From the Journals

New self-persuasion app to promote HPV vaccine appears effective

Publish date: March 22, 2017

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Education, communication, vaccination

The media has not been kind when it comes to HPV vaccinations. When most parents are approached with the option to have their children vaccinated, they are hesitant because of what they have heard from television, news articles, or online mom chat rooms about the dangerous side effects of the vaccine. When a mother hears about other mothers’ daughters fainting or being subjected to pain, she usually wonders if it is really worth the risk.

The same goes for parents who expect their daughters to practice celibacy until marriage. After all, why expose a child to negative side effects when she won’t be having sex anyway? The problem with this thinking, however, is that, often, it is not based in reality. When I approach families about HPV vaccine, or any other vaccine for that matter, I make sure to present studies that explain the lack of evidence on negative vaccine side effects, as well as information pertaining to how common HPV is.

Dr. Francine Pearce

When it comes to the issue of vaccinations, especially for sexually transmitted diseases, education and communication are paramount. Pediatricians have so much misinformation to dispel, especially considering how easy it is for someone to add to the stigmas of HPV by typing a few paragraphs and sending it out to the Internet. Parents assume that, because the virus is sexually transmitted, by choosing to vaccinate their child, they are acknowledging, or even promoting, promiscuous behavior. Yet, there is scientific evidence that, because the HPV virus is so common in men, a woman could choose to wait until she was married to engage in sex and still get it. The information is there.

However, simply handing out a fact sheet is not enough. Parents who are convinced that their children do not need to be vaccinated will not be persuaded through statistics but through personal anecdotes. I like to tell mothers to ask their girlfriends about being vaccinated, to not only see how common HPV is but to break the stigma as well. I explain to parents who do not want their child having sex now that, at some point, they might want their child to grow their family, and, when that time comes, don’t they want their child to be safe? Even if it is just one time, shouldn’t their child be protected? From that point on, the language of conversation has changed, and the channels of communication are more open.

As pediatricians, we are the medical advocates for our patients and their families, not just someone to prescribe medication for them. Establish that role through knowledge and conversation, and persuasion will soon follow.

Francine Pearce, MD, is a pediatrician in Frankfort, Ill. She writes the Pediatric News teen column, Pearce-ings .

FROM PATIENT EDUCATION & COUNSELING

A new tablet application using a self-persuasion method has been successful in convincing parents in underserved communities to have their children vaccinated for human papillomavirus (HPV), according to a study.

Of 45 participating parents, 27 of the 33 (82%) parents whose adolescents were not vaccinated reported that they decided to get their children vaccinated after completing the application. The remaining 12 already had an HPV-vaccinated adolescent. Children of participating parents were aged 11-17 years (Patient Educ Couns. 2016. doi: 10.1016/j.pec.2016.11.014).

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Self-persuasion methodology is a process that forces participants to contemplate the reasoning behind their own actions, which, according to Austin S. Baldwin, PhD, of Southern Methodist University, Dallas, and his colleagues, has proven to be a successful persuasion tool in addressing other aspects of behavior. “Approaches to self-persuasion have improved health behaviors, including smoking cessation, dietary behaviors, and safer sex practices.” However, “self-persuasion [has not previously] been developed to promote the ... HPV vaccine,” especially in medically underserved communities.

Of the 45 parents, 31 (69%) were Hispanic and 29 (64%) held a high school education or less, according to the study.

To test the effectiveness of self-persuasion, researchers developed a tablet application which started with a 5 minute video on HPV and vaccine efficacy, and then asked parents to complete two tasks: answer questions about the HPV vaccine that prompt thought on its benefits and come up with personal reasons for why having their child vaccinated is important.

Parents then participated in a 45-60 minute interview with one of six research assistants, who prompted participants to address four research points: Did they like the application? Which questions generated interest in the HPV vaccine without raising concerns? Were they able to communicate reasons for vaccination? Were they convinced to have their children vaccinated?

After watching the video, 18 (55%) of the 33 parents whose children were not vaccinated changed their minds, and, after participating in the self-persuasion questionnaire, an additional 9 parents decided to vaccinate their children, according to the study. Five parents remained undecided, and one decided against HPV vaccination.

Overall, participants reported that the application questions were helpful in their decision to vaccinate their children, with question ratings ranging from 4.33 to 4.98 on a scale of 1 to 5.

Mr. Baldwin and his colleagues said that, while the initial test showed promise, further research must be done on actual vaccine behavior, as these tests only studied verbally reported decisions by parents.

One of the limitations to the study was that the research was primarily conducted at a research facility. While some was conducted in local clinics, Mr. Baldwin and his colleagues consider that further studies should be conducted in more public areas. All but one of the participants were female, which may make it hard to generalize about the effects of this application with male parents.

The researchers reported no relevant financial disclosures.

ezimmerman@frontlinemedcom.com

On Twitter @EAZTweets

New self-persuasion app to promote HPV vaccine appears effective

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