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Fontenot HB, Quist KM, Glauberman G, Michel A, Zimet G. Impact of the COVID-19 pandemic on social media utilization, influences related to parental vaccine decision making, and opinions on trustworthy social media vaccination campaigns: A qualitative analysis. Hum Vaccin Immunother 2024; 20:2311476. [PMID: 38356267 PMCID: PMC10878019 DOI: 10.1080/21645515.2024.2311476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 01/25/2024] [Indexed: 02/16/2024] Open
Abstract
There is a continued need for research to better understand the influence social media has on parental vaccination attitudes and behaviors, especially research capturing the effects of the COVID-19 pandemic. The goal of this study was to explore parents' perspectives related to the impact the pandemic had on 1) social media engagement, 2) vaccine messaging on social media, and 3) factors to guide future intervention development. Between February and March 2022, 6 online, synchronous, text-based focus groups were conducted with parents of adolescents aged 11 to 17 years. Participants who all utilized social media were recruited from across the United States. Qualitative data were analyzed using content analysis. A total of 64 parents participated. Average age was 47 years, and participants were predominantly White (71.9%), female (84.3%), and engaged with social media multiple times per day (51.6%). Participants (95.3%) viewed obtaining all recommended vaccines as important or very important; however, overall vaccination rates for their adolescents were varied (50% ≥1 dose HPV; 59.4% MenACWY; 78.1% Tdap; 65.6% Flu; 81.3% COVID-19). Three themes emerged highlighting the pandemic's impact on parent's (1) general patterns of social media use, (2) engagement about vaccines on social media and off-line behaviors related to vaccination, and (3) perspectives for developing a credible and trustworthy social media intervention about vaccination. Participants reported fatigue from contentious vaccine-related content on social media and desired future messaging to be from recognizable health institutions/associations with links to reputable resources. Plus, providers should continue to provide strong vaccine recommendations in clinic.
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Affiliation(s)
| | - Kevin M. Quist
- Department of Pediatrics, Herman B Wells Center for Pediatric Research, Indianapolis, IN, USA
| | - Gary Glauberman
- School of Nursing, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Alexandra Michel
- School of Nursing, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Gregory Zimet
- Department of Pediatrics, Division of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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Bustamante G, Liebermann E, McNair K, Fontenot HB. Women's perceptions and preferences for cervical cancer screening in light of updated guidelines. J Am Assoc Nurse Pract 2023; 35:699-707. [PMID: 37498967 DOI: 10.1097/jxx.0000000000000923] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/13/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Updated risk-based guidelines for cervical cancer screening (CCS) allow for individualized screening that minimizes unnecessary testing. However, these guidelines are complex and may not be easily understandable to patients. PURPOSE To describe women's perceptions and preferences about CCS in light of recent guideline changes. METHODOLOGY This qualitative study conducted in February 2020 used online, text-based focus groups with a sample of US women ( n = 49) ages 27-45. After participants completed a short demographic survey, an experienced moderator used a semistructured guide to solicit participants' perceptions of routine gynecologic care and CCS. We summarized survey data using descriptive statistics. Two authors analyzed transcripts using conventional content analysis and met with other team members to resolve discrepancies and determine final themes. RESULTS Most participants were non-Hispanic White (65%), had health insurance (90%), and reported having a routine gynecologic examination in the past year (70%). We identified four common themes: (1) low perceived risk of human papillomavirus (HPV) coupled with low knowledge about HPV as a causative factor for cervical cancer, (2) confusion about-and mistrust of-recent individual risk-based guidelines that determine the indicated timing and type of CCS test (Pap or HPV testing), (3) mixed opinions about performing a self-swab for HPV testing, and (4) conflicting perceptions of trust toward providers and the health care industry. CONCLUSIONS Findings highlight women's uncertainty and hesitancy about updated CCS guidelines. IMPLICATIONS Provider-patient communication strategies should consider women's gaps in knowledge about HPV, include the rationale for guidelines and types of tests, and build trust between patients and providers.
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Affiliation(s)
- Gabriela Bustamante
- Instituto de Medicina Social & Desafíos Globales, School of Public Health, Universidad San Francisco de Quito, Quito, Ecuador. Dr. Bustamante is previously at the Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Erica Liebermann
- College of Nursing, University of Rhode Island, Providence, Rhode Island
| | - Katelyn McNair
- Beth Israel Deaconess Lahey Health Breast Center, Plymouth, Massachusetts. Dr. McNair is previously at the Boston College, Connell School of Nursing, Chestnut Hill, Massachusetts
| | - Holly B Fontenot
- School of Nursing, University of Hawaii, Honolulu, Hawaii. Dr. Fontenot is previously at the Boston College, Connell School of Nursing, Chestnut Hill, Massachusetts
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Meites E, Wilkin TJ, Markowitz LE. Review of human papillomavirus (HPV) burden and HPV vaccination for gay, bisexual, and other men who have sex with men and transgender women in the United States. Hum Vaccin Immunother 2022; 18:2016007. [PMID: 35294325 PMCID: PMC8993076 DOI: 10.1080/21645515.2021.2016007] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Gay, bisexual, and other men who have sex with men (MSM) and transgender women, particularly those who are living with HIV, are disproportionately affected by human papillomavirus (HPV). For this narrative review of HPV health outcomes and vaccination for gay, bisexual, and other MSM and transgender women in the United States, we highlighted 71 publications regarding 1) burden of HPV infections and related diseases; 2) HPV vaccine efficacy; 3) HPV vaccination recommendations; 4) HPV vaccination coverage; 5) real-world vaccine effectiveness and health impacts; and 6) HPV vaccination acceptability. Vaccination is effective at reducing HPV infections among MSM; in the United States, routine HPV vaccination is recommended for all adolescents at age 11-12 years and for all persons through age 26 years. Efforts are ongoing to increase vaccination coverage and monitor health impacts of vaccination. Increasing vaccination coverage before sexual exposure to HPV is expected to reduce the burden of HPV-related disease.
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Affiliation(s)
- Elissa Meites
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Timothy J Wilkin
- Division of Infectious Diseases, Weill Cornell Medicine, New York, NY, USA
| | - Lauri E Markowitz
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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4
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Eysenbach G, Kennedy CE, Minamitani A, Baggaley R, Shah P, Verster A, Luhmann N, de Mello MB, Macdonald V. Web-Based Service Provision of HIV, Viral Hepatitis, and Sexually Transmitted Infection Prevention, Testing, Linkage, and Treatment for Key Populations: Systematic Review and Meta-analysis. J Med Internet Res 2022; 24:e40150. [PMID: 36548036 PMCID: PMC9816952 DOI: 10.2196/40150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/30/2022] [Accepted: 10/20/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Despite the growth of web-based interventions for HIV, viral hepatitis (VH), and sexually transmitted infections (STIs) for key populations, the evidence for the effectiveness of these interventions has not been reported. OBJECTIVE This study aimed to inform the World Health Organization guidelines for HIV, VH, and STI prevention, diagnosis, and treatment services for key populations by systematically reviewing the effectiveness, values and preferences, and costs of web-based outreach, web-based case management, and targeted web-based health information for key populations (men who have sex with men, sex workers, people who inject drugs, trans and gender-diverse people, and people in prisons and other closed settings). METHODS We searched CINAHL, PsycINFO, PubMed, and Embase in May 2021 for peer-reviewed studies; screened abstracts; and extracted data in duplicate. The effectiveness review included randomized controlled trials (RCTs) and observational studies. We assessed the risk of bias using the Cochrane Collaboration tool for RCTs and the Evidence Project and Risk of Bias in Non-randomized Studies of Interventions tools for non-RCTs. Values and preferences and cost data were summarized descriptively. RESULTS Of 2711 records identified, we included 13 (0.48%) articles in the effectiveness review (3/13, 23% for web-based outreach; 7/13, 54% for web-based case management; and 3/13, 23% for targeted web-based health information), 15 (0.55%) articles in the values and preferences review, and 1 (0.04%) article in the costs review. Nearly all studies were conducted among men who have sex with men in the United States. These articles provided evidence that web-based approaches are as effective as face-to-face services in terms of reaching new people, use of HIV, VH, and STI prevention services, and linkage to and retention in HIV care. A meta-analysis of 2 RCTs among men who have sex with men in China found increased HIV testing after web-based outreach (relative risk 1.39, 95% CI 1.21-1.60). Among men who have sex with men in the United States, such interventions were considered feasible and acceptable. One cost study among Canadian men who have sex with men found that syphilis testing campaign advertisements had the lowest cost-per-click ratio on hookup platforms compared with more traditional social media platforms. CONCLUSIONS Web-based services for HIV, VH, and STIs may be a feasible and acceptable approach to expanding services to key populations with similar outcomes as standard of care, but more research is needed in low-resource settings, among key populations other than men who have sex with men, and for infections other than HIV (ie, VH and STIs).
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Affiliation(s)
| | - Caitlin Elizabeth Kennedy
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Ayako Minamitani
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Rachel Baggaley
- Testing, Prevention and Population Unit, Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland
| | - Purvi Shah
- Testing, Prevention and Population Unit, Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland.,Regional Support Team Asia Pacific, Joint United Nations Programme on HIV/AIDS, New Delhi, India
| | - Annette Verster
- Testing, Prevention and Population Unit, Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland
| | - Niklas Luhmann
- Testing, Prevention and Population Unit, Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland
| | - Maeve Brito de Mello
- Testing, Prevention and Population Unit, Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland
| | - Virginia Macdonald
- Testing, Prevention and Population Unit, Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland
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Rea S, Zynda A, Allison B, Tolleson-Rinehart S. Adolescent Perceptions of Technology-Based Sexual and Reproductive Health Services: A Systematic Review. J Adolesc Health 2022; 71:533-544. [PMID: 35717326 DOI: 10.1016/j.jadohealth.2022.05.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/28/2022] [Accepted: 05/06/2022] [Indexed: 10/31/2022]
Abstract
Technology-based services, including telehealth, text messaging, and the internet are increasingly popular methods for adolescents and young adults (AYA) to access sexual and reproductive health (SRH) information and healthcare. This systematic review examined AYA perceptions of privacy and confidentiality of technology-based SRH services. The PubMed, Scopus, and PsycINFO were systematically searched in May 2021 to capture relevant qualitative or quantitative articles from the past 10 years. Included studies had AYA (i.e., mean age, 13-26-years with <10% of the sample outside this range), technology-based services for SRH, and outcomes of perceived privacy or confidentiality. Twenty-eight articles were included (N = 8638 AYA). Most studies utilized the internet and mobile apps to address human immunodeficiency virus infection (HIV), sexually transmitted infections, and general SRH topics. Most AYA reported that these services were private and confidential, with minimal differences across SRH topic addressed. More interactive services had greater concerns (e.g., family or friends seeing notifications). Most AYA considered technology-based SRH to be confidential and private. As technology will likely remain an integrated part of healthcare delivery, improving the privacy and confidentiality of these services can facilitate AYA's independent and autonomous engagement in SRH care, and potentially improve their SRH outcomes.
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Affiliation(s)
- Samantha Rea
- University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina.
| | - Aaron Zynda
- Department of Kinesiology, Michigan State University, East Lansing, Michigan
| | - Bianca Allison
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Sue Tolleson-Rinehart
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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Dwyer AA, Uveges M, Dockray S, Smith N. Advancing qualitative rare disease research methodology: a comparison of virtual and in-person focus group formats. Orphanet J Rare Dis 2022; 17:354. [PMID: 36089593 PMCID: PMC9465872 DOI: 10.1186/s13023-022-02522-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 09/06/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Rare disease research is hampered in part by the fact that patients are geographically dispersed. Rare disease patient communities are recognized for their use of the internet to learn about their condition and find peer-to-peer support. As such, web-based technologies offer promise for overcoming geographic barriers in rare disease research for many. Qualitative focus groups (FGs) are a widely used methodology used to understand patients and parents/families ‘lived experience’ and unmet needs is important to improve care for rare diseases. It is unclear if web-enabled (virtual) FGs are comparable to traditional in-person approaches. We conducted in-person (n = 3) and virtual (n = 3) FGs with rare disease patients to determine if virtual FGs produce similar results in-person FGs.
Results
Three in-person (n = 33 participants) and three virtual (n = 25 participants) FGs were conducted examining attitudes and beliefs regarding genetic testing and family communication of risk. Participants included 30 males, 18 females, and 10 parents/guardians. Two independent investigators identified excerpts (meaningful sections of text) and coded themes/sub-themes using a codebook. Inter-coder agreement across identified excerpts (n = 530) in both FG formats was 844/875 (96.5%). Two additional investigators reviewed coded excerpts and did not identify additional themes/sub-themes—supporting data saturation across FG formats. Virtual FGs accounted for 303/530 (57.2%) of total excerpts and 957/1721 (55.7%) of all identified themes/sub-themes. Formats were similar in terms of overall number of excerpts (101 ± 7.8 vs. 75.7 ± 18.8, p = 0.26) and themes/sub-themes (319 ± 6.1 vs. 254.7 ± 103.6, p = 0.34) between virtual and in-person FGs. However, virtual FGs had significantly more coded excerpts specifically relating to sensitive/intimate topics including ‘attitudes and beliefs’ (n = 320 vs. n = 235, p < 0.001), ‘information and support’ (n = 184 vs. n = 99, p < 0.001), and ‘family communication’ (n = 208 vs. n = 114, p < 0.001).
Conclusions
Virtual FGs yielded similar numbers of coded excerpts compared to traditional in-person FGs. Virtual FGs appear to support the relative anonymity of participants, resulting in richer discussion of highly sensitive, intimate topics. Findings support the validity and methodologic rigor of using web-enabled technologies for conducting FGs in rare diseases.
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Wong HTH, Jin D, Wang P, Sun Y, Mao L, Zhang Y, Ogilvie E, Vujcich D, Newman C, O'Connor CC, Vaughan C, Carter A. Using Videoconferencing Focus Groups in Sexual and Reproductive Health Research With Chinese Im/Migrants in Australia. QUALITATIVE HEALTH RESEARCH 2021; 31:2757-2769. [PMID: 34636281 DOI: 10.1177/10497323211043823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Videoconferencing focus groups have emerged as a popular method for collecting qualitative data. However, its use in sexual and reproductive health research is still very much in its infancy. Based on participants' feedback and researchers' reflections on using videoconferencing focus groups to collect sexual and reproductive health data with 39 heterosexual and non-heterosexual Chinese im/migrants in Australia, we discuss some of the key lessons learned, and considerations involved in shifting from face-to-face to online focus groups. Overall, videoconferencing focus groups appeared to be a highly feasible and acceptable way to discuss "sensitive" topics with Chinese im/migrants. Importantly, researchers need to be both creative and reflexive during the research process and must not forget that the success of a study lies not only in troubleshooting technical issues but also in cultivating and maintaining a trusting relationship with research participants.
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Affiliation(s)
- Horas T H Wong
- University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Defeng Jin
- University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Pan Wang
- University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Yingli Sun
- University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Limin Mao
- University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Ye Zhang
- University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Erin Ogilvie
- University of New South Wales Sydney, Sydney, New South Wales, Australia
| | | | - Christy Newman
- University of New South Wales Sydney, Sydney, New South Wales, Australia
| | | | - Cathy Vaughan
- The University of Melbourne, Melbourne, Victoria, Australia
| | - Allison Carter
- University of New South Wales Sydney, Sydney, New South Wales, Australia
- Simon Fraser University, Burnaby, British Columbia, Canada
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Becker ER, Shegog R, Savas LS, Frost EL, Healy CM, Spinner SW, Vernon SW. Informing Content and Feature Design of a Parent-Focused Human Papillomavirus Vaccination Digital Behavior Change Intervention: Synchronous Text-Based Focus Group Study. JMIR Form Res 2021; 5:e28846. [PMID: 34806991 PMCID: PMC8663705 DOI: 10.2196/28846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 07/25/2021] [Accepted: 09/18/2021] [Indexed: 01/09/2023] Open
Abstract
Background Human papillomavirus (HPV) is a common and preventable sexually transmitted infection; however, vaccination rates in the United States among the target age group, which is 11-12 years, are lower than national goals. Interventions that address the barriers to and facilitators of vaccination are important for improving HPV vaccination rates. Web-based, text-based focus groups are becoming a promising method that may be well suited for conducting formative research to inform the design of digital behavior change intervention (DBCI) content and features that address HPV vaccination decision-making. Objective This study aims to explore parental HPV vaccination decision-making processes using a web-based, text-based focus group protocol to inform content and feature recommendations for an HPV prevention DBCI. Methods We conducted 4 web-based, text-based synchronous focus groups via Skype with the parents of patients aged 11-13 years within a large urban US pediatric clinic network. Results The 22 parents were mostly female, White, non-Hispanic college graduates, and they mostly had private health insurance for their children. Approximately half (14/25, 56%) of the parents' 11-13 year old children had initiated HPV vaccination. Most parents had experience using Skype (19/22, 86%). Approximately half (8/17, 47%) of parents expressed no preference for the focus group format, whereas 47% (8/17) requested a text-only chat format and 6% (1/17) requested an audiovisual format. The three main themes from the qualitative data were barriers to HPV vaccination, facilitators of HPV vaccination, and suggestions for improving the HPV vaccination clinic experience. A total of 11 intervention content and feature recommendations emerged from the themes, including addressing HPV knowledge barriers using trusted sources, designing for a family audience, focusing on the framing of messages, reporting reputable HPV research in a comprehensible format, and expanding the clinic visit experience. Conclusions Synchronous text-based focus groups are feasible for conducting formative research on HPV vaccination decision-making. Among well-educated and well-resourced parents, there are barriers such as misinformation and facilitators such as pediatrician recommendations that influence HPV vaccination decision-making. Parents want to conduct their own HPV research as well as receive relevant HPV vaccination advice from their child’s pediatrician. In addition, parents want an enhanced clinic visit experience that lets them access and connect to tailored information before and after clinic visits. The results gathered provide guidance for content and features that may inform a more responsive DBCI to address HPV vaccination decision-making among parents.
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Affiliation(s)
- Elisabeth Rb Becker
- The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Ross Shegog
- The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Lara S Savas
- The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Erica L Frost
- The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - C Mary Healy
- Baylor College of Medicine, Houston, TX, United States
| | | | - Sally W Vernon
- The University of Texas Health Science Center at Houston, Houston, TX, United States
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Cahill SR, Wang TM, Fontenot HB, Geffen SR, Conron KJ, Mayer KH, Johns MM, Avripas SA, Michaels S, Dunville R. Perspectives on Sexual Health, Sexual Health Education, and HIV Prevention From Adolescent (13-18 Years) Sexual Minority Males. J Pediatr Health Care 2021; 35:500-508. [PMID: 34154868 PMCID: PMC8419154 DOI: 10.1016/j.pedhc.2021.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/13/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Adolescent sexual minority males (ASMM) are at disproportionate risk of HIV infection. The purpose of this study was to assess ASMM's attitudes about sexual health, barriers/facilitators to accessing HIV prevention, and actual versus ideal interactions for receiving sexual health care and information. METHOD Two online and two in-person focus groups were conducted with ASMM from across the United States. Qualitative data were analyzed using content analysis. RESULTS Twenty-one racially diverse ASMM participated (average age = 16.4 years). Online focus groups were superior for reaching the target population. Four themes emerged: 1: identity formation and sources of support, 2: challenges to obtaining sexual health information, 3: attitudes/beliefs about sex and sexual behaviors, and 4: barriers to HIV prevention. DISCUSSION These findings illustrate current gaps in sexual health knowledge, as well as barriers and facilitators to obtaining sexual health information, sexual health care, and affirming education and support for ASMM.
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Affiliation(s)
- Sean R Cahill
- Sean R. Cahill, Director of Health Policy Research, The Fenway Institute, Fenway Health; Adjunct Associate Professor of the Practice, Department of Health Law, Policy and Management, Boston University School of Public Health; Affiliate Associate Clinical Professor and Visiting Scholar, Bouve College of Health Sciences, Northeastern University, Boston, MA.
| | - Timothy M Wang
- Timothy M. Wang, Director of Policy and Advocacy, Howard Brown Health Center, Chicago, IL
| | - Holly B Fontenot
- Holly B. Fontenot, Affiliated Faculty, The Fenway Institute, Fenway Health, Boston, MA and Associate Professor & Frances A. Matsuda Chair in Women's Health, School of Nursing & Dental Hygiene, University of Hawaii at Manoa, Honolulu, HI
| | - Sophia R Geffen
- Sophia R. Geffen, HIV Prevention Research Project Manager, The Fenway Institute, Fenway Health, Boston, MA
| | - Kerith J Conron
- Kerith Conron, Blachford-Cooper Research Director and Distinguished Scholar, The Williams Institute, UCLA School of Law, Los Angeles, CA
| | - Kenneth H Mayer
- Kenneth H. Mayer, Medical Research Director and Co-Director, The Fenway Institute, Fenway Health; Professor of Medicine, Harvard Medical School; Attending Physician, Division of Infectious Disease, Beth Israel Deaconess Medical Center, Boston, MA
| | - Michelle M Johns
- Michelle M. John, Health Scientist, Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sabrina A Avripas
- Sabrina A. Avripas, Senior Research Director, Public Health, NORC at the University of Chicago, Chicago, IL
| | - Stuart Michaels
- Stuart Michaels, Senior Research Scientist, Ogburn-Stouffer Center for the Study of Social Organizations, NORC at the University of Chicago, Chicago, IL
| | - Richard Dunville
- Richard Dunville, Deputy Director, Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA
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10
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Biello KB, Hill-Rorie J, Valente PK, Futterman D, Sullivan PS, Hightow-Weidman L, Muessig K, Dormitzer J, Mimiaga MJ, Mayer KH. Development and Evaluation of a Mobile App Designed to Increase HIV Testing and Pre-exposure Prophylaxis Use Among Young Men Who Have Sex With Men in the United States: Open Pilot Trial. J Med Internet Res 2021; 23:e25107. [PMID: 33759792 PMCID: PMC8074990 DOI: 10.2196/25107] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/11/2020] [Accepted: 02/08/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND HIV disproportionately affects young men who have sex with men (YMSM) in the United States. Uptake of evidence-based prevention strategies, including routine HIV testing and use of pre-exposure prophylaxis (PrEP), is suboptimal in this population. Novel methods for reaching YMSM are required. OBJECTIVE The aim of this study is to describe the development and evaluate the feasibility and acceptability of the MyChoices app, a mobile app designed to increase HIV testing and PrEP use among YMSM in the United States. METHODS Informed by the social cognitive theory, the MyChoices app was developed using an iterative process to increase HIV testing and PrEP uptake among YMSM. In 2017, beta theater testing was conducted in two US cities to garner feedback (n=4 groups; n=28 YMSM). These findings were used to refine MyChoices, which was then tested for initial acceptability and usability in a technical pilot (N=11 YMSM). Baseline and 2-month postbaseline assessments and exit interviews were completed. Transcripts were coded using a deductive approach, and thematic analysis was used to synthesize data; app acceptability and use data were also reported. RESULTS The MyChoices app includes personalized recommendations for HIV testing frequency and PrEP use; information on types of HIV tests and PrEP; ability to search for nearby HIV testing and PrEP care sites; and ability to order free home HIV and sexually transmitted infection test kits, condoms, and lube. In theater testing, YMSM described that MyChoices appears useful and that they would recommend it to peers. Participants liked the look and feel of the app and believed that the ability to search for and be pinged when near an HIV testing site would be beneficial. Some suggested that portions of the app felt repetitive and preferred using casual language rather than formal or medicalized terms. Following theater testing, the MyChoices app was refined, and participants in the technical pilot used the app, on average, 8 (SD 5.0; range 2-18) times over 2 months, with an average duration of 28 (SD 38.9) minutes per session. At the 2-month follow-up, the mean System Usability Scale (0-100) score was 71 (ie, above average; SD 11.8). Over 80% (9/11) of the participants reported that MyChoices was useful and 91% (10/11) said that they would recommend it to a friend. In exit interviews, there was a high level of acceptability for the content, interface, and features. CONCLUSIONS These data show the initial acceptability and user engagement of the MyChoices app. If future studies demonstrate efficacy in increasing HIV testing and PrEP uptake, the app is scalable to reach YMSM across the United States. TRIAL REGISTRATION Clinicaltrials.gov NCT03179319; https://clinicaltrials.gov/ct2/show/NCT03179319. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/10694.
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Affiliation(s)
- Katie B Biello
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States.,Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States.,Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI, United States.,The Fenway Institute, Fenway Health, Boston, MA, United States
| | | | - Pablo K Valente
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Donna Futterman
- Adolescent AIDS Program, Children's Hospital at Montefiore Medical Center, The Bronx, NY, United States
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Global Public Health, Emory University, Atlanta, GA, United States
| | - Lisa Hightow-Weidman
- Division of Infectious Diseases, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Kathryn Muessig
- Department of Health Behavior, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, United States
| | | | - Matthew J Mimiaga
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States.,Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States.,Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI, United States.,The Fenway Institute, Fenway Health, Boston, MA, United States.,Department of Epidemiology, Fielding School of Public Health, University of California, Los Angelas, CA, United States
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States.,Beth Israel Deaconess Medical Center, Boston, MA, United States
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11
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McKenna KC, Geoghegan C, Swezey T, Perry B, Wood WA, Nido V, Morin SL, Grabert BK, Hallinan ZP, Corneli AL. Investigator Experiences Using Mobile Technologies in Clinical Research: Qualitative Descriptive Study. JMIR Mhealth Uhealth 2021; 9:e19242. [PMID: 33576742 PMCID: PMC7910119 DOI: 10.2196/19242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 08/13/2020] [Accepted: 09/02/2020] [Indexed: 12/02/2022] Open
Abstract
Background The successful adoption of mobile technology for use in clinical trials relies on positive reception from key stakeholders, including clinical investigators; however, little information is known about the perspectives of investigators using mobile technologies in clinical trials. Objective The aim of this study was to seek investigators’ insights on the advantages and challenges of mobile clinical trials (MCTs); site-level budgetary, training, and other support needs necessary to adequately prepare for and implement MCTs; and the advantages and disadvantages for trial participants using mobile technologies in clinical trials. Methods Using a qualitative descriptive study design, we conducted in-depth interviews with investigators involved in the conduct of MCTs. Data were analyzed using applied thematic analysis. Results We interviewed 12 investigators who represented a wide variety of clinical specialties and reported using a wide range of mobile technologies. Investigators most commonly cited 3 advantages of MCTs over traditional clinical trials: more streamlined study operations, remote data capture, and improvement in the quality of studies and data collected. Investigators also reported that MCTs can be designed around the convenience of trial participants, and individuals may be more willing to participate in MCTs because they can take part from their homes. In addition, investigators recognized that MCTs can also involve additional burden for participants and described that operational challenges, technology adoption barriers, uncertainties about data quality, and time burden made MCTs more challenging than traditional clinical trials. Investigators stressed that additional training and dedicated staff effort may be needed to select a particular technology for use in a trial, helping trial participants learn and use the technology, and for staff troubleshooting the technology. Investigators also expressed that sharing data collected in real time with investigators and trial participants is an important aspect of MCTs that warrants consideration and potentially additional training and education. Conclusions Investigator perspectives can inform the use of mobile technologies in future clinical trials by proactively identifying and addressing potential challenges.
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Affiliation(s)
- Kevin Christopher McKenna
- Department of Population Health Sciences, Duke University, Durham, NC, United States.,Clinical Trials Transformation Initiative, Durham, NC, United States
| | | | - Teresa Swezey
- Department of Population Health Sciences, Duke University, Durham, NC, United States.,Clinical Trials Transformation Initiative, Durham, NC, United States
| | - Brian Perry
- Department of Population Health Sciences, Duke University, Durham, NC, United States.,Clinical Trials Transformation Initiative, Durham, NC, United States
| | - William A Wood
- Department of Medicine, Division of Hematology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | - Steve L Morin
- Office of Health and Constituent Affairs, US Public Health Service, US Food and Drug Administration, Silver Spring, MD, United States
| | - Brigid K Grabert
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | - Amy L Corneli
- Department of Population Health Sciences, Duke University, Durham, NC, United States.,Clinical Trials Transformation Initiative, Durham, NC, United States.,Duke Clinical Research Institute, Duke University, Durham, NC, United States
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12
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Fontenot HB, White BP, Rosenberger JG, Lacasse H, Rutirasiri C, Mayer KH, Zimet G. Mobile App Strategy to Facilitate Human Papillomavirus Vaccination Among Young Men Who Have Sex With Men: Pilot Intervention Study. J Med Internet Res 2020; 22:e22878. [PMID: 33146621 PMCID: PMC7673982 DOI: 10.2196/22878] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/24/2020] [Accepted: 10/09/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Mobile app-based interventions have been identified as potential facilitators for vaccination among young men who have sex with men (MSM). OBJECTIVE This pilot study aimed to test the feasibility of a theoretically informed mobile health (mHealth) tool designed to reduce health disparities and facilitate human papillomavirus (HPV) vaccination among a sample of young MSM. METHODS The development of the mHealth tool was guided by previous research, implementation intention theory, and design thinking. We recruited MSM aged 18-26 years through a popular online dating app and linked participants to our mHealth tool, which provided HPV vaccine information and fostered access to care. RESULTS A total of 42 young MSM participated in this pilot study in Boston, Massachusetts. Participants reported variable HPV knowledge (ie, high knowledge of HPV risk factors and low knowledge of HPV-related cancer risks for men) and positive vaccine beliefs and attitudes. Of those who were either unvaccinated, not up to date, or did not report vaccine status, 23% (8/35) utilized the mHealth tool to obtain HPV vaccination. Participants primarily utilized the tool's (1) educational components and (2) capabilities facilitating concrete vaccine action plans. CONCLUSIONS We recruited an underserved at-risk population of youth via an online dating app for our mHealth intervention that resulted in in-person health care delivery. This study was limited by enrollment challenges, including low willingness to download the mHealth tool to mobile devices.
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Affiliation(s)
- Holly B Fontenot
- School of Nursing and Dental Hygiene, University of Hawaii at Manoa, Honolulu, HI, United States
- The Fenway Institute, Boston, MA, United States
- Connell School of Nursing, Boston College, Chestnut Hill, MA, United States
| | | | - Joshua G Rosenberger
- College of Health and Human Development, Penn State University, University Park, PA, United States
| | - Hailee Lacasse
- Connell School of Nursing, Boston College, Chestnut Hill, MA, United States
| | - Chokdee Rutirasiri
- Proper Villains, Boston, MA, United States
- School of Arts and Sciences, Boston College, Chestnut Hill, MA, United States
| | - Kenneth H Mayer
- The Fenway Institute, Boston, MA, United States
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
- School of Medicine, Harvard University, Boston, MA, United States
| | - Gregory Zimet
- Division of Adolescent Medicine, School of Medicine, Indiana University, Indianapolis, IN, United States
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13
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Gerend MA, Madkins K, Crosby S, Korpak AK, Phillips GL, Bass M, Houlberg M, Mustanski B. Evaluation of a Text Messaging-Based Human Papillomavirus Vaccination Intervention for Young Sexual Minority Men: Results from a Pilot Randomized Controlled Trial. Ann Behav Med 2020; 55:321-332. [PMID: 32914838 DOI: 10.1093/abm/kaaa056] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Men who have sex with men (MSM) are at high risk for human papillomavirus (HPV) infection and HPV-related anal cancer. Although a safe and effective vaccine is available to prevent HPV infection, HPV vaccine uptake among young MSM remains low. PURPOSE This pilot randomized controlled trial tested the acceptability, feasibility, and preliminary efficacy of a text messaging-based HPV vaccination intervention for young sexual minority men. METHODS In 2018, unvaccinated sexual minority men aged 18-25 years were recruited from Chicago to participate in a 9 month sexual health program called txt2protect. Participants (N = 150) were randomized to the intervention or control condition. Intervention condition messages focused primarily on HPV vaccination, with only a brief mention of other sexual health practices (e.g., condom use and HIV testing), while control condition messages focused on a variety of sexual health practices with only a brief mention of HPV vaccination. Participants received daily text messages for the first 3 weeks and monthly text messages for the remaining ~8 months of the trial. Participants completed surveys at baseline and 3 week and 9 month follow-ups. RESULTS Participants reported high satisfaction with the intervention. Although trial retention was high (with over 88% completing the 9 month survey), the study fell short of meeting its recruitment goal. HPV vaccine series initiation was significantly higher among intervention participants (19.4%) compared to control participants (6.6%), odds ratio = 3.43, 95% confidence interval: 1.17, 10.08. CONCLUSIONS Findings suggest that txt2protect is an acceptable and potentially promising intervention for increasing HPV vaccine initiation among young sexual minority men. CLINICAL TRIAL REGISTRATION NCT02994108.
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Affiliation(s)
- Mary A Gerend
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA.,Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Krystal Madkins
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Shariell Crosby
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Aaron K Korpak
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Gregory L Phillips
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Michael Bass
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
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14
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Zimet GD, Osazuwa-Peters N. There's Much Yet to be Done: Diverse Perspectives on HPV Vaccination. Hum Vaccin Immunother 2020; 15:1459-1464. [PMID: 31365327 PMCID: PMC6746479 DOI: 10.1080/21645515.2019.1640559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Gregory D Zimet
- a Department of Pediatrics, School of Medicine, Indiana University , Indianapolis , IN , USA
| | - Nosayaba Osazuwa-Peters
- b Department of Otolaryngology-Head and Neck Surgery, Saint Louis University , St Louis , MO , USA
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15
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Fontenot HB, Abuelezam NN, Rosenberger JG, Novak D, Mayer KH, Zimet G. The Impact of Advertisement Messaging on Enrollment of Young Men Who Have Sex With Men for Web-Based Research: Observational Study. J Med Internet Res 2020; 22:e16027. [PMID: 31929103 PMCID: PMC6996771 DOI: 10.2196/16027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/18/2019] [Accepted: 10/20/2019] [Indexed: 12/26/2022] Open
Abstract
Background Recruiting young men who have sex with men (YMSM) in community settings is difficult. The use of Web-based social networks and dating apps for recruitment can be successful approaches, although little work has been done on the impact of study advertisement content on recruitment. Objective The aim of this study was to evaluate the effects of advertisement message content on the recruitment of YMSM (aged 18-26 years) for a Web-based focus group study, examining perspectives and preferences for a mobile app that was designed to support sexual health among YMSM. Methods Between March and April 2017, a recruitment campaign to promote human papillomavirus vaccination was launched on a popular social networking and dating app for YMSM, with 3 different text-based advertisement themes (technology, cancer prevention, and sexual innuendo). The campaign recruited YMSM across 3 states (Massachusetts, New York, and Pennsylvania). We examined the click-through rates, conversion rates, and enrollment rates of each of the advertisements and examined differences in views and clicks by age, state, and time of day. Results The sexual innuendo advertisement had the highest click rates when compared with both the technology (click rate ratio [CRR] 2.06, 95% CI 1.74-2.45) and cancer prevention (CRR 1.62, 95% CI 1.38-1.90) advertisements. The sexual innuendo advertisement also had higher study enrollment rates compared with the technology (CRR 1.90, 95% CI 1.23-2.83) and cancer prevention (CRR 2.06, 95% CI 1.37-3.13) advertisements. No differences were observed in clicks or enrollment by age, state, or time of day. Conclusions Our marketing campaign, targeting YMSM, was effective in recruiting participants for a qualitative study, using Web-based focus groups. The sexual innuendo advertisement was the most effective and cost-efficient advertisement of the 3 approaches trialed. Different populations need different targeted strategies for study recruitment. Researchers should work with key representatives to develop and test culturally relevant messaging and approaches that utilize current and popular technologies.
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Affiliation(s)
- Holly B Fontenot
- Connell School of Nursing, Boston College, Chestnut Hill, MA, United States.,The Fenway Institute, Boston, MA, United States
| | - Nadia N Abuelezam
- Connell School of Nursing, Boston College, Chestnut Hill, MA, United States
| | - Joshua G Rosenberger
- Department of Biobehavioral Health, Penn State University, University Park, PA, United States
| | - David Novak
- DSN Consulting, LLC, Quincy, MA, United States
| | - Kenneth H Mayer
- The Fenway Institute, Boston, MA, United States.,Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Gregory Zimet
- Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
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16
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Teitelman AM, Gregory EF, Jayasinghe J, Wermers Z, Koo JH, Morone JF, Leri DC, Davis A, Feemster KA. Vaccipack, A Mobile App to Promote Human Papillomavirus Vaccine Uptake Among Adolescents Aged 11 to 14 Years: Development and Usability Study. JMIR Nurs 2020; 3:e19503. [PMID: 34345789 PMCID: PMC8279454 DOI: 10.2196/19503] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/31/2020] [Accepted: 09/28/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND More than 90% of human papillomavirus (HPV)-related cancers could be prevented by widespread uptake of the HPV vaccine, yet vaccine use in the United States falls short of public health goals. OBJECTIVE The purpose of this study was to describe the development, acceptability, and intention to use the mobile app Vaccipack, which was designed to promote uptake and completion of the adolescent HPV vaccine series. METHODS Development of the mobile health (mHealth) content was based on the integrated behavioral model (IBM). The technology acceptance model (TAM) was used to guide the app usability evaluation. App design utilized an iterative process involving providers and potential users who were parents and adolescents. App features include a vaccine-tracking function, a discussion forum, and stories with embedded messages to promote intention to vaccinate. Parents and adolescents completed surveys before and after introducing the app in a pediatric primary care setting with low HPV vaccination rates. RESULTS Surveys were completed by 54 participants (20 adolescents aged 11 to 14 years and 34 parents). Notably, 75% (15/20) of adolescents and 88% (30/34) of parents intended to use the app in the next 2 weeks. Acceptability of the app was high among both groups: 88% (30/34) of parents and 75% (15/20) of adolescents indicated that Vaccipack was easy to use, and 82% (28/34) of parents and 85% (17/20) of adolescents perceived the app to be beneficial. Higher levels of app acceptability were found among parents with strong intentions to use the app (P=.09; 95% CI -2.15 to 0.15). CONCLUSIONS mHealth technology, such as Vaccipack, may be an acceptable and nimble platform for providing information to parents and adolescents and advancing the uptake of important vaccines.
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Affiliation(s)
- Anne M Teitelman
- University of Pennsylvania School of Nursing Philadelphia, PA United States
| | - Emily F Gregory
- Children's Hospital of Philadelphia Philadelphia, PA United States
- Perelman School of Medicine University of Pennsylvania Philadelphia, PA United States
| | - Joshua Jayasinghe
- University of Pennsylvania School of Nursing Philadelphia, PA United States
| | | | - Ja H Koo
- University of Pennsylvania School of Nursing Philadelphia, PA United States
| | - Jennifer F Morone
- Yale University New Haven, CT United States
- Veterans Affairs West Haven, CT United States
| | - Damien C Leri
- Big Yellow Star, Inc. Philadelphia, PA United States
| | - Annet Davis
- University of Pennsylvania School of Nursing Philadelphia, PA United States
| | - Kristen A Feemster
- Children's Hospital of Philadelphia Philadelphia, PA United States
- Perelman School of Medicine University of Pennsylvania Philadelphia, PA United States
- Division of Disease Control Department of Public Health Philadelphia, PA United States
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17
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Gerend MA, Madkins K, Crosby S, Korpak AK, Phillips GL, Bass M, Houlberg M, Mustanski B. A Qualitative Analysis of Young Sexual Minority Men's Perspectives on Human Papillomavirus Vaccination. LGBT Health 2019; 6:350-356. [PMID: 31556791 DOI: 10.1089/lgbt.2019.0086] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Purpose: Men who have sex with men (MSM) are affected disproportionately by cancers caused by human papillomavirus (HPV). A safe and effective vaccine is available to prevent HPV infection, yet rates of HPV vaccination among young MSM are low. Guided by the Information, Motivation, and Behavioral Skills model, the purpose of this study was to identify young sexual minority men's perspectives on HPV vaccination. Methods: Men (N = 29) 18-26 years of age, who identified as gay, bisexual, or queer, completed a semistructured interview. Vaccinated (n = 9) and unvaccinated men (n = 20) were interviewed. The interview assessed knowledge, motivation, and behavioral skills related to HPV vaccination as well as relevant contextual factors (e.g., provider recommendation). Interviews were coded for recurring themes. Results: Most participants were aware of HPV and the HPV vaccine; however, misconceptions and knowledge gaps were common with many believing that HPV vaccination was only for women. Motivational factors included perceived advantages (e.g., reducing risk of HPV-related disease) and disadvantages (e.g., stigma) of HPV vaccination, perceived threat of HPV-related disease, and subjective norms for HPV vaccination. Relevant behavioral skills included disclosure of sexual orientation and comfort discussing HPV vaccination. Concerns about vaccine cost, access, and convenience were salient barriers to initiating and completing the series. Encouragement from a health care provider was cited as the primary reason for receiving the HPV vaccine. Conclusion: When developing interventions to increase HPV vaccination among young sexual minority men, it is important to address facilitators and barriers that reflect the unique needs of this population.
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Affiliation(s)
- Mary A Gerend
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, Florida.,Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| | - Krystal Madkins
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| | - Shariell Crosby
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| | - Aaron K Korpak
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| | - Gregory L Phillips
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| | - Michael Bass
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
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