Pilot Testing of a Game-Based Intervention to Promote HPV Vaccination in Families with Unvaccinated Children

基于游戏的干预措施的试点测试，以促进有未接种疫苗的儿童的家庭接种 HPV 疫苗

• 批准号: 10647454
• 负责人: Angela Chia-Chen Chen
• 金额: $ 23.01万
• 依托单位: HENRY FORD HEALTH + MICHIGAN STATE UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-16 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10647454
• 关键词: Address; Administrator; Advocate; Age; Agreement; American; Arizona; Behavior; Behavioral; COVID-19; COVID-19 pandemic; COVID-19 prevention; Child; Child health care; Clinic; Clinic Visits; Clinical; Collaborations; Communication; Computers; Data; Decision Making; Devices; Disease; Disparity; Dose; Drops; Economic Burden; Economics; Education; Effectiveness; Effectiveness of Interventions; Eligibility Determination; Enrollment; Family; Feedback; Female; Goals; Health; Health Personnel; Healthcare; Healthcare Systems; Human Papilloma Virus Vaccination; Human Papilloma Virus Vaccine; Human Papilloma Virus-Related Malignant Neoplasm; Human Papillomavirus; Incidence; Institution; Intervention; Interview; Job loss; Knowledge; Knowledge acquisition; Learning; Literature; Malignant Neoplasms; Measures; Mediator; Methods; Mission; Modification; Morbidity - disease rate; Outcome; Parents; Participant; Patient Self-Report; Play; Preparation; Prevention; Process; Provider; Public Health; Randomized; Reduce health disparities; Reporting; Research; Risk; Risk Factors; Science; Self Efficacy; Structure; Tablets; Technology; Testing; Time; Treatment Efficacy; United States National Institutes of Health; Vaccinated; Vaccination; Vaccines; Video Games; Visit; Youth; acceptability and feasibility; aged; behavioral outcome; boys; care providers; cost; design; effective intervention; efficacy evaluation; expectation; girls; group intervention; health goals; health knowledge; implementation intervention; infection rate; innovation; innovative technologies; insight; longitudinal design; male; mortality; novel; pandemic disease; pilot test; post intervention; preventive intervention; recruit; response; sex; social; social cognitive theory; theories; therapy design; treatment as usual; unvaccinated; uptake; vaccine acceptance; videogame intervention

ABSTRACT An estimated 80 million Americans are currently infected with human papilloma virus (HPV). HPV is strongly associated with cancers for females and males. High morbidity, mortality, and economic burden are attributable to HPV-associated cancers. Given the high infection rate of HPV in the US, vigorous prevention efforts are needed—including timely and effective HPV vaccination for boys and girls. Before COVID-19, the youth vaccination rate was suboptimal with about 50% youth 13-17 years having been vaccinated in contrast to the national goal of 80%. Vaccination rates dropped dramatically during the pandemic. Evidence for game- based health interventions is promising to facilitate knowledge acquisition and retention, and to promote vaccination behaviors in youth. As healthcare providers often find it challenging to promote HPV education and vaccination in clinical settings, an educational gamed-based intervention to promote HPV vaccination among youth in clinical settings offers an innovative and scalable approach to address this disparity in children’s healthcare. Guided by Social Cognitive Theory, we propose to (1) examine the feasibility and acceptability of a new HPV preventive intervention, the HPV Detective video game, designed for youth and their parents; (2) explore pre-post, intervention-related change in vaccine intent and uptake as well as change in theoretically posited intervention mediators; and (3) assess the potential for broader intervention implementation. Using a sequential mixed-methods, 2-group (intervention vs usual care), longitudinal design, 64 parent-youth dyads (32/per study condition) will be recruited. Parent-youth dyads in the intervention will play HPV Detective (tablet format) at the clinic prior to the healthcare provider visits. The control dyads will receive standard clinic treatment. Youth ages 11-14 need to receive two doses, 6-12 months apart, for maximum protection; thus, three weekly reminder messages will be sent 6-mos post enrollment to participants in both conditions. Data will be collected at T0 (baseline), T1 (immediately post game for intervention only) and at T2 (7-mos post enrollment). At 7-mo post enrollment, semi-structured interviews will be conducted with a subset of 8 parent- youth dyads in the intervention group, representing differences in child sex, age, and game completion, to solicit parent/youth feedback about factors that influenced their engagement in the intervention during the clinical visit; interviews with 3 healthcare providers (1 administer, 2 providers) will be conducted to examine factors related to intervention implementation. This study addresses the significant public health problem of HPV-associated cancers through timely youth vaccination, aligning with the mission of NIH. If the findings are promising, we will conduct a larger-scale RCT to examine the efficacy and effectiveness of the intervention that is likely to impact cancer-related morbidity and mortality, and reduce economic and social costs related to HPV-associated diseases. The findings will also extend prevention science with respect to the use of innovative computer technology to reduce incidence of HPV-associated cancers.

抽象的 据估计，目前有 8000 万美国人感染了人乳头状瘤病毒 (HPV)。 与女性和男性癌症的高发病率、死亡率和经济负担有关。 由于美国 HPV 感染率较高，因此应大力预防。 需要——包括为男孩和女孩及时有效地接种 HPV 疫苗。 青少年疫苗接种率未达最佳水平，13-17 岁青少年接种疫苗的比例约为 50% 疫情期间，国家疫苗接种率大幅下降。 基于健康的干预措施有望促进知识的获取和保留，并促进 由于医疗保健提供者经常发现促进 HPV 教育和预防接种行为具有挑战性。 临床环境中的疫苗接种，一种基于游戏的教育干预措施，旨在促进 HPV 疫苗接种 临床环境中的青年提供了一种创新且可扩展的方法来解决儿童的这种差异 在社会认知理论的指导下，我们建议（1）审查医疗保健的可行性和可接受性。 新的 HPV 预防干预措施，即专为青少年及其父母设计的 HPV 侦探视频游戏 (2)； 探索疫苗意图和接种前后干预相关的变化以及理论上的变化 设定干预中介；(3) 评估更广泛干预实施的潜力。 序贯混合方法，两组（干预与常规护理），纵向设计，64 名父母-青少年二人组 （每个研究条件 32 名）将招募父母-青少年二人组参与干预，扮演 HPV 侦探（平板电脑）。 格式）在医疗保健提供者就诊之前在诊所接受标准诊所治疗。 11-14 岁的青少年需要接受两次疫苗接种，间隔 6-12 个月，以获得最大程度的保护； 在这两种情况下，注册后 6 个月内将向参与者发送三周提醒消息。 在 T0（基线）、T1（比赛后立即进行干预）和 T2（比赛后 7-mos）收集 注册后 7 个月，将与 8 名家长进行半结构化访谈。 干预组中的青年二人组，代表儿童性别、年龄和游戏完成情况的差异， 征求家长/青少年对影响他们参与干预的因素的反馈 临床访问；将采访 3 名医疗保健提供者（1 名管理人员，2 名提供者）以进行检查 这项研究的实施解决了重大的公共卫生问题。 通过及时为青少年接种疫苗来预防 HPV 相关癌症，这符合 NIH 的使命。 有希望的是，我们将进行更大规模的随机对照试验来检验干预措施的功效和效果 可能会影响与癌症相关的发病率和死亡率，并降低与癌症相关的经济和社会成本 HPV 相关疾病的研究结果还将扩展预防科学的使用。 创新的计算机技术可降低 HPV 相关癌症的发病率。