Web App Technology for Boys and Parents: Improving HPV Vaccine Uptake

The President's Cancer Advisory Board and the Centers for Disease Control have called for
renewed efforts in promoting vaccination for Human Papillomavirus (HPV), including
vaccination for adolescent boys, because the uptake of this new vaccine remains alarmingly
low. Currently, less than 15% of adolescent boys have received the HPV vaccine; thus, most of
this population remains at risk for oropharyngeal, anal, and penile cancers. Many parents
remain unconvinced of the safety and effectiveness of HPV vaccines, so effective and
accessible messaging to improve decision-making on this vaccine is needed. Parents of
adolescent boys also have different concerns about HPV vaccination than for adolescent girls,
creating a need for unique health communication interventions to promote vaccine uptake among
boys. Interventions also need to address the unique challenges of minority populations and
populations for whom English is not the first language. A novel digital intervention will be
produced and evaluated for its ability to improve HPV vaccine outcomes. Specifically, a
mobile responsive web application ("mobile web app") will be created that performs similar to
a mobile app but runs on a variety of computing platforms from personal desktop and laptop
computers to the latest smart phones and tablet computers. Mobile web app content will be
targeted to parents and adolescent boys aged 11-13 years. The specific aims are to: 1)
carefully and systematically develop a mobile web app (BoyVac) for smart phones, tablet
computers, and personal computers that will utilize Diffusion of Innovations principles to
provide targeted information concerning HPV vaccine adoption to adolescent males and their
parents, particularly minority adolescents and parents; 2) implement a comprehensive and
rigorous test of the impact of the BoyVac mobile web app intervention on HPV vaccine adoption
outcomes via a randomized efficacy trial (BoyVac v. usual and customary care); and 3) examine
the dose-response relationships between mobile web app usage and vaccine outcomes within a
components analysis. A group-randomized pretest-posttest controlled design will be
implemented, recruiting 1800 pairs of parents and adolescent boys from 30 pediatric clinics
(n=60 parents and boys per clinic). Parents will be surveyed at baseline, a 3-month
follow-up, and a 9-month follow-up and records HPV vaccination adoption for the boys will be
obtained from the clinics' medical records at the 9-month follow-up. Analyses will test the
hypotheses that 1) more 11-13 year old boys in the intervention group (BoyVac mobile web app)
will adopt the HPV vaccine than boys in the usual and customary care comparison group and 2)
adoption of HPV vaccine will be mediated by improvements in theoretical mediators among
parents in the intervention compared to the usual and customary care comparison group.

Inclusion Criteria:

Adolescent boys:

1. being male

2. being 11-13 years old

3. being a patient at a participating University of New Mexico (UNM) Hospital's Envision
pediatric practice

4. parental consent for testing, and

5. child assent for testing

Parents/Guardians:

1. being a parent/guardian of an eligible and participating 11-13 year old boy

2. demonstrated ability to comprehend study requirements, and

3. providing informed consent for oneself and assent for their youth's participation

Exclusion Criteria:

Adolescent boys:

1. another immediate family member is participating in the project (i.e., a sibling)

2. the participant has already received any or all doses for the HPV vaccine, or

3. the participant refuses to assent.

Parents/Guardians:

1. under the age of 18, or

2. another immediate family member is participating in the project (i.e., another
parent).