The purpose of this Phase II research project is to evaluate and market an innovative health message intervention to increase uptake of the human papillomavirus (HPV) vaccine and reduce women?s cervical cancer risk through partnership with Planned Parenthood. The overall aim is to reach a broad population through Planned Parenthood, the nation?s leading sexual and reproductive health care center, especially among low socioeconomic status (SES) and historically underserved populations. Despite an overall increase in vaccination and reduction in HPV-related infections in younger populations targeted by previous health promotion efforts, young adult women who are recommended for vaccination demonstrate much lower vaccination rates and higher rates of infection. In a recent Phase I grant, we developed and demonstrated the usability and feasibility of an innovative, culturally-grounded, technology-based narrative intervention that delivers decision narratives in the form of videos via a health kiosk, an underutilized communication strategy for reaching less involved audiences. This brief, low-cost, easily implementable intervention doubled the uptake of the vaccine in a separate pilot study. The proposed Phase II project will: (1) Complete development of the intervention, (2) Evaluate its effectiveness through a randomized clinical trial, and (3) Prepare the product for the market. To accomplish these aims, we will develop the intervention for implementation in waiting rooms as part of check-in procedures and exam rooms as part of intake. Our pilot research suggests these are both viable implementation strategies. Development includes programing and installing tablets to accomplish these tasks (Aim 1). We will then conduct the evaluation study in six Planned Parenthood clinics in southeastern Pennsylvania (Aim 2). In the waiting room condition, women will complete check-in via a tablet and that information used to identify and recruit eligible volunteers (unvaccinated women aged 18-26). In the exam room condition the intervention will be viewed on a tablet as part of the intake procedure, facilitated by a nurse or other designated clinic staff. Eligible women will be consented, complete a pretest, and then randomized to view the brief intervention or attention control messages via the tablet. After viewing the messages, they will complete a short posttest. Participants will receive follow up texts/emails reminding them to vaccinate, as well as texts/emails with links that allow them to complete posttest surveys at 3- and 9 months. Finally, we will prepare the intervention for the market that includes not only Planned Parenthood but other clinics that are currently served by the project partners as well as the broader market for HPV vaccination (Aim 3). In summary, the proposed communication strategy has wide reaching implications not only for reducing cancer risk, but more broadly for designing brief and easily implemented prevention messages across many domains of public health. The research will also close the health disparities gap in minority, underserved young adult women?s access to preventive health care.
