Communicating with Families About HPV Vaccines

Looking Into the Future

Moving forward, additional interventions to improve providers’ ability to communicate with families about HPV vaccination will undoubtedly be developed. A major area of interest in this regard is leveraging the power of technology and the internet, including using social media, mobile technologies, and online interventions to augment the provider/parent interaction that occurs during the clinical visit [50,120]. Web-based approaches have the benefit of generally being low cost and easy to disseminate to large populations. Such interventions have already been developed for a number of other health issues, some of which have proven effective [121,122]. However, use of the internet to promote healthy behaviors in general, and vaccination specifically, is still in its infancy. There is still much to be learned about how to create effective web-based tools, how to engage patients with them, and how to assess their impact on health outcomes [123].

Another interesting area for future research is identifying psychological “levers” to motivate parents’ vaccination intentions [94]. One example is focusing on using parents’ values (ie, protecting my child from harm) as an intervention target rather than beliefs or attitudes. This is because values tend to be inherent and static over time, compared to beliefs and attitudes, which are subject to change depending on the context [124]. Prior research has shown that interventions that leverage values rather than facts can be an effective way to overcome beliefs that are highly emotional or controversial, and that individuals are more likely to trust sources and individuals with shared values than those without [125], suggesting that this may be a useful way to motivate parents toward vaccinating their children. Self-affirmation is another example of a psychological lever that has a significant evidence base from the social science literature as a helpful tool for moving patients towards a desired health behavior [126,127], but it has not been extensively applied to the field of vaccination. Researchers in the field of vaccine delivery are increasingly recognizing the potential value of these unique intervention approaches [101,128–134], and it may be fruitful in the future to more closely examine the efficacy of interventions that target things like values, self-affirmation or other psychological levers to change parents’ HPV vaccination behaviors.

A final notable area for intervention research related to HPV vaccination is the use of video games. Although not likely to be used directly during patient visits, this strategy could be conceptualized as a potential way to augment the information conveyed to a parent by a provider directly during a clinical encounter. A meta-analysis from 2016 identified 16 different “serious” video games that were used to train and educate users about specific vaccine preventable diseases (usually influenza, none for HPV) and the need for vaccination [135]. In many of them, the objective of the game was to protect a virtual community from a vaccine preventable disease and/or manage outbreaks. Only 2 of the games evaluated outcomes in the short term (ie, at the time the game was being played). None have evaluated longer-term impacts such as vaccination intention or utilization. In the era of “plugged in” parents and adolescents, video games represent a unique but understudied mechanism for helping providers “communicate,” albeit indirectly, with families about the need for vaccination. Imagine providing a prescription to an HPV-vaccine hesitant family to “go play Zombie Wars HPV!” One would expect the curiosity factor alone would result in significant engagement with this intervention tool.