Web enhanced adoption of HPV vaccine in minority communities

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The recent development and regulatory approval of the first vaccine (Gardasil-Merck) to reduce human papillomavirus (HPV) infections represents an important medical innovation that can potentially reduce the incidence of cervical cancer. Vaccination of female eariy adolescents prior to sexual debut (age range 9-12 years) will have a consequent reduction in two specific HPV types 16 and 18, known to cause a majority (-70%) of cervical cancer woridwide. As with many other science-based medical innovations, vaccine adoption is not always rapid and often depends on a variety of social and cultural factors, as well as the nature of the innovation itself In this particular case, the diffusion and adoption of HPV vaccination may be especially complicated because of the association of HPV with sexual behavior and transmission. These issues are likely to be pronounced in minority communities where access to valid information about medical innovations is often lacking, and the role of culture and community is neglected in the provision of medical services. Proposed here is an investigation that will employ Diffusion of Innovations theory as well as uncertainty reduction to guide the iterative development of web-based tools to prompt the informed adoption of the HPV vaccines. Three sets of web tools will be developed: 1) web tools designed for allied health care team members that will aid in their communication about HPV vaccine; 2) web tools designed for parents of female early adolescents that will provide information and reduce uncertainty surrounding the decision to have their daughters vaccinated, and 3) web tools designed for female eariy adolescents themselves that wil also provide information and reduce uncertainty about HPV vaccination. A randomized efficacy trial of this web intervention is planned for school-based health clinics (SBHCs) in New Mexico. Participating SBHCs would be randomized to either receive the set of vaccination web tools or offer HPV vaccine under the usual and customary protocol. The web tools will be culturally tailored and appropriate. Outcome measures will include assessments of parent and adolescent vaccine understanding, reduction of vaccination adoption uncertainty, and vaccine adoption and inoculation adherence measures.