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Background: Public health (PH) agencies must partner with health care (HC) systems to impact consumer behaviors, including decisions around vaccination. New strategies, like mobile health (mHealth) technologies, are needed to enable PH and HC systems to integrate preventative care strategies into routine encounters. A growing number of mHealth devices used by consumers offer an opportunity to deliver targeted, just-in-time educational interventions aimed at increasing utilization of preventative services. Despite their potential, however, mHealth is not in widespread use.
Methods: In a cluster randomized trial, we assessed whether adolescent patients whose parents watch a digital video on a mHealth device during a routine visit to an urban clinic were more likely to accept a provider’s recommendation of the HPV vaccine (1st, 2nd, or 3rd dose) compared to those who do not watch the video. The videos were designed by PH and health services researchers. Random effects logistic regression was employed to examine the results following the 9-month trial.
Results: Out of 1066 well child visits, the mHealth platform was used 367 times (34%) and 619 adolescents (58%) received a dose of the HPV vaccine. There was no difference with respect to rate of vaccine administration in clinics that used the mHealth intervention and those which did not (Estimate=0.07; p=0.79). Rates of administration across clinics in each cluster varied dramatically. Clinic A (56%) and clinic E (74%) used the mHealth intervention. Clinics B (48%), C (45%), and D (74%) did not.
Conclusions: The mHealth intervention does not appear to increase parental acceptance of the HPV vaccine. Underlying patient populations (e.g., ethnicity, social determinants) and provider behavior (e.g., recommendation of vaccine) play a bigger role than patient education about the benefits and risks of vaccination.