Tailoring of Vaccine-Focused Messages: Disease Salience

Genital human papillomavirus (HPV) is the most common sexually transmitted infection in the
United States. Most HPV infections are asymptomatic and clear on their own within 2 years
but persistent infections can lead to diseases, including several cancers. Cervical cancer
is the most common cancer caused by HPV infection, and virtually all cervical cancers can be
attributed to HPV infection. There is no cure for HPV, but HPV can be prevented through
vaccination. Current recommendations from the Advisory Committee on Immunization Practices
(ACIP) state that the HPV vaccine may be given starting at 11-12 years of age for boys and
girls, through age 26. Despite the safety and efficacy of this vaccine, the coverage among
adolescents aged 11-17 years old remains low. Attaining high vaccination rates among
adolescents is essential to decreasing the burden of disease due to cervical cancer, and
other cancers caused by HPV.

Parental decision to vaccinate their children, specifically with the HPV vaccine, can be
tied to multiple constructs of the Health Belief Model. These include perceived
susceptibility of HPV infection (is my child at risk of infection), perceived benefit, and
perceived severity (of disease, and of vaccine related adverse events). This would suggest
that messaging surrounding the HPV vaccination should be highly salient within these
constructs. The current message tied to the HPV vaccine presented by the Centers for Disease
Control (CDC) has a focus on HPV as an infection and is clinical in nature. In a randomized
trial, parents given information about HPV were no more likely to be accepting of an HPV
vaccine and no more likely to get their child vaccinated. Based on this literature, the
researchers hypothesize that reframing the message to promote HPV vaccination as a means of
protection against cervical cancer will impact intent to vaccinate among parents of
adolescent females (aged 11-17 years old).

In the first phase of this study the researchers assessed how appealing to different moral
foundations impacted attitudes towards vaccination and intent to vaccinate. For this phase
of this study, the researchers will conduct a 3-arm randomized trial to compare the current
CDC HPV, a cervical cancer focused message developed by the study team, and a non-vaccine
related control passage among parents of adolescent females. The goal of the trial will be
to determine if the new cervical cancer framed message has an increased impact on intent to
have daughters receive the HPV vaccine over the trial period as compared to the current CDC
message. Additionally, the researchers will examine the impact both the CDC message and the
new message have on intent to vaccinate when compared to the non-vaccine related control
message.

The participant's vaccine beliefs and intent to vaccinate will be assessed through an online
survey at baseline. Two weeks later, participants will be randomized to view one of the
three messages: the current CDC message, the cervical cancer framed message, or a
non-vaccine related control message. Immediately afterwards, vaccine beliefs and intent to
vaccinate will be assessed to determine the impact of the message.

Inclusion Criteria:

- Have at least one daughter between 9 and 17 years of age (inclusive)

- Reside in the United States

Exclusion Criteria:

- Have previously participated in the disease salience phase of this study