school-based vaccine access on HPV vaccination. College students aged 18- 26 who are not previously vaccinated against HPV will be randomly assigned to one of the six groups. Primary outcomes are HPV vaccine initiation and completion at 3- and 9-month follow-ups, respectively. This study has implications for creating a new paradigm in HPV vaccination by inspiring future new research directions that include multiple levels of influence to improve HPV vaccinations. This study will make a significant positive impact on public health, as it is using evidence-based strategies tailored for young adults aged 18-26 years to promote “catch up” HPV vaccination. If successful, the web-based intervention can be easily disseminated because it is brief and scalable. School-based HPV vaccinations can be implemented on college campuses in the future to improve healthcare delivery. Success and lessons learned in this study will inform future strategies to develop tailored narrative messages for different social groups.