Varying Messaging Strategies Increases Likelihood of Vaccination Against HPV

Using agency and deviance regulation messages helped to significantly increase human papillomavirus (HPV) vaccination, according to findings of a new study. The investigators noted that there were differences in the variables that influenced vaccination decision making for adults aged 18 to 26 years and for parents making the decision to vaccinate their child.¹

Image Credit: Tobias Arhelger - stock.adobe.com

HPV is the most common sexually transmitted infection in the United States, with some types resulting in a low risk of cancer and others at high risk of causing cancer. Cervical cancer is the most common HPV-associated cancer for females, whereas oropharyngeal cancer is the most commonly associated among males. From 2011 to 2014, the prevalence of oral HPV was 7.3%, with high-risk HPV in 4% of adults aged 18 to 69 years. From 2013 to 2014, the prevalence of any and high-risk genital HPV among adults aged 18 to 59 years was 45.2%.^2,3

HPV vaccination is recommended for all preteens at 11 to 12 years of age and catch-up vaccination is recommended for all adults through age 26. Vaccination is not recommended for those 27 years or older due to the decrease of benefits in older ages, according to the CDC.³

It has been reported that uptake rates remain low among adults aged 18 to 26, with approximately 40% completing the recommended vaccination series. Among those 13 to 17 years old, approximately 70% of patients received at least 1 dose, which is below the US goal of 80%. In the study, investigators tested the use of HPV vaccination message strategies for young adults and parents making vaccination decisions for their children. The investigators used agency assessment, defined as messages containing vocabulary about responsibility or control over a situation, as well as deviance regulation, which emphasizes the consequences of deviating from health behavioral norms.¹

In the study, the investigators evaluated the intent to get vaccinated based on vaccination confidence, knowledge about HPV, and knowledge about HPV vaccines. Additionally, risk perception—both the logical judgement of risk and the emotional response to risk—were included in the meta-analysis. Self-efficacy was also an important predictor included. The investigators also acknowledged that the design of specific messages for parents and for young adults impacted the results.¹

There were 862 individuals recruited to participate and investigators separated them into 2 groups: parents or guardians of a child 17 years or younger who had not yet been vaccinated for HPV; and individuals aged 18 to 26 who had not been vaccinated for HPV. Investigators included 718 participants with an age range of 22 to 60 years for those who were parents/guardians and 18 years to 26 years for the second group. In the study, individuals were assigned to 1 of 18 messages, and they were required to spend a minimum of 20 seconds reading it before responding to attention-check questions. Individuals also answered questions related to psychological factors, demographic information, and health data.¹

Investigators found that both agency and deviance regulation-based questions were significant in increasing the intention to get vaccinated. However, these messages increased vaccination confidence among young adults but not parents. The study authors reported that young adults with more knowledge about HPV and vaccination reported higher intentions to get vaccinated, but parents who had more knowledge reported lower intentions to have their children vaccinated.¹

REFERENCES

1. Su R, Stephens KK, McGlone MS, Jia M. One HPV Vaccination Message Does Not Fit All: Differences Between Young Adults Deciding to Be Vaccinated and Parents Deciding for Their Children. Health Commun. Published online October 31, 2024. doi:10.1080/10410236.2024.2417115

2. CDC. Prevalence of HPV in Adults Aged 18–69: United States, 2011–2014. National Center for Health Statistics. Updated April 6, 2017. Accessed November 6, 2024. https://www.cdc.gov/nchs/products/databriefs/db280.htm

3. CDC. Cancers Associated with Human Papillomavirus. US Cancer Statistics. 2024. Accessed November 6, 2024. https://www.cdc.gov/united-states-cancer-statistics/publications/hpv-associated-cancers.html