As part of a generalized effort to boost the number of teens vaccinated against the human papilloma virus (HPV) to prevent cervical cancer, a new Southwestern Methodist University study found that self-persuasion could be an innovative tool to bring parents on board.
The study is part of a five-year research initiative supported by a $2.5 million grant from the National Cancer Institute (NCI). Part of the grant is to be used to develop a mobile app that can easily be used by low-income parents who may find it difficult to read and write and who speak only Spanish.
The study, “Translating self-persuasion into an adolescent HPV vaccine promotion intervention for parents attending safety-net clinics,” was published in Patient Education & Counselling. It found that parents will decide to vaccinate their teens if they persuade themselves of the vaccination’s benefits.
“This approach is based on the premise that completing the vaccination series is less likely unless parents internalize the beliefs for themselves, as in ‘I see the value, I see the importance, and because I want to help my child,'” Austin S. Baldwin, psychology professor and principal investigator of the study, said in a press release.
The Centers for Disease Control and Prevention (CDC) recommends a series of two shots of the vaccine for early teenagers who have not yet initiated sexual activity and three shots for 15- to 26-year-olds.
About 60 percent of teenage girls and 40 percent of teenage boys receive their first dose of the HPV vaccine, but about 20 percent in each group fail to follow through after the first dose. The goal would be to vaccinate 80 percent of teenagers, to achieve the herd immunity effect – when virtually everyone is protected through indirect protection when most of the population has been vaccinated.
A previous study in the grant initiative demonstrated that a person’s own motivation had the strongest correlation with intention – as autonomous motivation increased, so did the intention to vaccinate.
In the current study, researchers surveyed 223 patients from Parkland Memorial Hospital’s safety-net outpatient pediatric clinics throughout Dallas County. Participants were asked to complete questionnaires related to motivation, intentions, and barriers to vaccination.
This part of the research included low-income parents with a limited education or who speak only Spanish.
Self-persuasion has been successful among well-educated English-speaking parents, but until now, it had never been tested among poorly-educated populations in safety-net clinics.
Even though recommendations from doctors matter, people are much more likely to sustain a certain behavior over time when they personally commit to it, such as stopping smoking, losing weight, or exercising. But this can only happen if people fully understand the benefits of a certain action – in this case, if parents could learn about the benefits in Spanish.
For the study’s purposes, researchers educated parents in a waiting room by providing them with an iPad tablet with a custom-designed app. The program guided the parents in English or Spanish to scroll through audio prompts that helped them understand why HPV vaccination can be life-saving.
Participants in this study were recruited in the same outpatient pediatric clinics as they were in the previous study. Most of the parents were Hispanic with a high school education or less.
Among 33 parents with unvaccinated teens, 27 (81 percent) said they would vaccinate their child after completing the self-persuasion tasks.
“So they may get the first dose because the doctor says it’s important,” Baldwin said. “But the second and third doses require they come back in a couple months and again in six months. It requires the parent to feel it’s important to their child, and that’s perhaps what’s going to push or motivate them to complete the series. So that’s where, downstream, there’s an important implication.”