BACKGROUND
HPV-attributed cancers are preventable, yet HPV vaccination rates severely lag other adolescent vaccinations. HPVcancerFree is an mHealth intervention developed to influence parental HPV vaccination decision making by raising awareness of HPV, reducing HPV vaccination barriers and enabling HPV vaccination scheduling and reminders through a smartphone. Evaluating the feasibility and user experience of mHealth interventions are vital components in assessing their quality and success.
OBJECTIVE
We aimed to evaluate the feasibility of HPVcancerFree using mixed methods data collected from log files, survey measures and qualitative feedback
METHODS
Study data was evaluated from parents in a large U.S. pediatric clinic network using HPVcancerFree in the intervention arm of a group randomized controlled trial. Log data captured HPVcancerFree retention and use. Post intervention rating scales and items, including the uMARS survey (reflecting engagement, functionality, aesthetics and information), assessed HPVcancerFree utility, usefulness, understandability, appeal, credibility, perceived impact and overall quality. Open-ended responses assessed patient recommendations for HPVcancerFree enhancement.
RESULTS
The 98 parent participants were mainly female (96%), 41±5.67 years of age, college educated (56%), white, non-Hispanic (56%) and had private health insurance for their children (77%). Parents used HPVcancerFree 197 times with average visit duration approximating 3.5 minutes. The uMARS app quality score was positively skewed (4.2/5). Mean ratings were highest for information (4.46±0.53) and lowest on engagement (3.74±0.69). Forty-seven percent of parents rated HPVcancerFree as helpful in HPV vaccination decision making and 17% attributed HPV vaccine initiation to HPVcancerFree. Parents reported that HPVcancerFree increased their awareness (89%), knowledge (89%) and HPV vaccination intentions (68%). Most parents rated the four HPVcancerFree components as useful (74-94%). Parents agreed that HPVcancerFree was clear (91%), accurate (91%), and more helpful than other HPV vaccine information they had received (94%), and that they would recommend it to others (85%). Parents suggested increasing awareness about the app, incorporating a tailored reminder system and creating opportunities to engage with adolescents about HPV and sexual health as enhancements for future iterations.
CONCLUSIONS
HPVcancerFree is a feasible mHealth intervention to support regular pediatric clinic HPV vaccine education. HPVCF was well received by parents. Future research is indicated to determine its efficacy to persuade parents to vaccinate and best promotional strategies to motivate parents to use HPVcancerFree.
Parents Experience with an mHealth Intervention to Influence HPV Vaccination Decision-Making: Mixed Methods Study (Preprint)
