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Using health behavior theories and theories related to the effects of persuasive messages (i.e., inoculation theory), we plan to: 1. Systematically test the effects of brief persuasive message interventions on receipt of the first dose of HPV vaccine; and 2. evaluate the effects of the interventions on followup with subsequent doses of vaccine (using reminder notices with persuasive message content). One set of interventions will involve a comparison of a 1 sided message, which only emphasizes the positive aspects of a recommended behavior, with a 2 sided message, which presents negative aspects of the behavior followed by positive counterarguments. A second set of interventions will involve a test of a social compliance (foot-in-the-door technique, in which half of the parent participants will be asked to respond to a high compliance request (i.e., a request likely to generate high compliance, such as, "Do you want to protect your daughter from cervical cancer?" before subsequently being asked about actually having their daughters vaccinated. The other half of the parents will not receive a high compliance request. Parents of 11-14 year old girls will be randomized to the two sets of interventions, resulting in a 2 X 2 design: message sidedness (1 sided; 2 sided) and social compliance request (yes; no). The specific aims of this proposal are to evaluate the 1) efficacy of 2 sided vs. 1 sided messages on rates of HPV vaccination; 2) the efficacy of a social compliance intervention on rates of HPV vaccination; and 3) potential moderators and mediators of message effect on vaccine acceptance.
The proposed study will employ a randomized, full factorial experimental design to examine the effects of brief message interventions on parents' acceptance of the first dose of HPV vaccine for their daughters aged 11-14 years, as well as follow through with subsequent doses. Specifically, the study will employ a 2 x 2 experimental design, in which participants will be assigned randomly to one of two different message sidedness conditions (1 sided vs. 2 sided) and two social compliance conditions (high compliance request [HCR] vs. noHCR). The interventions will be administered by research assistants who will read, verbatim, scripts provided to them. Computer assisted telephone interview (CATI) will be used to gather demographic and background information as well as parental health beliefs regarding preexisting worries about HPV vaccine leading to sexual disinhibition (moderator variable) prior to administration of the interventions. After the interventions, additional health beliefs will be assessed (mediators).
Hypothesis 1: We expect the 2 sided message to result in higher rates of first dose acceptance of the HPV vaccine compared to the 1 sided message.
Hypothesis 2: We expect the 2 sided message, which will be repeated in appointment reminders sent to the parents, to result in higher rates of 3 dose completion than the 1 sided message, within one year of starting the series. Hypothesis 3: We expect the social compliance intervention to result in higher rates of first dose acceptance of the HPV vaccine compared to the nonintervention group.
Hypothesis 4: We expect the social compliance intervention, which will be repeated in appointment reminders sent to the parents, to result in higher rates of 3 dose completion than the nonintervention group, within one year of starting the series. We also expect that the two interventions will have an additive effect on both first dose acceptance rates and on 3 dose completion.
Hypothesis 5: As predicted by inoculation theory, we expect parents who have preexisting concerns about HPV vaccination of their daughters to be most responsive to the 2 sided compared to the 1 sided message. We expect parents with no preexisting concerns about sexual disinhibition due to HPV vaccination to not differentiate between the two messages. That is, we expect preexisting concerns will moderate the effect of this intervention.
Hypothesis 6: We expect both sets of interventions to alter health beliefs about HPV and the HPV vaccine (e.g., increase perceived severity of HPV infection and perceived benefits of vaccination and decrease perceived barriers to vaccination). We expect that these health beliefs, in turn, will predict acceptance of the vaccine. That is, we expect health beliefs to mediate the effect of the interventions on vaccine uptake.
Allocation: Randomized, Control: Uncontrolled, Intervention Model: Factorial Assignment, Masking: Open Label, Primary Purpose: Treatment
Human Papillomavirus Infection
Compliance, Message sidedness
Teen Health Center, Inc
Not yet recruiting
Published on BioPortfolio: 2014-08-27T03:15:12-0400
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