Helping Children to Participate in Human Papillomavirus-Related Discussions: Mixed Methods Study of Multimedia Messages

Aurora Occa, Hayley M. Stahl, Sarah Julien-Bell

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Human papillomavirus (HPV) can cause several types of cancers and genital warts. A vaccine is available to prevent HPV infections, and several efforts have been made to increase HPV education and, eventually, vaccination. Although previous studies have focused on the development of messages to educate children about HPV and the existence of the HPV vaccine, limited research is available on how to help children better communicate with their parents and health care professionals about the HPV vaccination. In addition, limited research is available on the target audience of this study (Italian children). Objective: This manuscript describes a study assessing the feasibility of using an evidence-based animated video and a web-based game to help children (aged 11-12 years) participate in discussions about their health-in particular when such conversations center around the HPV vaccination-and improve several HPV-related outcomes. The study also compares the effects of these 2 educational multimedia materials on children's knowledge and perceptions of HPV prevention. Methods: A mixed methods approach consisting of focus group discussions and an experiment with children (N=35) was used to understand children's experiences with, and perceptions of, the animated video and the game and to measure possible improvements resulting from their interaction with these materials. Results: Both the animated video and a web-based game increased children's knowledge and positive perceptions about HPV and HPV vaccination. Any single message was not more effective than the others. The children discussed aspects of the features and characters they liked and those that need improvements. Conclusions: This study shows that both materials were effective for improving children's education about the HPV vaccine and for helping them to feel more comfortable and willing to communicate with their parents and health care professionals about their health. Several elements emerged that will allow further improvements in the design and development of the messages used in this study as well as the creation of future campaigns.

Original languageEnglish
Article numbere28676
JournalJMIR Formative Research
Issue number4
StatePublished - Apr 1 2022

Bibliographical note

Funding Information:
The authors wish to thank all the children who participated in this study; the school that helped with the recruitment of the children and offered the spaces to conduct the focus groups; the Rotary Club del Seprio, which supported the project and created a connection with the school; and the designers who worked on the animated video (Michela Burzio) and the videogame (Giorgio Ratti). The publication of this manuscript was supported by the National Cancer Institute Cancer Center Support Grant (P30 CA177558).

Publisher Copyright:
© 2022 JMIR Publications Inc.. All right reserved.


  • HPV
  • animation
  • child-parent communication
  • child-physician communication
  • children
  • communication technologies
  • game
  • health communication
  • health education
  • pilot study
  • vaccination

ASJC Scopus subject areas

  • Health Informatics
  • Medicine (miscellaneous)


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