From the Journals

Strongly recommend HPV vaccine to increase uptake


 

To convince parents to get their kids vaccinated against human papillomavirus (HPV), tell them “I strongly believe in the importance of this cancer-preventing vaccine for [their child’s name],” researchers concluded after an online survey of 1,504 parents of children aged 11-17 years.

Sixty-five percent of parents agreed it was a persuasive argument, the highest percentage among 15 statements in favor of vaccination; 69% of 776 surveyed physicians said they’d use it in practice, also the highest physician endorsement for the various arguments (Cancer Epidemiol Biomarkers Prev. 2016 Sep 30. doi: 10.1158/1055-9965.EPI-16-0224).

In general, parents disinclined to vaccinate were most receptive to messages about HPV infection being common, cancers caused by HPV, and HPV vaccine effectiveness.

Other persuasive arguments included “[child’s name] can get anal/cervical cancer as an adult, but you can stop that right now;” and “there will be many things in [child’s name]’s life that you can’t control. But you can control whether [he/she] gets some dangerous kinds of HPV.”

vaccine ©jarun011/Thinkstock

Both “placed the onus of protection on the parent and emphasized the control they possess over their child’s health. This finding is aligned with the tenets of various theories of fear appeals, which posit that fear messages inspire action if the receiver believes he or she has some control over the situation. Parents without prior intentions to vaccinate their child may be particularly receptive to messages that arouse fear while fostering a sense of efficacy,” said Teri Malo, PhD, of the University of North Carolina, Chapel Hill, and associates.

Although almost 60% of parents said they’d pay attention if told they could control if their child gets HPV cancer, only 37% of physicians said they’d use the argument. It’s not clear why, but the team said the finding was “concerning ... given that it was one of the top messages that would persuade parents without prior intentions to vaccinate their child.”

At present, 40% of girls and 22% of boys aged 13-17 years receive all three HPV shots. The goal of the study was to help doctors increase those numbers with persuasive arguments. “Physician communication about human papillomavirus vaccine is a key determinant of uptake,” but not all physicians strongly recommend the vaccine, especially if they anticipate parent resistance. “We sought to identify messages that would motivate HPV vaccination,” the researchers said.

Argument by analogy was the weakest approach. Only 5% of parents found “would you wait until [child’s name] is in a car accident before you tell [him/her] to wear a seatbelt?” persuasive, and only 9% of physicians said they’d use it, which made it the least endorsed statement in the study.

The same arguments seemed to work regardless of parents’ race, education, or income, or their child’s age or sex, which led the team to suggest the messages will work across demographic subgroups.

Slightly more moms than dads filled out the survey, and most were white, with about 9% of parents black and 14% Hispanic. Most parents lived in metropolitan areas, nearly two-thirds had at least some college, and almost half reported an annual household income of at least $75,000. For simplicity, parents limited their responses to their child with the most recent birthday. About half of children were boys, and just over half hadn’t been vaccinated against HPV.

About two-thirds of the physicians were men. Over half had practiced for at least 20 years, just over half were pediatricians, and the rest were family practitioners.

The work was funded by an unrestricted educational grant from Pfizer to senior investigator Noel Brewer, PhD. Dr. Brewer receives commercial research grants from Merck, maker of the HPV vaccine Gardasil, and Pfizer. He is also a Merck consultant and advisory board member. Coauthor Melissa B. Gilkey, PhD, and Dr. Malo were supported by other grants. The report noted that “the costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with” U.S. law.

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