Developing a Self-persuasion Intervention Promoting Adolescent HPV Vaccination

HPV vaccine coverage among adolescents in the US is suboptimal. This is particularly true among traditionally underserved adolescents. Few parent-targeted interventions have focused on the parental decision-making process. Self-persuasion, generating one's own arguments for engaging in a behavior, may be an effective means to influence parents' motivation to vaccinate their children. In a three-phase study, investigators are using quantitative and qualitative research methods to develop and refine a tablet-based self-persuasion intervention for parents who are undecided about the HPV vaccine. This clinical trial submission focuses on the second phase of the study. The results of the second phase will inform the third phase of the trial (also registered in clinical trials).

Study Overview

• Status: Completed
• Conditions: Human Papillomavirus Vaccines
• Intervention / Treatment: Behavioral: Project Voice

Detailed Description

Despite the fact that HPV vaccination is recommended for male and female adolescents, HPV vaccine 3 dose coverage among adolescents is poor (38% for girls, 14% for boys). HPV-related cancers are a significant burden on the US healthcare system and could be prevented through adolescent vaccination. Rates of vaccination are suboptimal among underserved populations (uninsured, low-income, racial and ethnic minorities) often seen in safety-net clinics. Few interventions have been designed that target decision-making among parents of unvaccinated adolescents. Self-persuasion, generating of one's own arguments for a health behavior, may be an effective means of influencing HPV vaccination behaviors among undecided or ambivalent parents. Through three stages, investigators will identify and develop a self-persuasion intervention strategy to promote adolescent HPV vaccination in safety-net clinics. The current trial, Stage 2, is a four-arm randomized controlled trial (RCT), using a 2x2 factorial design, in which investigators will assign participants to one of four self-persuasion intervention conditions that vary by cognitive processing level (verbalize vs. listen to arguments) and choice of argument topics (parents choose vs. are assigned topics) to identify which intervention condition is optimal. Conducted in a laboratory setting, investigators will identify and select the optimal intervention condition through quantitative analysis of the effects on parents' vaccination intentions and qualitatively by exploring parental experiences with the self-persuasion tasks.

• Study Type: Interventional
• Enrollment (Actual): 737
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Texas
    • Dallas, Texas, United States, 75390-8557
      • UT Southwestern Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Undecided parents (18 years and older) whose children are 11-17 year old patients who have not begun the HPV vaccine series.

Exclusion Criteria:

• Parents whose child is a pregnant adolescent
• Lack telephone access
• Having impairing hearing or speech
• Participants will be excluded from participation in future stages

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: Single

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 1- Verbalize, Choice; Parents will use a tablet-based application (Project Voice) that directs them to verbalize their own arguments based on topics they choose	Behavioral: Project Voice; A tablet-based intervention that directs participants through different activities related to adolescent HPV vaccination based on their assigned condition
Experimental: 2- Listen, Choice; Parents will use a tablet-based application (Project Voice) that directs them to listen to peer-generated arguments based on topics they choose	Behavioral: Project Voice; A tablet-based intervention that directs participants through different activities related to adolescent HPV vaccination based on their assigned condition
Experimental: 3- Verbalize, Assigned; Parents will use a tablet-based application (Project Voice) that directs them to verbalize their own arguments based on topics assigned to them	Behavioral: Project Voice; A tablet-based intervention that directs participants through different activities related to adolescent HPV vaccination based on their assigned condition
Experimental: 4- Listen, Assigned; Parents will use a tablet-based application (Project Voice) that directs them to listen to peer-generated arguments based on topics assigned to them	Behavioral: Project Voice; A tablet-based intervention that directs participants through different activities related to adolescent HPV vaccination based on their assigned condition

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Survey Items Measuring Parental Intentions to vaccinate	Change in intentions of the parent to vaccinate from baseline survey to exit survey using measures adapted from Gerend & Shepherd (2012). Intentions Likert Scale responses range from 1-very likely to 5-very unlikely.	During the intervention visit (1 hr)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
HPV vaccination behavior documented in the electronic medical record, initiation	Number of parents who initiated the series by vaccinating their child within 12 months of the study appointment as evidenced by documentation in the child's electronic medical record.	12 months
Change in Decision Stage	Change in decision stage response of parents from baseline survey to post-educational video to post-intervention tasks.	During the intervention visit (1 hr)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
HPV vaccination behavior documented in the electronic medical record, completion	Number of doses received and the dates of those doses within 15 months of the study appointment as evidenced by documentation in the child's electronic medical record.	15 months
Vaccination Concerns, qualitative	Number of parents reporting concerns during the intervention and exit interview; Describe the theme/category of concern expressed by parents about HPV vaccination	During the intervention visit (1 hr)
Manipulation checks	Measure of the accuracy of parental argument recall during intervention (cognitive processing: verbalize own arguments); Change in autonomous motivation during intervention (argument topic choice).	During the intervention visit (1 hr)

Collaborators and Investigators

• Sponsor: University of Texas Southwestern Medical Center
• Collaborators: National Cancer Institute (NCI); Southern Methodist University; Parkland Health and Hospital System
• Investigators: Principal Investigator: Jasmin A Tiro, PhD, UT Southwestern Medical Center; Principal Investigator: Austin S Baldwin, PhD, Southern Methodist University

Publications and helpful links

General Publications

• Tiro JA, Lee SC, Marks EG, Persaud D, Skinner CS, Street RL, Wiebe DJ, Farrell D, Bishop WP, Fuller S, Baldwin AS. Developing a Tablet-Based Self-Persuasion Intervention Promoting Adolescent HPV Vaccination: Protocol for a Three-Stage Mixed-Methods Study. JMIR Res Protoc. 2016 Jan 29;5(1):e19. doi: 10.2196/resprot.5092.

Study record dates

Study Major Dates

• Study Start (Actual): April 5, 2016
• Primary Completion (Actual): July 26, 2018
• Study Completion (Actual): October 26, 2019

Study Registration Dates

• First Submitted: August 26, 2015
• First Submitted That Met QC Criteria: August 28, 2015
• First Posted (Estimate): September 2, 2015

Study Record Updates

• Last Update Posted (Actual): May 18, 2020
• Last Update Submitted That Met QC Criteria: May 14, 2020
• Last Verified: May 1, 2020

More Information

Terms related to this study

• Other Study ID Numbers: STU 022013-016; 1R01CA178414-01 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Deidentified individual participant data (including data dictionaries) will be made available, in addition to study protocols, the statistical analysis plan, and the informed consent form. The data will be made available upon publication to researchers who provide a methodologically sound proposal and sign a data use agreement. Proposals should be submitted to Dr. Jasmin Tiro (jasmin.tiro@utsouthwestern.edu).
• IPD Sharing Time Frame: January 2020, for 10 years
• IPD Sharing Access Criteria: Researchers who provide a methodologically sound proposal and sign a data use agreement. Proposals should be submitted to Dr. Jasmin Tiro (jasmin.tiro@utsouthwestern.edu).
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF