ASPO Abstracts
Efficacy of an HPV Vaccine App for Hesitant Parents: A Test of Self-Persuasion
Category: Behavioral Science & Health Communication
Conference Year: 2019
Abstract Body:
Background/Purpose: Many parents are hesitant about the HPV vaccine. Self-persuasion— process of generating one’s own arguments for changing behavior— could be effective at addressing parental hesitancy. To meet the needs of low-literacy parents and busy clinics, we developed and tested a mHealth app with voiceover narration (in English and Spanish) to elicit parental self-persuasion for adolescent HPV vaccination. Methods: Using a 2x2 factorial randomized trial design, we tested 4 self-persuasion app versions, that varied by cognitive engagement (deep processing/verbalized reasons vs. shallow processing/listened to reasons) and argument topic choice (yes vs. no). Hypotheses were that intentions score and proportion deciding to get the vaccine would be highest in the verbalize, choice condition and lowest in the listen, no choice condition. Undecided parents (N=161) of unvaccinated adolescents aged 11-18 years attending 6 safety-net clinics viewed a 4-minute educational video, and then were randomized to 1 of 4 app versions. Pre/post surveys measured intentions and decision stage. Multivariate linear/logistic regressions estimated impact of app versions on intentions/decision stage controlling for baseline score, parent language, child sex and age, clinic, and trial enrollment month. Results: Most parents were Hispanic (68%) and used the app in Spanish (56%). Multivariate intent-to-treat analyses found intentions to vaccinate their child was highest in the verbalize, choice condition compared to listen, no choice condition (p=.003). 52 parents decided to get the HPV vaccine after seeing the educational video. Among the remaining 108 parents, those exposed to the verbalization versions were more likely to decide to get the vaccine compared to those in the listen, no choice version (adjusted odds ratio=4.06, 95% CI: 1.06,15,56). Conclusions: The self-persuasion app significantly changed parents’ intentions and decision stage. The optimal app version requires parents to verbalize their reasons for getting the HPV vaccine. This suggests that the app can effectively engage undecided parents in deep, reflective cognitive processing of information and shift them out of “echo chambers” that reinforce vaccine hesitancy.
Keywords: HPV vaccinationself-persuasionmHealthinterventions for safety-net systems