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#4Corners4Health: Protocol for a Randomized Stepped-Wedge Trial

#4Corners4Health: Protocol for a Randomized Stepped-Wedge Trial

Dr. David Buller from Klein Buendel and Dr. Andrew Sussman from the University of New Mexico are leading a large multiple state research team on the design, implementation, and evaluation of #4Corners4Health. The research study aims to decrease cancer risk factors among emerging adults (ages 18-26) living in rural counties in the Four Corners states of Arizona, Colorado, New Mexico, and Utah using a targeted social media campaign. The team has published a full description of their study procedures in JMIR Research Protocols.

Many emerging adults are prone to making unhealthy choices, which increase their risk of premature cancer morbidity and mortality. In the era of social media, rigorous research on interventions to promote health behaviors for cancer risk reduction among emerging adults delivered over social media is limited. Cancer prevention information and recommendations may reach emerging adults more effectively over social media than in settings such as health care, schools, and workplaces, particularly for emerging adults residing in rural areas.

Specifically, the research team will recruit a sample of 1000 emerging adults aged 18 to 26 years residing in rural counties in the Four Corners states from the Qualtrics’ research panel and enroll them in a randomized stepped-wedge, quasi-experimental design. The inclusion criteria include English proficiency and regular social media engagement. A social media intervention will promote guideline-related goals for increased physical activity, healthy eating, and HPV vaccination and reduced nicotine product use, alcohol intake, and solar UV radiation exposure. Posts will cover digital and media literacy skills, responses to misinformation, communication with family and friends, and referral to community resources. The intervention will be delivered over 12 months in Facebook private groups and will be guided by advisory groups of community stakeholders and emerging adults and focus groups with emerging adults. The emerging adults will complete assessments at baseline and five additional data after randomization. Assessments will measure six cancer risk behaviors, theoretical mediators, and participants’ engagement with the social media campaign.

The trial is being led by a steering committee. Team members are working in three subcommittees to optimize community engagement, the social media intervention, and the measures to be used. The Stakeholder Organization Advisory Board and Emerging Adult Advisory Board were formed and provided initial input on the priority of cancer risk factors to target, social media use by emerging adults, and community resources available. A framework for the social media intervention with topics, format, and theoretical mediators has been created, along with protocols for social media management.

In summary, the researchers believe that social media can be used as a platform to counter misinformation and improve reliable health information to promote health behaviors that reduce cancer risks among emerging adults. Because of the popularity of web-based information sources among emerging adults, an innovative, multiple risk factor intervention using a social media campaign has the potential to reduce their cancer risk behaviors.

This research is supported by a 5-year R01 grant from the National Cancer Institute (CA268037) to Klein Buendel. Dr. David Buller from Klein Buendel and Dr. Andrew Sussman from the University of New Mexico are the project’s Multiple Principal Investigators. The JMIR publication has 24 collaborating authors from multiple institutions.

#4Corners4Health

#4Corners4Health

A collaborative team of highly-experienced cancer prevention and control investigators from the Four Corners Cancer Centers Collaborative (University of Arizona, University of Colorado, University of New Mexico, and University of Utah), Colorado State University, and Klein Buendel is launching a research study that focuses on decreasing cancer risk factors among emerging adults (ages 18-26) living in rural counties in the “Four Corners” states (Arizona, Colorado, New Mexico, and Utah) using a social media campaign. Cancer risks related to infrequent physical activity, unhealthy diet, nicotine product use, alcohol intake, ultraviolet radiation exposure and lack of HPV vaccination are prevalent among emerging adults and contribute to cancer later in life.

The project will test a theory-based, multi-risk factor social media approach to cancer prevention through the use of Facebook and its private group function. Social media can improve information dissemination, credibility, and relevance, be used to detect and respond to emerging trends, and engage users with user-generated content that personalizes information. It offers a superior intervention for emerging adults compared to health care, schools, and workplaces which can be challenging to implement in low-resourced rural communities and will not reach many emerging adults who have low preventive health care utilization, school enrollment, and/or employment.

#4Corners4Health Specific Aims

  • Develop a social media intervention for diverse emerging adults in rural communities via a community-engaged process that combines expert advice, user-generated content, and online instruction about behavioral cancer risks, cancer misinformation, counter marketing, digital and media literacy, and family communication.
  • Evaluate the effect of a theory-based social media intervention on moderate to vigorous physical activity (MVPA), health eating patterns, nicotine product use, alcohol intake, sunburn prevalence, and HPV vaccination with the diverse (ethnically/ socioeconomically) population of emerging adults aged 18-26 in rural counties in the Four Corner states recruited from Qualtrics’ survey panel and enrolled in a pragmatic randomized trial using a stepped-wedge design in which individual emerging adults will be randomized to one of four cohorts and receive social media feed for varying durations in separate Facebook private groups.
  • Test if improvements in merging adults cancer risk knowledge and beliefs, digital and media literacy skills, accurate cancer prevention information, and family communication mediate impact of the social media campaign.
  • Explore whether the impact of the social media campaign differs according to a) level of emerging adults engagement with campaign, b) cancer risk factors, and c) biological sex of the participants.

The investigators hypothesize that (1) emerging adults will increase MVPA and healthy eating pattern, reduce nicotine product and alcohol use, and sunburns, and increase HPV vaccine uptake from pre to post when receiving social media campaign, and (2) positive impact of the social media campaign on cancer risk factors among emerging adults will be mediated by improved cancer risk knowledge and beliefs (self-response efficacy; norms; social support; vaccine antecedents), digital and media literacy skills, misinformation, and family communication.

This research will be led by Dr. David Buller from Klein Buendel and Dr. Andrew Sussman from the University of New Mexico (Multiple Principal Investigators). It is being funded by a 5-year R01 grant from the National Cancer Institute (CA268037). Key collaborators include Dr. Kimberly Henry from Colorado State University; Dr. Cindy Blair from the University of New Mexico; Dr. Judith Gordon, Dr. Cynthia Thomson, and Dr. Jennifer Hatcher from the University of Arizona; Dr. Evelinn Borrayo and Dr. Douglas Taren from the University of Colorado; Dr. Deanna Kepka, Dr. Echo Warner, and Dr. David Wetter from the University of Utah; and Dr. Gill Woodall, Dr. Barbara Walkosz, Dr. Kayla Nuss, and Ms. Julia Berteletti from Klein Buendel.

Promoting Social Distancing and COVID-19 Vaccination in a Social Media Feed for Mothers

Promoting Social Distancing and COVID-19 Vaccination in a Social Media Feed for Mothers

The Health Chat team from Klein Buendel, the University of Connecticut, Colorado State University, and East Tennessee State University has published findings from a health communication study in the journal JMIR Infodemiology. The purpose of the study was to examine how the source of health information shared via a Facebook social media feed might impact behavioral intentions related to practicing social distancing or accepting COVID-19 vaccination. The Facebook group participants were mothers of adolescent daughters. The social media feed varied the source of information in posts on four topics: social distancing, COVID-19 vaccines, digital and media literacy, and family communication about COVID-19. The information sources were government agencies, near-peer parents, and news media.

In summary, 303 mothers with adolescent daughters from a previous study testing a social media campaign on indoor tanning were recruited in January 2021 and enrolled in a randomized single-factor design (government agencies vs. near-peer parents vs. news media) evaluating the 9-week Facebook feed with four assessments at baseline and 3-week, 6-week, and 9-week follow-ups. Mothers received one social media post each day (Monday-Friday) in three randomly assigned Facebook private groups, covering all four topics plus one additional post on a positive non-pandemic topic to promote engagement. Posts in the three groups had the same messages but differed by links to information from government agencies, near-peer parents, or news media in the post. Views, reactions, and comments related to each post were counted to measure engagement with the messages. Mothers reported on social distancing and vaccine intentions for themselves and their daughters at the four assessment points.

Research methods and analyses are detailed in the JMIR Infodemiology paper. Nearly all mothers (98%) remained in the Facebook private groups throughout the 9-week trial period, and assessment completion rates were high. Analysis showed that social distancing behavior by mothers and daughters decreased over time but vaccine intentions increased. Decrease in social distancing by daughters was greater in the near-peer source group and lesser in the government agency group. The higher perceived credibility of the assigned information source increased social distancing and vaccine intentions. Mothers’ intentions to vaccinate themselves may have increased when they considered the near-peer source to be not credible. According to the authors, decreasing case counts, relaxation of government restrictions, and vaccine distribution during the study may explain the decreased social distancing and increased vaccine intentions.

This research was funded by a grant and supplement from the National Cancer Institute (CA192652). Dr. David Buller from Klein Buendel and Dr. Sherry Pagoto from the University of Connecticut were the project’s Multiple Principal Investigators. Additional authors on this publication include Joseph Divito from the University of Connecticut; Dr. Kim Henry from Colorado State University; Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University; and Dr. Barbara Walkosz, Dr. Gill Woodall, Julia Berteletti, and Alishia Kinsey from Klein Buendel.

COVID-19 Social Media Feed for Mothers and Teen Daughters

COVID-19 Social Media Feed for Mothers and Teen Daughters

Social media is a key channel for information on COVID-19 from government agencies, near-peers, and news media. The Health Chat team developed a social media feed that varied type of information source in posts on social distancing, COVID-19 vaccines, digital and media literacy, and family communication. Dr. David Buller from Klein Buendel presented findings from the COVID-19 social media feed at the 43rd Annual Meeting & Scientific Sessions of the Society of Behavioral Medicine in Baltimore, MD, April 6-9 2022.

A total of 303 mothers with adolescent daughters from a previous study testing a social media campaign on indoor tanning were recruited in January 2021 and enrolled in a randomized single-factor design (government agencies v. near-peer parents v. news media) of a 9-week Facebook feed with four assessments (baseline, 3-week, 6-week, and 9-week follow-ups). The feed contained five posts per week based on social cognitive theory, transportation theory, and diffusion of innovation theory. Mothers reported on social distancing and vaccine intentions for self and daughters.

Using intention-to-treat analyses, mothers’ reports of social distancing by self and daughter declined over the 9-weeks. Daughters’ social distancing declined faster in the near-peer condition but less quickly in the government condition. Vaccine intentions increased over the nine weeks in all experimental condition. Baseline intentions seemed to moderate effect of condition on change in intentions. Mothers with initially high vaccine intentions (relative to moderate intentions) assigned to the government condition reported a less steep increase in intentions over time and had slightly lower intentions to vaccinate at the end of the study. Baseline credibility of the assigned information source predicted increased vaccine intentions. However, in the near-peer condition, mothers who assigned them lower as opposed to higher credibility showed increased vaccine intentions.

Theory-based posts emphasizing information from government agencies may have provided credible counterarguments against local jurisdictions relaxing pandemic restrictions that slowed declines in daughters’ social distancing. The near-peer sources may have been influential with mothers who did not expect them to convey the credible arguments supporting vaccines which they did in the experimental feed, consistent with violations of expectations theory in persuasive communication.

This research is funded by a grant and supplement from the National Cancer Institute (CA192652; Dr. David Buller and Dr. Sherry Pagoto, Multiple Principal Investigators). Authors on this presentation include Dr. Sherry Pagoto and Joseph Divito from the University of Connecticut; Dr. Kim Henry from Colorado State University; and Dr. David Buller, Dr. Barbara Walkosz, Dr. Gill Woodall, Julia Berteletti, and Alishia Kinsey from Klein Buendel.

Dr. David Buller Presenting at SBM
Persisting Effects of the Health Chat Program

Persisting Effects of the Health Chat Program

The use of indoor tanning facilities by minors is a public health concern. In an effort to reduce risk for skin cancer, the Health Chat social media intervention was launched by Klein Buendel researchers and their colleagues to reduce mothers’ permissiveness toward their teenage daughters’ indoor tanning behavior.

For the Health Chat study, mothers with daughters aged 14-17 were recruited in 34 states that do not ban indoor tanning by minors. Participating mothers received an adolescent health social media campaign in Facebook private groups. Half of the mothers were in a group in which the health campaign included posts about preventing indoor tanning (intervention) and the other half, included posts on preventing prescription drug misuse (control). Follow-up surveys with mothers at 12 months and 18 months measured indoor tanning permissiveness, attitudes, intentions, communication, behavior, and support for state indoor tanning bans.

Analysis of the 18-month follow-up data from the Health Chat social media intervention was e-published recently in Cancer Epidemiology, Biomarkers & Prevention. The research was led by Dr. David Buller from Klein Buendel and Dr. Sherry Pagoto from the University of Connecticut.

The methods and results of this randomized trial are detailed in the publication. Data analysis showed that at 18 months after the intervention, mothers in the intervention group were less permissive of indoor tanning by daughters and had greater self-efficacy to refuse daughter’s indoor tanning requests than mothers in the control group. Intervention-group mothers also had lower intentions to indoor tan themselves and were more supportive of bans on indoor tanning by minors than control-group mothers. In addition, daughters in the intervention group expressed less positive attitudes toward indoor tanning than daughters in the control group.

In summary, the Health Chat social media intervention may have influenced mothers’ decisions to withhold permission for their daughters to indoor tan for six months after the end of the program. Mothers’ support for bans on indoor tanning by minors also appears to have persisted.

This research was funded by a grant and supplement from the National Cancer Institute (CA192652; Dr. David Buller and Dr. Sherry Pagoto, Multiple Principal Investigators). Collaborating authors include Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University; Dr. Kimberly Henry from Colorado State University; Jessica Bibeau from the University of Connecticut; and Dr. Barbara Walkosz, Julia Berteletti and Alishia Kinsey from Klein Buendel. 

WayToServe Plus

WayToServe Plus

Among effective interventions to reduce driving while intoxicated (DWI) by alcohol, Responsible Beverage Service (RBS) training of alcohol servers has shown promise. RBS training is currently required or incentivized by 36 states and California will require it starting in 2022.

Klein Buendel and its research collaborators from the University of New Mexico and the Pacific  Institute for Research and Evaluation (PIRE) have shown that an online RBS training, named WayToServe®, was effective in two randomized research trials. WayToServe is currently commercially available in multiple states in English and Spanish.

Now, researchers from Klein Buendel and PIRE are launching a new research project funded by the National Institute on Alcohol Abuse and Alcoholism (AA029364) to develop and test an in-service professional development component for alcohol servers trained by WayToServe to enhance its effectiveness. It is intended to motivate servers to implement the RBS skills in the face of common barriers, provide support for RBS actions from a “community” of alcohol servers, and prevent natural degradation of skills over time. The in-service component – WayToServe Plus – will be delivered through the WayToServe Facebook page that currently is followed by over 20,000 alcohol servers trained by WayToServe.

The Fast-Track SBIR project will complete a 12-month Phase I feasibility study and a 2-year Phase II effectiveness trial in New Mexico and Washington State. The primary outcome will be the effect of WayToServe Plus on refusal of sales to pseudo-intoxicated patrons. The research will be led by Dr. David Buller and Dr. Gill Woodall (Multiple Principal Investigators) from Klein Buendel, and Dr. Robert Saltz from PIRE.

This research is innovative as WayToServe Plus will be the first continuous in-service professional development for RBS training and will increase the WayToServe training’s effectiveness and commercial advantage with alcohol servers and corporate clients.

Engagement with a Social Media Campaign for Mothers to Reduce Permissiveness for Daughters’ Indoor Tanning

Engagement with a Social Media Campaign for Mothers to Reduce Permissiveness for Daughters’ Indoor Tanning

Indoor tanning (IT) by adolescents increases lifetime risk of developing melanoma. Dr. David Buller, Director of Research at Klein Buendel, is leading an examination of a social media campaign for mothers to reduce their permissiveness toward indoor tanning by their teenage daughters. Dr. Buller presented findings on mothers’ engagement with the social media campaign – Health Chat – at the D.C. Health Communication (Virtual) Conference, April 23-24, 2021.

Several states require parents to consent or accompany minor children using IT facilities. Engagement of mothers with the social media campaign was examined to see if it modified campaign effects on mothers’ permissiveness for their teen daughters to indoor tan. Mothers (N=869) with daughters aged 14-17 were recruited in 34 states that do not ban IT by minors under 18 for a randomized trial with follow-ups at 12-month and 18-month post-randomization.

Mothers received an adolescent health social media campaign in Facebook private groups. Half of mothers were in a group in which the campaign included posts about preventing IT (intervention) and the other half, included posts on preventing prescription drug misuse (control). Engagement was measured by extracting reactions (e.g., like, sad, etc.) and comments posted by mothers to the campaign posts addressing IT or prescription drug misuse. Follow-up surveys assessed mothers’ permissiveness for daughters to indoor tan, i.e., whether mothers would permit daughters to indoor tan or facilitate them doing so (e.g., take them to a tanning facility). Daughters (n=469; 54.0%) were invited to complete baseline and follow-up assessments.

Mothers were mostly non-Hispanic white, college educated, and had household incomes exceeding $80,000. Nearly one-third had a family history of skin cancer and just over one quarter had high-risk skin types. At 12-month and 18-month follow-up, engagement with the social media campaign moderated the impact of treatment group on mothers’ permitting and facilitating IT by daughters. Specifically, among mothers who engaged with the campaign, mothers in the intervention group had lower permissiveness for IT and less facilitation of IT by their daughters than in the control group. These differences did not occur between treatment groups among mothers with no engagement in either permissiveness or facilitation at either follow-up.

Social media campaigns may be used to improve IT public policies by decreasing mothers’ permissiveness and increasing communication with daughters about avoiding IT. However, social media messages need to reach and engage mothers to be effective, in this case on convincing mothers to not permit or facilitate daughters’ request to indoor tan. Prevention messages, when interspersed in a social media feed on adolescent health, may reduce IT by female adolescents by improving compliance with public policies restricting minor access to IT facilities.

This research is funded by a grant and supplement from the National Cancer Institute (CA192652; Dr. David Buller and Dr. Sherry Pagoto, Multiple Principal Investigators). Collaborating authors include Dr. Sherry Pagoto and Jessica Bibeau from the University of Connecticut, Dr. Kimberly Henry from Colorado State University, Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University, and Dr. Barbara Walkosz, Julia Berteletti, and Lucia Liu from Klein Buendel.

Sun Safe Partners Online

Sun Safe Partners Online

Findings from a pilot randomized controlled trial evaluating the feasibility and preliminary impact of an online couple-focused intervention to improve sun protection behavior were published recently in the Journal of Medical Internet Research. The research team was led by Dr. Sharon Manne from the Rutgers Cancer Institute of New Jersey. Collaborators from Michigan State University, the University of Connecticut, Memorial Sloan Kettering Cancer Center, and Klein Buendel rounded out the research team.

At the time of the study, Sun Safe Partners Online was a web-based intervention with four individual-focused modules and four couple-focused modules. A total of 75 couples who reported suboptimal levels of sun protection were randomly assigned to receive either Sun Safe Partners Online or a generic sun safety education intervention. Participants were recruited through Facebook advertising, resulting in rapid enrollment and higher acceptance than was evident in a previous trial testing telephone and print intervention. Feasibility was assessed by enrollment, engagement, survey completion, module completion, and module satisfaction. Participants also completed pre/post surveys assessing sun protection, sun exposure on weekends, sunburn incidence, and attitudes toward sun protection. A full description of the methods, analyses, and effects of the study can be found in the publication.

Sun Safe Partners Online was found to be an innovative strategy for engaging adults in sun safety. The authors conclude that “a couple-focused intervention may hold promise as a way to improve sun protection behaviors beyond interventions focused solely on individuals by leveraging the concern, collaboration, and support among intimate partners and addressing relationship-based barriers to sun protection.”

This pilot research was supported by Rutgers Cancer Institute of New Jersey Institutional funds.

Testing The Impact Of Social Media Messaging On COVID-19 Mitigation

Testing The Impact Of Social Media Messaging On COVID-19 Mitigation

Klein Buendel researchers and collaborators are launching a supplemental study to test the impact of social media messaging on COVID-19 mitigation, such as social distancing behaviors and vaccination, in a sample of mothers with daughters aged 14-17 years. The study, which is funded by the National Cancer Institute, will examine the impact of different sources frequently providing COVID-19 and vaccination information via Facebook.

The Internet, including social media, is a preferred channel for health information for many Americans (1,2). At their best, social media provide flexible, responsive, and accessible platforms for distributing information to the public from trusted voices such as Centers for Disease Control and Prevention (CDC) and National Institutes of Health to promote needed health behaviors (3,4). Social media can improve information dissemination and personal relevance (8-12), create social support and collective action (13,14), and detect and respond to emerging issues and trends such as the COVID-19 response (5,6). At their worst, social media circulate inaccurate, misleading, unsupported, and harmful information (5,7), which may be especially detrimental in this age of filter bubbles separating Americans into like-minded groups (5).

Following a pretest survey, mothers will be randomly assigned to one of three Facebook private groups varying in types of source in the COVID-19 social media posts – government health agencies, near-peer parents and family members, or news media. Social media platforms are directing users to health organizations (6) but other sources may be credible with users, as well. The private groups prevent experimental contamination while delivering the social media feed. Mothers will complete a posttest at 3-, 6-, and 9-weeks post-randomization. The primary outcomes, assessed at pretest and all posttests, will be social distancing behaviors by self and daughter and intention to vaccinate self and daughter for COVID-19 (if a vaccine becomes available). Secondary outcomes are mother-daughter communication about COVID-19 mitigation behaviors and vaccination, theoretic antecedents of mitigation behaviors and vaccination, media literacy, and COVID-19 misinformation. Individual differences among mothers and other covariates will be measured at baseline or obtained from the parent trial. Engagement with the social media feed will be recorded.

This research is funded by an administrative supplement to a grant from the National Cancer Institute (CA192652; Dr. David Buller, Klein Buendel, and Dr. Sherry Pagoto, University of Connecticut, Multiple Principal Investigators). Collaborators include Dr. Katie Baker, Dr. Joel Hillhouse, and Jessica Bibeau from East Tennessee State University; Dr. Kim Henry from Colorado State University; and Dr. Barbara Walkosz and Julia Berteletti from Klein Buendel.

References

1. Purcell K; Pew Research Center. The State Of Online Video. Available at: http://www.pewinternet.org/2010/06/03/the-state-of-online-video/. Published June 3 2010. Accessed May 22, 2020.

2. Majority of Adults Look Online for Health Informaiton. FactTank: News in the Numbers. February 1, 2013. http://www.pewresearch.org/fact-tank/2013/02/01/majority-of-adults-look-online-for-health-information/. Accessed May 22, 2020.

3. Veil SR, Buehner T, Palenchar MJ. A work-in-process literature review: incorporating social media in risk and crisis communication. J Contingencies Crisis Manage. 2011;19(2):110-122.

4. Breland JY, Quintiliani LM, Schneider KL, May CN, Pagoto S. Social media as a tool to increase the impact of public health research. Am J Public Health. 2017;107(12):1890-1891.

5. Sutton J. Health communication trolls and bots versus public health agencies’ trusted voices. Am J Public Health. 2018;108(10):1281-1282.

6. Merchant RM, Lurie N. Social media and emergency preparedness in response to novel coronavirus [published online ahead of print March 24, 2020]. JAMA. 2020 doi: 10.1001/jama.2020.4469

7. Broniatowski DA, Jamison AM, Qi S, et al. Weaponized health communication: Twitter bots and Russian trolls amplify the vaccine debate. Am J Public Health. 2018;108(10):1378-1384.

8. Valle CG, Tate DF, Mayer DK, Allicock M, Cai J. A randomized trial of a Facebook-based physical activity intervention for young adult cancer survivors. J Cancer Surviv. 2013;7(3):355-368.

9. Young SD, Cumberland WG, Lee SJ, Jaganath D, Szekeres G, Coates T. Social networking technologies as an emerging tool for HIV prevention: a cluster randomized trial. Ann Intern Med. 2013;159(5):318-324.

10. Pagoto S, Baker K, Griffith J, et al. Engaging moms on teen indoor tanning through social media: protocol of a randomized controlled trial. JMIR Research Protocols. 2016;5:e228. doi: 10.2196/resprot.6624. PMCID: PMC5147712

11. Witte K. Putting the fear back in fear appeals: the extended parallel process model. Communication Monographs. 1992;59:329-349.

12. Rogers RW. A Protection Motivation Theory of fear appeals and attitude change1. J Psychol. 1975;91(1):93-114. doi: 10.1080/00223980.1975.9915803

13. Rogers RW. Cognitive and physiological processes in fear appeals and attitude change: a revised theory of protection motivation. In: Cacioppo, J, Petty, R, eds. Social Psychophysiology. New York, NY: Guilford Press; 1983:153-176.

14. Woodall GW, Starling R, Buller DB, Kong A, Wheeler C. Beta-test and randomized trial results for GoHealthyGirls: a website for HPV vaccine adoption. 29th Meeting of the International Papillomavirus Conference; August 20-25; Seattle, Washington.

HPV VACCINATION RATES IN A TRIAL TESTING A SOCIAL MEDIA CAMPAIGN WITH MOTHERS OF TEENAGE DAUGHTERS

HPV VACCINATION RATES IN A TRIAL TESTING A SOCIAL MEDIA CAMPAIGN WITH MOTHERS OF TEENAGE DAUGHTERS

Dr. David Buller, Director of Research from Klein Buendel, presented findings from the Health Chat Project at the virtual 33rd International Papillomavirus Conference & Basic Science, Clinical and Public Health Workshops (IPVC), July 20-24, 2020.

Parental decisions on HPV vaccine uptake in the United States are influenced by information and misinformation about the vaccine in social media. Mothers’ reports on vaccination of their adolescent daughters were examined in an evaluation of a social media adolescent health campaign.

For this intervention, 881 mothers from 34 states were recruited into a randomized controlled trial evaluating a social media adolescent health campaign. Eligibility criteria included having a daughter aged 14-17, in state without a complete ban on indoor tanning by minors, using a Facebook account one or more times a week, completing the baseline survey, and joining the Facebook group. The campaign included didactic and narrative posts some of which promoted HPV vaccination, such as the need for vaccine, percent of adolescents vaccinated, and how HPV vaccines are decreasing infection rates. It was delivered through two Facebook private groups differing on inclusion of indoor tanning or prescription drug mis-use posts .

At baseline, nearly two-thirds of mothers reported that their daughters had been vaccinated for HPV. HPV vaccine uptake increased during the 12-month social media campaign. At the 12-month posttest, nearly 8% more mothers reported that daughters had been vaccinated for HPV. The increase appeared to be largest in completion of the multi-dose series. Uptake increased among older and more educated mothers and those with a family history of skin cancer. Mothers’ reports of HPV vaccine uptake were corroborated by daughters. Effective strategies are needed in social media to promote HPV vaccines and counter misinformation about and resistance to them.

This research is funded by a grant from the National Cancer Institute (CA192652; Dr. David Buller, Klein Buendel, and Dr. Sherry Pagoto, University of Connecticut, Multiple Principal Investigators). Collaborators include Jessica Oleski from the University of Connecticut, Dr. Katie Baker and Dr. Joel Hillhouse from East Tennessee State University, Dr. Kim Henry from Colorado State University, and Dr. Barbara Walkosz and Julia Berteletti from Klein Buendel.