Conversational Agents to Improve HPV Vaccine Acceptance in Primary Care

会话代理可提高初级保健中 HPV 疫苗的接受度

• 批准号: 10665764
• 负责人: TIMOTHY W. BICKMORE
• 金额: $ 68.32万
• 依托单位: TUFTS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10665764
• 关键词: Address; Adolescent; Adult; Age; Ambulatory Care Facilities; Behavior; Boston; COVID-19 pandemic; Caregivers; Cellular Phone; Cervical; Child; Childhood; Clinic; Clinic Visits; Clinical Trials; Communication; Computer Interface; Computer Literacy; Computers; Counseling; Development; Education; Eligibility Determination; Ethnic Origin; Evaluation; Exclusion; Family; Health; Health Professional; Health Status; Health behavior change; Health care facility; Hospitals; Human Papilloma Virus Vaccination; Human Papilloma Virus Vaccine; Human Papillomavirus; Immunization; Income; Information Systems; Intention; Intervention; Intuition; Knowledge; Language; Malignant Neoplasms; Malignant Vaginal Neoplasm; Malignant neoplasm of anus; Malignant neoplasm of cervix uteri; Malignant neoplasm of vulva; Medical; Medical center; Misinformation; Monitor; New England; Notification; Outcome; Parents; Participant; Patients; Population; Preventive care; Primary Care; Race; Randomized, Controlled Trials; Recommendation; Research; Series; System; Technology; Time; Vaccinated; Vaccination; Vaccines; Variant; Visit; Work; aged; animation; cancer health disparity; design; empowerment; ethnic minority; global health; health literacy; improved; innovative technologies; intervention participants; low health literacy; malignant mouth neoplasm; minority patient; motivational enhancement therapy; non-verbal; premalignant; primary outcome; racial disparity; racial minority; recruit; response; safety net; secondary outcome; tertiary care; treatment arm; treatment as usual; vaccine acceptance; vaccine hesitancy; verbal

Universal Human Papillomavirus (HPV) vaccination would significantly decrease cervical, vaginal, vulvar, anal, and oral cancers, and reduce racial disparities in these cancers. However, HPV vaccination rates for U.S. adolescents of all races, ethnicities, and income levels remain far below national targets. Increasing anti-vaccine information, limited clinician time to engage with hesitant parents, and backlogs of preventive care incurred during the COVID pandemic contributed to deficits of HPV vaccination that may years to resolve. Embodied Conversational Agents (ECAs) are animated computer agents that simulate face-to-face conversation between a patient and a caregiver, using both verbal and nonverbal conversational behavior, to provide a natural and intuitive computer interface that is accessible to patients of all levels of health and computer literacy. We have successfully developed and evaluated this interface in several clinical trials to motivate health behavior change for a wide range of populations, including a pilot evaluation of an ECA that promotes HPV vaccination for the families of patients with cervical pre-cancer and cancer. In this project we will adapt this technology to produce English and Spanish smartphone ECAs for HPV vaccination (ECA-HPV) to provide vaccine recommendations and motivational interviewing to parents/guardians and vaccine-eligible adolescents and facilitate communication with clinic staff. HPV vaccine promotion over time can lead to acceptance among parents who initially decline, and the ECA can provide continual interactions both prior to and following clinic visits. We will evaluate ECA-HPV in a randomized controlled trial for HPV-vaccine eligible adolescents aged 9-12 to evaluate ECA-HPV, comparing usual care (UC) (n=175) versus usual care plus four design variants of the ECA-HPV (UC+ECA) (n= 175 x 4 = 700). All intervention participants will get the ECA-HPV for the parent; the design variants include inclusion vs exclusion of ECA-HPV for the adolescent and inclusion vs exclusion of clinic notification of information from the system in a 2x2 factorial design to differentiate the impact of the adolescent- facing and clinic notification features of the intervention. The research team is nationally recognized as leaders in HPV vaccination, health literacy, and innovative technologies to improve health. This study will advance our research on the development of easy-to-use technologies to empower patients. This scalable approach has a significant potential to reduce vaccine hesitancy and increase adolescent vaccination. If successful, our team will promote the ECA-HPV through national networks for broad implementation and work to adapt ECA-HPV to include other childhood, adolescent, maternal, and adult immunizations.

通用人乳头瘤病毒（HPV）疫苗接种将显着降低宫颈，阴道，外阴，肛门，肛门， 和口服癌症，并减少这些癌症中的种族差异。但是，美国的HPV疫苗接种率 所有种族，种族和收入水平的青少年仍然远低于国家目标。增加抗疫苗 信息，有限的临床医生与犹豫不决的父母互动的时间以及预防保健的积压 在共同大流行期间，有助于5月份解决的HPV疫苗接种缺陷。体现 会话代理（ECA）是动画计算机代理，可以模拟面对面的对话 患者和护理人员都使用言语和非语言对话行为，提供自然和 所有级别的健康和计算机素养的患者都可以使用直观的计算机接口。我们有 在几项临床试验中成功开发和评估了该界面，以激发健康行为改变 对于广泛的人群，包括对促进HPV疫苗接种的ECA的试点评估 宫颈前和癌症患者的家庭。在这个项目中，我们将调整这项技术以生产 用于HPV疫苗接种的英语和西班牙智能手机ECA（ECA-HPV）提供疫苗建议 并向父母/监护人和符合疫苗的青少年进行励志采访，并促进 与诊所工作人员进行沟通。随着时间的推移，HPV疫苗促进会导致父母接受 最初下降，ECA可以在诊所就诊之前和之后提供连续的相互作用。我们将 在一项随机对照试验中评估ECA-HPV的HPV-VACCINE合格青少年9-12岁以评估 ECA-HPV，比较常规护理（UC）（n = 175）与通常的护理以及ECA-HPV的四个设计变体 （UC+ECA）（n = 175 x 4 = 700）。所有干预参与者都将为父母提供ECA-HPV；设计 变体包括与青少年和纳入的ECA-HPV的包含在内 在2x2阶乘设计中通知系统信息，以区分青少年的影响 面对干预的特征和诊所通知特征。研究小组在全国范围内被认为是领导者 在HPV疫苗接种，健康素养和创新技术中，以改善健康。这项研究将推动我们的 研究易于使用的技术以增强患者能力的研究。这种可扩展的方法具有 减少疫苗犹豫并增加青少年疫苗接种的巨大潜力。如果成功，我们的团队 将通过国家网络促进ECA-HPV，以进行广泛的实施，并努力使ECA-HPV适应 包括其他童年，青少年，孕产妇和成人免疫。