A Message Framing Intervention for Increasing Parental Acceptance of Human Papillomavirus Vaccination

Study Overview
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Brief Summary
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The goal of this study is to determine the effects of message framing (gain vs. loss) on African American parents' acceptance of the HPV vaccine and how such effects are moderated by parents' salient beliefs prior to message exposure. Participants are randomized into gain and loss conditions in which they view either gain-framed or loss-framed HPV vaccination messages. Key outcome variables include parents' attitudes and intentions toward vaccinating their children against HPV.

Detailed Description
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The goal of this study is to determine the effects of message framing (gain vs. loss) on African American parents' acceptance of the HPV vaccine and how such effects are moderated by parents' salient beliefs prior to message exposure. Participants recruited from local communities and online panels will complete a computer-assisted survey. In the survey participants will first answer questions related to their beliefs about HPV and the HPV vaccine (e.g., perceived susceptibility, perceived severity, perceived efficacy, perceived safety, etc.), as well as other background information. Then they will be presented with either a gain-framed or loss-framed human papillomavirus vaccination message. After the message exposure, they will answer questions related to their attitudes toward HPV vaccination, intentions to vaccinate their children, as well as other message response measures. Eligible participants are at least 21 years old, self-identify as African American, and are custodial parents or caretakers of at least one child ages 9-17 who has not initiated the HPV vaccine series.

Official Title
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A Message Framing Intervention for Increasing Parental Acceptance of Human Papillomavirus Vaccination

Conditions
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Cervical Cancer, Anal Cancer, Penile Cancer

Intervention / Treatment
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* Behavioral: HPV vaccination messages


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years or older Self-identify as African American Custodial parent or caretaker of at least one child under the age of 18 who has not been fully vaccinated against HPV. Has access to Internet to complete the study Exclusion Criteria: Younger than 18 years Does not self-identify as African American Not a custodial parent or caretaker of at least one child under the age of 18 who has not been fully vaccinated against HPV. Has no access to Internet to complete the study

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Gain-framed messages<br>Participants in this arm receive gain-framed HPV vaccination messages. | Behavioral: HPV vaccination messages<br>* Digital multimedia messages consisting of text and imagery conveying the benefits of being vaccinated against HPV, the costs of not being vaccinated against HPV, or neither benefits or costs but simply a call for action.<br>|
| Experimental: Loss-framed messages<br>Participants in this arm receive loss-framed HPV vaccination messages. | Behavioral: HPV vaccination messages<br>* Digital multimedia messages consisting of text and imagery conveying the benefits of being vaccinated against HPV, the costs of not being vaccinated against HPV, or neither benefits or costs but simply a call for action.<br>|
| Active Comparator: Control messages<br>Participants in this arm receive non-framed HPV vaccination messages. | Behavioral: HPV vaccination messages<br>* Digital multimedia messages consisting of text and imagery conveying the benefits of being vaccinated against HPV, the costs of not being vaccinated against HPV, or neither benefits or costs but simply a call for action.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Attitudes | Attitudes toward HPV vaccination will be assessed by three semantic differential items adapted from previous research. Participants will be presented with a statement (i.e., vaccinating my child against HPV would be ____) followed by adjectives such as Bad/Good, Stupid/Wise, and A bad idea/A good idea. | baseline posttest | 
| Attitudes | Attitudes toward HPV vaccination will be assessed by three semantic differential items adapted from previous research. Participants will be presented with a statement (i.e., vaccinating my child against HPV would be ____) followed by adjectives such as Bad/Good, Stupid/Wise, and A bad idea/A good idea. | 1-month follow up | 
| Intentions | Behavioral intentions toward HPV vaccination will be assessed with three questions adapted from previous research. Participants will be asked questions such as how likely would you be to get your child vaccinated with the HPV vaccine sometime soon? Since cost of the vaccine is a potential barrier, all participants will be asked to indicate their intentions to get their children vaccinated for two scenarios: 1) if they have to purchase the vaccine for the full retail price at the time and 2) if the vaccine is offered to them free of cost. The two measures will be kept separate as outcome variables. | baseline posttest | 
| Intentions | Behavioral intentions toward HPV vaccination will be assessed with three questions adapted from previous research. Participants will be asked questions such as how likely would you be to get your child vaccinated with the HPV vaccine sometime soon? Since cost of the vaccine is a potential barrier, all participants will be asked to indicate their intentions to get their children vaccinated for two scenarios: 1) if they have to purchase the vaccine for the full retail price at the time and 2) if the vaccine is offered to them free of cost. The two measures will be kept separate as outcome variables. | 1-month follow up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Thoughts | Participants will be asked to list the thoughts they had while viewing the message. They will categorize the thoughts into positive (in support of the message), negative (in opposition to the message), and irrelevant. | baseline posttest | 
| Emotions | Participants will report how they felt while viewing the message. Anger, Guilt, Fear, Sadness, and Happiness will be measured by an established scale. | baseline posttest | 
| Perceived argument strength | Perceived argument strength will be measured by an established scale. | baseline posttest |