Abstract A57: Bug Your Doc: Get 3 shots! – A culturally appropriate social marketing intervention to increase HPV vaccination
Authors: Hull Pamela C. , Williams Elizabeth A. , Khabele Dineo , McAfee Caree R. , Sanderson Maureen 
Published: May 2016

Abstract
HPV vaccination is recommended for all children ages 11-12, with catch up for females to age 26 and males to age 21, for prevention of HPV-associated cancers, which disproportionately affect African Americans. However, uptake of HPV vaccine has lagged far behind that of other adolescent vaccines recommended for the same ages (meningococcal and Tdap), and completion was lower among African Americans than whites until 2013. The purpose of this study was to pilot test a culturally-appropriate social marketing intervention targeting parents of African American pre-adolescents to increase initiation and completion of the 3-dose HPV vaccine series, using a community-engaged approach. A Community Advisory Board (CAB) and Teen and Parent Committee participated in the development of the intervention. While the messages were developed to be culturally-appropriate for African American parents based on formative research, the CAB wanted to ensure that the intervention was designed to be appropriate for use with families of diverse backgrounds. The goal of the “Bug Your Doc: Get 3 Shots!” social marketing intervention was to encourage parents to ask their child's doctor for all three pre-teen vaccines, including HPV vaccine, when they update their immunization record for 7th grade entry. This strategy aimed to “normalize” the HPV vaccine as just another routine vaccination for both boys and girls, rather than treating HPV vaccine as different. The messages focused on parents' desire to protect their children from harm (serious illnesses). Intervention materials included a short educational video, website (www.get3shots.org), promotional flyer, and refrigerator magnet. We used a two-group, delayed crossover design to pilot test the intervention materials with groups of parents in a workshop format, compared to a workshop on an unrelated topic. Participants were recruited through community-based organizations and university email listservs, and were able to attend the different workshops at the same location. We enrolled a convenience sample of 36 parents of 5th and 6th grade boys and girls (73% African American), of whom 29 completed two-month follow-up before crossover. Based on parent self-reports, very few children had already received any dose of the HPV vaccine at baseline, which was not significantly different between study arms (0% control, 12.5% intervention). By two month follow up, 43.8% of the parents in the intervention arm reported that they had obtained the HPV vaccine for their child, compared to no change in the control arm (0%). This difference was significant at p&lt;.05, indicating a significant effect of the intervention on increasing HPV vaccine uptake. Qualitative feedback from parents also indicated that the parents liked the materials and found the information to be useful. These intervention materials could be used for parent/patient education in a variety of contexts, such as healthcare practices, schools, and community organizations, to improve parent knowledge and acceptability of the HPV vaccine as part of the adolescent vaccine platform and to increase vaccination. Increasing HPV vaccine uptake among African American adolescents will contribute to reducing disparities in incidence and mortality from HPV-related cancers.
Citation Format: Pamela C. Hull, Elizabeth A. Williams, Dineo Khabele, Caree R. McAfee, Maureen Sanderson. Bug Your Doc: Get 3 shots! – A culturally appropriate social marketing intervention to increase HPV vaccination. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A57.