Culturally-Appropriate Social Marketing Intervention to Increase HPV Vaccination

Theoretical Background and research questions/hypothesis:  HPV vaccination is recommended for all children ages 11-12, with catch up for females to age 26 and males to age 21, for prevention of HPV-associated cancers, which disproportionately affect African Americans and Hispanics. However, HPV vaccine uptake has lagged behind that of other vaccines recommended for the same ages (meningococcal and Tdap), and completion of the three-dose series has been lower among African American and Hispanic adolescents until recently. This study used the Community-Based Prevention Marketing model and Exchange Theory to design a culturally-appropriate social marketing intervention aimed at increasing HPV vaccination, using a community-engaged approach. The purpose of this study was to pilot test the efficacy of the intervention among parents of racially/ethnically diverse pre-adolescents. The presentation will describe the social marketing strategy and pilot outcomes.

Methods:  English and Spanish versions of the intervention were developed based on formative research and collaboration with a Teen and Parent Committee and a community center. The messages were designed to be culturally-appropriate for families of diverse backgrounds, specifically focusing on African Americans and Hispanics. The goal of the “Bug Your Doc: Get 3 Shots!” social marketing intervention was to encourage parents to ask their child’s doctor for all three pre-teen vaccines, including HPV vaccine, when they update their immunization record for 7^th grade entry. This strategy of bundling adolescent vaccines aimed to “normalize” the perception of the HPV vaccine as a routine vaccination for both boys and girls, rather than treating HPV vaccine as different. The product strategy was to promote getting the three vaccines (actual product) as a way for parents to protect their children from harm (core product). Further details of the social marketing strategy will be presented. Intervention materials included a short educational video, website (www.get3shots.org), promotional flyer, list of questions to ask the doctor, and refrigerator magnet. We used a two-group, delayed crossover design to pilot test the intervention materials with groups of parents in a workshop format, compared to a workshop on an unrelated topic. Participants were recruited through community-based organizations and university email listservs.

Results:  We enrolled a convenience sample of 83 parents of 5^th and 6^th grade boys and girls, of whom 72 completed follow-up two to four months after baseline and before crossover. Based on parent self-reports, few children had already received any dose of the HPV vaccine at baseline; no significant difference between study arms.  By follow up, a significantly higher percentage of parents in the intervention arm reported that they had obtained the HPV vaccine for their child, compared to the control arm (p<.05).

Conclusions:  Results indicated a significant effect of the intervention on increasing HPV vaccine uptake. Qualitative feedback also suggested that the parents perceived the materials as acceptable and useful.

Implications for research and/or practice:  These intervention materials could be used in a variety of contexts, such as primary care, schools, community organizations, and social media, to improve parental acceptability of the HPV vaccine within the adolescent vaccine platform and to increase vaccination.