Multi-Level Communication Strategies for HPV Vaccination in Hmong Adolescents
Condition: HPV-associated Cancer
Study type: Interventional

Summary: 
      The specific aims are: 1) to design a multilevel, theory-driven, highly interactive,
      culturally and cognitively tailored hAppy app intervention to facilitate HPV vaccination
      completion among Hmong adolescents and their parents using CBPAR; 2) establish a systematic
      health care provider protocol for identifying and engaging Hmong adolescents and their
      parents in the use of the hAppy app; and 3) examine participants' intent, knowledge and
      self-efficacy of HPV vaccinations, perceptions of the hAppy app and their patient-provider
      experiences. This study will advance existing knowledge of mHealth's impact on populations at
      risk for cancer and contribute new, important information to cancer health disparities
      research. If found to be effective, this intervention will have extensive implications for
      prevention of other types of cancer among different underserved populations, potentially
      reducing cancer-related disparities, morbidity, and mortality.
    

Detailed description: 
      A quarter million Hmong Americans (Hmong) reside in the United States and 25% live in the
      Twin Cities metropolitan area. With a median age of 20.4 years old, this young community has
      a poverty rate of 26% in Minnesota and 27.4% nationally. Cervical cancer knowledge and
      prevention, such as awareness of HPV's effectiveness in reducing cancer risk, is low among
      Hmong women (19-50%) and men (38%), which may explain Hmong's high cervical cancer incidence
      rates (three times higher than other Asian Americans (AA) and four times higher than
      Non-Hispanic Whites). This problem is further aggravated by the rise of cervical cancer
      incidence and mortality rates among Hmong women. Clearly, multilevel strategies to increase
      HPV vaccination rates and reduce HPV-related cancers among Hmong are urgently needed. Yet
      Hmong women face structural and cultural barriers that limit their access to preventive
      health care. Language difficulties, poor health literacy, lack of time or transportation,
      visiting a doctor only when symptomatic or in pain and abstaining from gynecological visits
      due to embarrassment are some of these barriers. These barriers and beliefs must be carefully
      integrated into the design of any effective multilevel strategy to promote HPV vaccination
      uptake and completion. This study proposes to use a Community-Based Participatory Action
      Research (CBPAR) approach to develop and test the effectiveness of a theory-based culturally
      and cognitively appropriate mobile application (hAppy app) intervention that facilitate HPV
      vaccination completion among Hmong adolescents (11 to 17 years old) and their parents. Mobile
      health (mHealth) technology is a promising tool allowing for effective person-centered
      customization. The study's primary objective is to evaluate the effectiveness of hAppy app
      intervention in Hmong adolescents and their parents. 100 Hmong adolescents and their parents
      will be recruited and a single blind, two arm, randomized controlled trial will be conducted.
      Participants will be randomized by a 1:1 ratio to receive the hAppy app intervention (N=50)
      or usual care (UC, N=50) for a 9-month period.
    

Intervention name(s): HPV app intervention
Intervention type(s): Behavioral
Intervention description(s): Participants assigned to this group will receive an HPV app that targets a dyad of parent and a teen boy or girl.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Two-Arm Randomized Clinical Trial
Masking: Single (Participant)
Primary purpose: Prevention