Pilot: Development and Pilot Testing of a Facebook HPV Vaccination Intervention for Young Black Adults

ABSTRACT: High risk Human Papillomavirus (HPV) infections are implicated in almost all cases of cervical cancers, 95% anal cancers, 70% oropharyngeal cancers, 65% of vaginal cancers, 50% of vulvar cancers, and 35% of penile cancers. Two doses of HPV vaccine are recommended for 9–14-year-olds to prevent HPV- related disease, including HPV related cancers and genital warts. Catch-up vaccination (3 doses) is recommended for male and female adults (up through age 26) who missed vaccination in their adolescent years. Despite the expansion in HPV vaccination recommendation, HPV vaccination rates among 18-26 years remain low among minority and underserved populations such as African Americans (AA) and Sub-Saharan African immigrants (SAIs). HPV vaccine uptake and completion rates are low for various reasons, including: lack of awareness of the need to be vaccinated, lack of knowledge, HPV risk misconceptions, high cost, lack of physician recommendation, and confusion about guidelines, as well as negative attitudes and beliefs about the HPV vaccine. In addition, lower willingness to vaccinate among Black individuals is attributed to HPV vaccine safety and efficacy, potential side effects, and a general distrust of the healthcare system. Transition to young adulthood is a time of increased sexual activity and spread of infection. It is important to catch up young adults for HPV vaccination. Given the potential serious consequences of HPV infection, effective interventions to promote HPV vaccination are needed, particularly among age groups and populations at increased risk of HPV-related disease. Social-media delivered health interventions are effective in public health and behavior changes. Young adults engage with media and technology daily; communicating information to AA/SAI Black adults and engaging them through social media may address some of the barriers experienced with face-to-face health promotion outreach. Social media interventions can circumvent barriers such as scheduling constraints, limited time, lack of transportation, and conflicting priorities identified in traditional face-to-face interventions. Using community based participatory research (CBPR), in collaboration with a young adult community advisory board (YCAB), we will develop and pilot a Facebook intervention (#HPVvaxtalks), to promote HPV vaccination among young Black adults. This study will focus on two sub-groups of Blacks (AAs/SAIs). We hypothesize that Black adults (18-26 years) who receive the #HPVvaxtalks will improve their HPV and HPV vaccine related knowledge, HPV risk perception, HPV vaccine hesitancy, vaccination intention and uptake. In Aim 1, we will develop and refine the message library for the intervention. In Aim 2, we will test the intervention and compare the outcomes (HPV vaccine related knowledge scores, hesitancy, risk perception, intention, and uptake) at baseline and 8 weeks post intervention. We will conduct interviews with participants to assess intervention likability, acceptability, content understandability, relevance, appropriateness, appeal, message formats, and engagement. One of the unique aspects of this pilot is the message development by referent peer groups, which is integral to intervention strategy and success. This study has the potential to provide an effective intervention to young adults. The goal of this study is to increase vaccination and eliminate the inequitable burden of HPV-related diseases among AA/SAI.