Addressing HPV vaccination disparities through tailored messaging for hesitant families

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PROJECT SUMMARY Human papillomavirus (HPV) causes over 34,800 cancers in the United States each year that disproportionately affect Black women. The HPV vaccine is highly effective, but less than half of adolescents aged 13-15 years have received recommended doses, with Blacks having the greatest disparity in completion. HPV vaccine hesitancy is associated with under-vaccination and refusal. An estimated 23% of parents with adolescents are hesitant about the HPV vaccine, but parents’ concerns vary due to a myriad of individual, interpersonal, and sociocultural factors. Effective strategies to overcome parents’ concerns are needed, especially among Black families, who have higher prevalence of general vaccine hesitancy and medical mistrust due to racial inequities. The purpose of this NCI Transition Career Development Award (K22) is to support me through specific training and research experiences as I become an independent investigator specializing in multilevel cancer prevention interventions to reduce cervical cancer disparities. Building on my strong health services research and behavioral science background in HPV screening, I will develop expertise in HPV vaccination communication, community- engaged intervention planning, and intervention trials. The objectives of this rigorous mixed methods proposal are to: (1) use a stakeholder-engaged approach to develop and refine an interactive, tailored text messaging intervention to address Black parents’ HPV vaccine hesitancy determinants and vaccination barriers; and (2) conduct a two-arm pilot RCT to determine feasibility, acceptability, appropriateness, and preliminary efficacy of the tailored messages compared to untailored messages. Following a provider’s initial recommendation, the intervention will allow parents of young adolescents to process HPV vaccination information on their preferred timeline, answer lingering questions and concerns, provide links to additional information from trusted sources, and support connections to local resources to help overcome barriers. By accomplishing these aims, I will address current gaps in strategies to increase vaccine confidence and motivation among high-risk Black families. Rutgers Cancer Institute with its well-funded behavioral research program, robust research infrastructure, and deep community connections is an exceptional environment to conduct high-impact, community-engaged cancer disparities research. As a logical next step in my career development, this K22 will give me the skills required to design, implement, and evaluate multilevel interventions to achieve HPV health equity. Findings and preliminary efficacy estimates will inform an R01 application of a multi-site trial to test a multiple component intervention addressing the complex, context-specific determinants of HPV vaccine hesitancy to motivate vaccination and change behaviors. Ultimately, this K22 proposal will facilitate my long-term goal to build an independent research program investigating community-driven solutions to reduce HPV disparities and advance the elimination of cervical cancer.