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Interactive web-based tailored education promoting the acceptability of HPV-vaccination among mothers of invited girls

Projectomschrijving

Is persoonlijke online voorlichting over de HPV-vaccinatie effectiever?

Vraagstuk

In 2009 startte de Nederlandse overheid voor het eerst de jaarlijkse campagne om 12-jarige meisjes te vaccineren tegen het humaan papillomavirus (HPV), een virus dat baarmoederhalskanker veroorzaakt. De vaccinatiegraad (ongeveer 61%) is vrij laag. Deze feiten en bevindingen uit onderzoek wijzen op de noodzaak tot verbetering van de voorlichting. Is er een aanpak op maat te ontwikkelen?

Onderzoek

In dit project is de effectiviteit van computer-tailored online voorlichting onderzocht. Helpt deze aanpak moeders bij het maken van een goed geïnformeerde keuze voor de HPV-vaccinatie van hun dochter?

Uitkomst

De online voorlichting aan 8.062 moeders leidde niet tot een hogere vaccinatiegraad, maar wel tot een betere geïnformeerde keuze, minder twijfel en een positievere mening over de HPV-vaccinatie. Daarnaast zijn moeders tevreden over de voorlichting. Ze vonden de voorlichting interessant, informatief en nuttig. Een logische volgende stap is inbedding ervan in de reguliere communicatie over de HPV-vaccinatie.

Verslagen


Samenvatting van de aanvraag

PROBLEM DEFINITION In 2009, the Dutch government started a nationwide human papillomavirus (HPV)-vaccination program (i.e., three vaccinations) for 12-year-old girls to prevent cervical cancer. The uptake (58%) is still much lower than expected. Research indicated that mothers played the most important role in the immunization decision of these girls. Socio-cognitive determinants largely (80%) contributed to the explained variance of the HPV-vaccination decision of mothers. Besides, a large proportion of the mothers did not actively process information about the HPV-vaccination and felt ambivalent about their final decision. Because informed decision making will make mothers less vulnerable for counter arguments, mothers need structured support for their decision making. Such an intervention should be interactive and tailored, because mothers indicated their preference for personal interaction over and above the usually applied general approach, and because they expressed differential needs concerning the amount and scope of information. The current project aims to develop and evaluate the effects of a tailored intervention providing mothers of girls-to-be-invited with interactive feedback from a virtual assistant on the possible HPV-vaccination of their daughter. COMPUTER TAILORING BY A VIRTUAL ASSISTANT Computer tailoring has proven to be an effective strategy for health-related behaviors. The effects have been attributed to greater message attention and acceptance. Computer-tailored interventions can reach large groups of people at relatively low costs, and have substantial impact at the population level. This especially accounts for second-generation (i.e., web-based) tailored feedback. So far, tailored interventions to promote vaccine uptake do not exist. The intended feedback will be delivered by a virtual assistant, because this already showed effects in the field of stress management and health-related self-management. RESEARCH QUESTIONS 1) What is the efficacy and effectiveness of an interactive web-based tailored feedback on HVP-vaccination uptake of participants’ daughters (primary outcome), on the mothers’ informed decision making and related determinants (secondary outcomes) regarding the HPV-vaccination of their daughter? 2) To what extent are mothers exposed to the planned intervention components (program adherence), and what is their subjective evaluation of the feedback? 3) What is the response rate of mothers from the National Immunization Register to the invitation to visit the web-site for receiving interactive support for their decision making about the HPV-vaccination of their daughter? DESIGN The effects will be tested by an RCT among two samples of participants: (1) derived from an internet panel for efficacy testing, and (2) derived from Praeventis, the National Immunization Register (i.e., ‘naturalistic sample’), for effectiveness testing. The primary outcome will be requested once from Praeventis (after closure of the vaccination round). Secondary outcomes will be measured at baseline (prior to the first vaccination) and follow-up (during the first vaccination). The rate of response to the invitation to visit the web-based feedback will be assessed among the ‘naturalistic sample’. A process evaluation will assess feasibility and program adherence. INTERVENTION DEVELOPMENT Development of the proposed intervention is a logical step after the recently completed empirical studies by the project team on (determinants of) the HPV-vaccination acceptability. We propose a three-stage process of development: 1) Preparation: Literature review, intervention development and pretests, and consultation of experts, mothers and girls-to-be-invited. 2) Field experiment: Data collection at baseline and follow-up. After baseline, a random sample drawn from both a ‘naturalistic sample’ and an internet panel will be exposed to the intervention. HPV-vaccination uptake behavior will be requested from the Praeventis after closure of the HPV-vaccination round. 3) Completion and dissemination: Data-analyses, reporting, and implementation of project results into the next HPV-vaccination round. INVOLVEMENT OF PARTICIPANTS AND IMPLEMENTING ORGANIZATIONS Intervention pretests will be conducted with mothers of girls-to-be-invited to maximize intervention exposure and fit. A linkage group of mothers and girls-to-be-invited will be formed to advise on the development of the intervention. Representatives of important linking agents (e.g. Public Health Services) and professionals involved in delivering the HPV-vaccination will participate in an advisory board. RIVM, responsible for the national HPV-vaccination, is full member and co-financier of the project team. EXPERTISE OF THE RESEARCH GROUP The team members have extensive and documented expertise in research on the (HPV-)vaccination, informed decision making, tailored interventions and situated Cognitive Engineering.

Onderwerpen

Kenmerken

Projectnummer:
200330007
Looptijd: 100%
Looptijd: 100 %
2012
2017
Onderdeel van programma:
Gerelateerde subsidieronde:
Projectleider en penvoerder:
Dr. T.G.W.M. Paulussen
Verantwoordelijke organisatie:
TNO