Using Text Messaging to Increase HPV Vaccination among Young Sexual Minority Men

项目概要/摘要 人乳头瘤病毒（HPV）是一种常见的性传播感染，导致肛门，阴茎， 男性口咽癌由于他们的性行为，与男性发生性关系的男性（MSM）在 HPV感染的风险特别高，并且不成比例地受到HPV相关癌症的影响。一个安全和 有效的疫苗可用于预防HPV感染，但美国的HPV疫苗接种率一直很低， 尤其是男性。免疫实践咨询委员会（ACIP）建议HPV 为26岁以下的所有MSM接种疫苗。然而，最近对全国同性恋和 18-26岁的双性恋男性表明，只有13-21%的人开始了3剂HPV疫苗系列。我们的飞行员 研究表明，许多MSM只是不知道疫苗或认为其他重要的障碍， 接种疫苗为了弥补这一差距，拟议研究的目标是开发和试点测试一个文本 信息干预，以增加年轻MSM的HPV疫苗接种。拟议的干预措施结合了 以证据为基础的方法，通过短信增加疫苗接种（“疫苗召回”）。除了 短信提供了基础教育和行动提示，可以针对具体障碍进行调整。的 本研究的长期目标是制定有效的策略，在MSM中增加HPV疫苗接种， 从而降低与HPV相关癌症相关的发病率、死亡率和差异。根据PA- 15-263（性和性别少数群体的健康），此R21应用程序的目标是 开发和试点测试短信干预，以增加年轻成年男男性接触者的HPV疫苗接种。指导 根据信息、动机和行为技能（IMB）模型，我们提出了两个具体目标：（1） 使用5步形成性研究程序开发、迭代改进和预测试消息。预期用户 程序的（即，18-26岁的男同性恋、双性恋或同性恋者将被招募， 这个过程(2)测试Txt 4Prevention（T4 P）文本的可行性、可接受性和初步有效性 在一项先导性随机对照试验（RCT）中进行信息干预。受试者将被随机分配至 处理（T4 P）或对照条件。治疗条件将接受文化上适当的HPV 基于IMB模型的疫苗接种干预，而对照条件将接受一般性的 健康干预，包括有关HPV疫苗接种的基本事实，可在网上查阅。主要结局 措施包括干预的可行性（招聘和保留），可接受性（对 干预），和初步疗效确定的3剂量系列的开始和完成时， 9个月的审判结束。疫苗接种状态将通过参与者的医疗记录和伊利诺伊州 免疫登记处。这些目标的成果预计将产生重要的积极影响， 确定在性少数男性中增加HPV疫苗接种的有效策略。

Project Summary/Abstract Human papillomavirus (HPV) is a common sexually transmitted infection that causes anal, penile, oropharyngeal cancers in men. Due to their sexual practices, men who have sex with men (MSM) are at particularly high risk for HPV infection and are disproportionately affected by HPV-related cancers. A safe and effective vaccine is available to prevent HPV infection, yet HPV vaccination rates in the U.S. have been low, particularly among males. The Advisory Committee on Immunization Practices (ACIP) recommends HPV vaccination for all MSM through age 26. Nevertheless, recent studies with national samples of gay and bisexual men aged 18-26 indicate that only 13-21% have initiated the 3-dose HPV vaccine series. Our pilot work suggests that many MSM are simply unaware of the vaccine or perceive other important barriers to getting vaccinated. To remedy this gap, the goal of the proposed research is to develop and pilot test a text messaging intervention to increase HPV vaccination in young MSM. The proposed intervention combines an evidence-based approach to increasing vaccination (“reminder-recall”) with text messaging. In addition to providing basic education and a cue to action, text messages can be tailored to address specific barriers. The long-term goal of this research is to develop effective strategies for increasing HPV vaccination among MSM, thereby reducing morbidity, mortality, and disparities associated with HPV-related cancers. In response to PA- 15-263 (The Health of Sexual and Gender Minority Populations), the objective of this R21 application is to develop and pilot test a text messaging intervention to increase HPV vaccination in young adult MSM. Guided by the Information, Motivation, and Behavioral Skills (IMB) Model, we propose to two specific aims: (1) Develop, iteratively refine, and pre-test messages using a 5-step formative research procedure. Intended users of the program (i.e., men who identify as gay, bisexual, or queer 18-26 years old) will be recruited to assist with this process. (2) Test the feasibility, acceptability, and preliminary efficacy of the Txt4Prevention (T4P) text messaging intervention in a pilot randomized controlled trial (RCT). Participants will be randomized to the treatment (T4P) or control condition. The treatment condition will receive a culturally appropriate HPV vaccination intervention based on the IMB model, whereas the control condition will receive a general sexual health intervention that includes basic facts about HPV vaccination readily accessible online. Primary outcome measures include intervention feasibility (recruitment and retention), acceptability (satisfaction with the intervention), and preliminary efficacy as determined by initiation and completion of the 3-dose series at the end of the 9-month trial. Vaccination status will be verified by participants' medical records and the Illinois Immunization Registry. Outcomes from these aims are expected to have an important positive impact by identifying effective strategies for increasing HPV vaccination among sexual minority men.