Developing an mHealth Intervention to Increase HPV Vaccine Confidence Among Black Families

Despite over 15 years of human papillomavirus (HPV) vaccination implementation, uptake remains below national targets. Black/African American adolescents are less likely to complete the HPV vaccine series, due to a myriad of multilevel factors including vaccine hesitancy. The objective of this study was to develop a tailored mHealth intervention to promote vaccine confidence among Black families with adolescents. We generated a message bank from the literature, then prioritized and edited content according to needs identified in previous research with Black parents, community stakeholder input, and expert consensus. We conducted three rounds of prototype feedback sessions with 16 parents of adolescents aged 9-13 years from the Greater Newark Area. We recruited at family-friendly events, through community researchers, and with snow-ball sampling. We employed user-centered design techniques, elicited open-ended feedback, and collected relevance ratings for rapid qualitative analysis. Transcripts were thematically analyzed. Results indicated intervention content and features should be tailored by information source and channel. Fact-based messages with neutral framing balancing cancer prevention benefits and safety were highly rated. Including links to trustworthy sources was perceived as increasing credibility and helpful for family-centered decision-making. Parents also wanted age-appropriate information with graphics to explain the purpose and importance of HPV vaccination to their adolescents. Developing the intervention with families highlighted the need for multi-modalities, including informational short-message-service (SMS) and detailed emails with tailored information. Multi-modal interventions providing accurate information tailored to parents' questions and concerns, have potential to educate and empower parents to protect their children from HPV cancers.