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Cancer Prevention Research Presented at ASPO

Cancer Prevention Research Presented at ASPO

Klein Buendel investigators and their collaborators presented research from two large studies at the 50th Annual Meeting of the American Society of Preventive Oncology on April 12-14 in Denver, Colorado. The theme of the conference was “50 Years of Impact: Empowering Communities Through Cancer Prevention Research.” 

*Klein Buendel authors are bolded.

ORAL PRESENTATION 1

Title: A Confederate Study of Indoor Tanning Facility Compliance with Laws

Presenter: Dr. Carolyn Heckman

Co-authors: Anna Mitarotondo, Melissa Goldstein, Rucha Janodia, Ileana Gonzalez, Dr. David Buller, Julia Berteletti

  • This submission was designated as a Best of ASPO Abstract.

Because indoor tanning is a known cause of skin cancer, state laws and federal regulations restricting indoor tanning for minors have been implemented: 22 states and the District of Columbia (DC) ban minors under age 18 from indoor tanning, 22 states have other age and parental involvement restrictions, and 6 states have no restrictions on minor access to indoor tanning. The assessed indoor tanning facility law compliance, hypothesized to be insufficient and inconsistent.

Trained and supervised pseudo-patrons called randomly selected indoor tanning facilities (indoor tanning salons, beauty salons/spas, gyms, apartment buildings) in 50 states and DC, posing as minors one year younger than the state’s permitted age to indoor tan (age 17 in states banning indoor tanning under 18) or age 16 in states with no age restriction. Using a semi-structured script, pseudo-patrons asked about scheduling an indoor tanning session, unlimited indoor tanning (contrary to FDA guidelines), risk of skin burns, and parental involvement requirements. Responses were coded, with discrepancies resolved by consensus, and summarized descriptively.

A total of 504 calls were completed to 206 indoor tanning salons, 111 gyms, 101 spas/beauty salons, and 86 apartment buildings. Overall, 55% of facilities would allow pseudo-patrons to book an appointment or “walk in” for indoor tanning, despite being underage, compared to 32% in states with under-18 bans. In states with minor restrictions, indoor tanning salons were least likely (48%) to permit minor indoor tanning and gyms, most likely to do so (56%). Twenty-six percent (26%) of staff did not ask pseudo-patrons their age, irrespective of law type. Forty-four percent (44%) of gyms/apartments did not require membership/tenancy to indoor tan. Most facilities (92%) offered unlimited indoor tanning packages or unlimited access to tanning beds when open. Only 52% of facility staff acknowledged that pseudo-patrons’ skin could be burned, when asked.

Although many states have laws restricting indoor tanning by minors, indoor tanning facilities were commonly non-compliant with age restrictions, suggesting inadequate law awareness and/or enforcement. Strategies must be identified to implement indoor tanning laws effectively and realize their benefits, including preventing skin burns, skin cancer, and other health consequences. Ongoing analyses are evaluating compliance when scheduling appointments online and by additional law provisions, state demographics, and U.S. region.

This research was supported by a grant to Rutgers University from the National Cancer Institute (CA244370; Dr. Carolyn Heckman and Dr. David Buller, Multiple Principal Investigators).

POSTER 1 

Title: Correlates of Human Papillomavirus Vaccination Among a Sample of Emerging Adults Aged 18-26 Living in Rural Locations in the Western United States

Presenter: Dr. David Buller

Co-authors:  Dr. Deanna Kepka, Dr. Echo Warner, Dr. Evelinn Borrayo, Dr. Andrew Sussman, Alishia Kinsey, Dr. W. Gill Woodall, Dr. David Buller

Dr. Borrayo, Dr. Buller and Dr. Warner

Human Papillomavirus (HPV) vaccination status and correlates were examined in a sample of emerging adults living in rural locations in the western United States. Eight hundred and ten (n=810) emerging adults residing in rural areas in 17 western U.S. states were recruited from online survey panels or by social media advertising from August 2024-2025 for a randomized trial. Emerging adults reported at baseline their HPV vaccine uptake status, including number of doses received. Using logistic regression analysis, we tested the association of demographics, attitudes, health care, and social media use with HPV vaccine uptake status (0=no/don’t know; 1=vaccinated) and vaccine doses received (0=0 or 1 dose/don’t know; 1=2 or 3 doses).

Overall, 424 (52.3%) rural emerging adults reported being vaccinated for HPV and 184 (22.7%) not being vaccinated, and 202 (24.9%) did not know. Of the 424 emerging adults vaccinated, 41 emerging adults (9.7%) recalled receiving one dose, 88 (20.7%) two doses, and 101 (23.8%) three doses of the vaccine, but 194 emerging adults (45.8%) did not know. More rural emerging adults who were vaccinated were female, more educated, attended religious services less frequently, had a personal/family history of cancer, were more confident vaccines are safe, and had less constraints on getting vaccinated. More rural emerging adults with multiple vaccine doses were older, female, visited a physician for a routine health check-up more recently, were more confident that vaccines are safe, and had less constraints on getting vaccinated.

Uptake of HPV vaccination among rural emerging adults (52.3%) was slightly higher than the national rate in the 2022 National Health Interview Survey (47.4%). Emerging adults need advice on how to confirm vaccination status (such as checking with parent, physician, or vaccine registry) when promoting catch-up HPV vaccination. HPV vaccination interventions should educate on vaccine safety/ constraints, how it can reduce personal/family cancer concerns, and religious groups that support it. Medical providers should offer HPV vaccination to emerging adults during routine health check-ups. Male and less educated emerging adults would benefit from intervention.

This research from the #4Corners4Health study was supported by a grant to Klein Buendel from the National Cancer Institute (CA268037; Dr. David Buller and Dr. Andrew Sussman, Multiple Principal Investigators). Other collaborators are from the University of Arizona, the University of Colorado, the University of Utah, and Colorado State University.

POSTER 2 

Title: Associations Between Food Insecurity and Dietary Intake and Nicotine Use Among Rural Emerging Adults in the Western United States

Presenter: Dr. Megan Skiba

Co-authors:  Dr. Doug Taren, Dr. Dolores Guest, Dr. Kim Henry, Dr. Judith Gordon, Noah Chirico, Dr. Echo Warner, Alishia Kinsey, Angela Jung, Dr. Andrew Sussman, Dr. David Buller

Dr. Skiba

The purpose of the study was to evaluate the associations between food insecurity, dietary intake, and tobacco/nicotine use among emerging adults aged 18-26 years living in rural areas of the western United States. 

This analysis used baseline data from 810 rural emerging adults participating in a randomized trial evaluating a social media-delivered cancer prevention intervention. Emerging adults completed self-report surveys assessing demographics, dietary intake (NCI Dietary Screener Questionnaire), and any nicotine product use (yes/no) in the past 30 days. Dietary measures included predicted intake of fruit and vegetable (servings/day), fiber (g/day), added sugar from sugar sweetened beverages (tsp/day), and red/processed meat (frequency/week). Food insecurity was categorized as very low food secure, low food secure, and high food secure from a single item measuring worry about running out of food before having money to buy more. Associations between food insecurity and dietary intake or tobacco/nicotine use were examined using linear or logistic regression models, adjusting for significant demographic covariates. Linear trend tests assessed graded relationships across food insecurity levels.

Of emerging adults (mean age 22.7 years), 62% reported low or very low food security. Food insecurity was associated with race, sex, education, and employment and were used as model covariates. A positive linear trend was observed between food insecurity and added sugar from sugar sweetened beverages, with very low food secure emerging adults consuming an average of 13.0 tsp/day from sugar sweetened beverages. There were no significant associations between food insecurity and fruit and vegetable, fiber, or red/processed meat intake, although fruit and vegetable and fiber intake were low overall (2.3 ± 0.6 servings/day and 15.1 ± 3.4 g/day, respectively). Percent of emerging adults using nicotine was greater with increasing levels of food insecurity: 24% among those with high food security, 41% among those with low food security, and 53% among those with very low food security. Odds increased 2.5 times for each stepwise increase in food insecurity.

Experiencing food insecurity may be a determinant of cancer-preventive health behaviors in rural emerging adults. Very low food security may be an important target for interventions aimed at improving multiple cancer preventive health behaviors among rural emerging adults.

This research from the #4Corners4Health study was supported by a grant to Klein Buendel from the National Cancer Institute (CA268037; Dr. David Buller and Dr. Andrew Sussman, Multiple Principal Investigators). Other collaborators are from the University of Arizona, the University of Colorado, the University of Utah, and Colorado State University.

TeenVac to Improve HPV Vaccine Uptake in Adolescent Boys

TeenVac to Improve HPV Vaccine Uptake in Adolescent Boys

Human papillomavirus (HPV) vaccine uptake remains below the Healthy People 2030 goal of 80% series completion in the United States. Parental concerns about the efficacy and safety of the vaccine remain and may be addressed by digital interventions tailored to their concerns.

Dr. W. Gill Woodall, Klein Buendel Senior Scientist, led a large study supported by the National Cancer Institute to increase HPV vaccination among adolescent boys . The results of the study have been published in the Journal of Adolescent Health. Specifically, the paper reports on the purpose, methods, and effectiveness of TeenVac, a mobile app to encourage HPV vaccination in families with adolescent boys.

A randomized trial was conducted between May 2019 and December 2020, testing the mobile web app (teenvac.org) that encouraged HPV vaccination for parents and sons aged 11–14 years old. Parents and 209 adolescent sons were randomized to receive either the TeenVac app or the Centers for Disease Control and Prevention (CDC) HPV vaccination pamphlet online. Participants had access to the TeenVac app or the CDC pamphlet for the 9-month study duration. Adolescent sons’ vaccination records were collected from the state vaccine registry at the end of the study.

Intent-to-treat and web usage analyses were conducted. Intent-to-treat analyses found that adolescent sons of parents randomized to the TeenVac app were significantly more likely to complete the HPV vaccination series than those randomized to the CDC pamphlet group. Web usage analysis confirmed that the TeenVac group parents who used the web app were significantly more likely to have sons complete the HPV vaccination series than those in the CDC pamphlet group.

The TeenVac app meaningfully impacted HPV vaccine series completion, particularly among parents who used the web app. The results provide further evidence that digital interventions can improve vaccine uptake when focused on parents’ and sons’ vaccine-related concerns.

This research was supported by a grant from the National Cancer Institute (CA210125; Dr. W. Gill Woodall, Principal Investigator). Dr. Woodall’s coauthors include Dr. Gregory Zimet from Indiana University; Dr. Alberta Kong, Dr. Lance Chilton, and Dr. Tamar Ginossar from the University of New Mexico; Jennyfer Reither from Denver Health Hospital; and Dr. David Buller, Lila Martinez, Marita Brooks, and Noah Chirico from Klein Buendel.

KB Scientists Present HPV Vaccination Research

KB Scientists Present HPV Vaccination Research

Two Klein Buendel scientists presented HPV vaccination research at the 36th International Papillomavirus Conference in Edinburgh, Scotland, November 12-15, 2024.

Poster 1

Title: HPV Vaccine Uptake Improvement for Adolescent Boys via a Mobile Web App:  TeenVac.org

Presenter: W. Gill Woodall, PhD

Authors: W. Gill Woodall, PhD; David Buller, PhD; Gregory Zimet PhD; Alberta Kong, MD, MPH; Jeannyfer Reither, MS; Lance Chilton, MD; Lila Martinez; Marita Brooks, MS; Noah Chirico, MPH; Tamar Ginnosar, PhD

Dr. Gill Woodall

Human Papillomavirus (HPV) vaccine uptake remains below the U.S. national goal of 80% series completion. Parental concerns and misinformation about the HPV vaccine’s efficacy and safety remain and may be addressed by digital interventions tailored to their concerns.

Based on a previous intervention focused on parents and adolescent daughters, a randomized controlled trial was conducted testing a mobile web app (TeenVac.org) for parents and their adolescent sons (ages 11-14 years), responsive to their concerns and encouraging HPV vaccination. Two hundred nine (209) participants were randomized to receive either the TeenVac app (n=100) or the standard CDC HPV vaccination pamphlet (n=109) online. Adolescent sons’ vaccination records were collected from the New Mexico vaccine registry at the end of the study.

Intent-to-treat and web usage analyses were conducted. Intent-to-treat analyses found that adolescent sons of parents who were randomized to the TeenVac app were significantly more likely to complete the HPV vaccination series than the CDC pamphlet comparison group. Web usage analysis determined that those parents in the TeenVac group who used the web app were significantly more likely to complete the HPV vaccination series than those in the CDC pamphlet group. Modules focused on nature of HPV, the vaccine, and who recommends it were most used, with average durations ranging from 84 to 122 seconds.

The TeenVac app had a meaningful impact on HPV vaccine shot completion, particularly among parents who used the web app. The study trial’s recruitment and implementation were affected by the COVID-19 pandemic, with 86% of parent-adolescent pairs recruited during this period. Despite these challenges, the results provide further evidence that digital interventions can improve vaccine uptake when focused on parents and sons’ vaccine-related concerns.

This research was funded by a grant from the National Cancer Institute (CA210125; Dr. W. Gill Woodall, Principal Investigator). Collaborators were from the University of New Mexico, Indiana University, and Klein Buendel.

Poster 2

Title: Development of Social Media Posts Promoting HPV Vaccination to Emerging Adults in Rural Communities of the united States

Presenter: David Buller, PhD

Authors: David Buller, PhD; Andrew Sussman, PhD; Echo Warner, PhD; Alishia Kinsey; W. Gill Woodall, PhD; Deanna Kepka, PhD; Barbara Walkosz, PhD; Julia Berteletti, MSW; Annelise Small; Dolores Guest, PhD; John Torres

Dr. David Buller

HPV-related cancers are increasing in rural areas of the United States and HPV vaccination rates of emerging adults are low. A social media campaign promoting HPV vaccine uptake, along with five other cancer risk-reduction behaviors, is being developed for emerging adults aged 18-26 living in rural counties in the western United States. Campaign posts were pilot-tested with emerging adults (n=188) in surveys on appropriateness, relevance, and trustworthiness and likelihood of engaging with them (such as read, scroll past, react [such as like, sad, etc.], comment, and click on a shared link). Also, emerging adults (n=26) were enrolled in a 4-week study where they received HPV vaccination posts in a Facebook private group and engagement (such as views, reactions, comments) was recorded.

Initially, 36 posts on HPV vaccination were developed addressing simplicity, benefits, response efficacy/cost, self-efficacy/perceived control, cancer risk perceptions, norms, relatedness, compatibility with goals/values, and intrinsic/extrinsic motivation. Posts debunked common misinformation on HPV vaccines, stressed that unvaccinated emerging adults should get vaccinated, and advised emerging adults on how to discuss HPV vaccination with family and friends. Emerging adults evaluated seven HPV vaccination posts in the surveys and rated them as appropriate, relevant, and trustworthy. Two-thirds of emerging adults said they would read the posts, but also might scroll past them. Over one-third would click on a shared link or leave a reaction, but few would comment. In the 4-week study, seven HPV vaccination posts received 115 views, 26 reactions, and 2 comments (both positive).

Social media is a primary health information source for young adults. Posts promoting HPV vaccination based on health behavior theories can reach and engage emerging adults with HPV vaccine-supportive messaging. The HPV posts will be included in a cancer prevention campaign evaluated in a randomized trial enrolling 1000 emerging adults in 2025.

This research was funded by a grant from the National Cancer Institute (CA268037; Dr. David Buller and Dr. Andrew Sussman, Multiple Principal Investigators). Collaborators were from the University of New Mexico Comprehensive Cancer Center, the University of Utah Huntsman Cancer Institute, and Klein Buendel.

#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.

EUROGIN HPV Panel Presentation

EUROGIN HPV Panel Presentation

Klein Buendel Senior Scientists, Dr. W. Gill Woodall and Dr. David Buller, presented two research projects in a panel discussion at the EUROGIN International Multidisciplinary HPV Congress on Feb 8-11, 2023 in Bilbao, Spain. The “Digital Interventions to Increase HPV Vaccination” panel featured four presentations and was moderated by Dr. Greg Zimet from the University of Indiana. Other Klein Buendel scientists and staff (at the time of abstract submission) contributing as co-authors included Dr. Barbara Walkosz, Ms. Marita Brooks, Ms. Lila Martinez, and Ms. Jeanny Reither. Klein Buendel employees’ names are bolded.

Presentation 1

Title: “Randomized Trials of HPV Vaccine Uptake Improvement: Web Apps for Parents and Young Adolescent Girls and Boys”

Presenter: W. Gill Woodall, PhD, Senior Scientist, Klein Buendel, Inc. Albuquerque, NM, USA

Co-authors: A. Kong, G. Zimet, D. Buller, L. Chilton, J. Reither, L. Martinez, M. Brooks

This presentation discussed the results of two randomized trials of parent-focused web apps to improve HPV vaccine uptake for young adolescents (ages 11-14).  For the first trial, the web app was tailored to parents and young adolescent girls, and in the second trial, the web app was tailored to parents and young adolescent boys. Results of both trials indicated significant web app impact on HPV vaccine uptake for adolescent girls and boys, as well as other vaccine uptake related variables.  The discussion included a consideration of web app content and tailoring to determine HPV vaccine uptake improvement.

Presentation 2

Title: “Successful technology-based rural patient HPV vaccination reminder intervention and social media assessment of strategies to reduce HPV vaccine misinformation”

Presenter: Deanna Kepka, PhD, MPH, University of Utah, Salt Lake City, UT, USA

Co-authors: K. Christini, E. McGough, B. Gibson, E. Warner, H. Brandt

This presentation described a multi-level and multi-component intervention that included healthcare team training activities and technology-based HPV vaccination reminders. Missed opportunities for HPV vaccination declined significantly from the pre-intervention to the post-intervention period. Participants who recalled receipt of an electronically delivered vaccination reminder had higher unadjusted odds of scheduling a visit compared with those who did not recall receiving a reminder. Social media-delivered misinformation related to HPV vaccination is pervasive. The presenters also discussed new strategies to evaluate and reduce the impact of HPV vaccine misinformation in rural settings.

Presentation 3

Title: “Promoting HPV vaccination to emerging adults in rural communities in a multi-risk factor cancer prevention social media intervention”

Presenter: David Buller, PhD, Senior Scientist, Klein Buendel, Inc., Denver, CO, USA

Co-authors: A. Sussman, D. Kepka, W. G. Woodall, E. Warner, B. Walkosz

This presentation described an innovative social media campaign targeting six cancer risk factors, including HPV vaccination. It is being developed for the diverse population of adults aged 18-26 in rural counties in the Mountain West region of the U.S. Emerging adults obtain health information online far more than information from health care providers and other media. A framework for social media message development was presented based on social cognitive, self-determination, and diffusion of innovation theory. Misinformation, especially on vaccination, will be combatted by instructing emerging adults in digital and media and by using an epidemiological model of monitoring and quickly responding to correct misinformation. The campaign will be tested with a sample of 1000 emerging adults in a stepped-wedge quasi-experimental design.

Presentation 4

Title: “U.S. National Digital Point of Care Communication to Improve Uptake of HPV and Other Adolescent Vaccines in Clinic Settings”

Presenter: Judy Klein, BA, BS, President, UNITY Consortium, Philadelphia, PA, USA

Co-authors: G. Zimet, V. Agadi, C. Hu, A. Jaramillo

This presentation reported on a study that involved digital targeted adolescent vaccination infographics and videos widely disseminated to clinical practices throughout the U.S. Over 11,000 clinicians whose practices received these digital interventions (exposed condition) were matched to an equal number of non-exposed comparison practices matched on multiple practice characteristics. The outcomes of interest were the number of vaccine doses (Tetanus-diphtheria-pertussis booster or Tdap, HPV, MenACWY, and MenB) administered to patients 11-18 years of age. The exposed clinics showed significant increases in administration of adolescent vaccines, including HPV vaccine, compared to the non-exposed clinics.

Mothers and Teenage Daughters: HPV Vaccination Information via Social Media

Mothers and Teenage Daughters: HPV Vaccination Information via Social Media

Dr. David Buller, Klein Buendel’s Director of Research, and his coauthors have published results from the Health Chat Project in the online journal, Frontiers in Digital Health. Health Chat was designed as a social media intervention to reduce mothers’ permissiveness toward their teen daughters’ indoor tanning behavior. It also addressed other adolescent health topics, including human papillomavirus vaccination.

“Parents acquire information about human papillomavirus (HPV) vaccines online and encounter vaccine-critical content, especially on social media, which may depress vaccine uptake,” according to the authors. To help address vaccine hesitancy and misinformation, the authors employed a Facebook-delivered adolescent health campaign targeting mothers with posts on HPV vaccination. The study examined the relationship between mothers’ comments and reactions to posts about HPV and any change in their self-reports of having their daughters vaccinated.

The online publication describes the study’s hypotheses, social media health intervention, research methods, results, communication strategies, and limitations. The behavioral research was guided by social cognitive theory, transportation theory, and diffusion of innovations theory. In summary, mothers commented both positively and negatively toward HPV vaccine-related posts. Also, vaccinations rates increased from baseline, through 12-month and 18-month follow-up assessments.

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; Kelsey Arroyo from the University of Florida; and Dr. Barbara Walkosz and Julia Berteletti from Klein Buendel. 

Vacteens: A Web App to Boost HPV Vaccine Uptake

Vacteens: A Web App to Boost HPV Vaccine Uptake

Dr. W. Gill Woodall, Klein Buendel Senior Scientist, and his coauthors published the results of the Vacteens Project in the online journal, Frontiers in Digital Health.

The uptake of HPV vaccine in the United States remains lower than preferred by health authorities, particularly for young adolescents, when immunogenic response to the vaccine is strongest. Potential parental barriers to low vaccine uptake include confusion, uncertainty, and misinformation about HPV vaccine schedule, safety, and effectiveness. Dr. Woodall and his collaborators believe that parental barriers to HPV vaccination may be addressed by digital interventions, such as web apps, that are tailored to their concerns.

The Vacteens Project project tested a web app for educating parents. The study was conducted with 82 parent-adolescent (daughter) pairs recruited from in nine pediatric clinics in New Mexico. It tested whether digital information delivered to parents in a community setting may be an effective way to help reach HPV vaccine uptake goals in the United States. Diffusion of Innovations Theory principles were used to guide the development of the Vacteens/Vacunadolescente mobile app in English and Spanish.

Parents were randomized to receive either the Vacteens/VacunaAdolescente mobile web app or the usual and customary online HPV vaccination pamphlet from the U.S. Centers for Disease Control and Prevention (CDC). Parents completed surveys at baseline and month 3, and child vaccine records were collected at month 12. Vaccine uptake results from the study found that parents who received the Vacteens/VacunaAdolescente web app were more likely to have their daughters vaccinated than parents in the control condition. Study methods, results, and limitations are detailed in the online publication.

This research was funded by a grant from the Patient-Centered Outcomes Research Institute (PCORI) to the University of New Mexico (#1511-33018; Dr. W. Gill Woodall, Principal Investigator). Dr. Woodall’s collaborators include Dr. Greg Zimet from Indiana University, Dr. Alberta Kong, Dr. Lance Chilton, and Dr. Randall Starling from the University of New Mexico, and Dr. David Buller, Jeannyfer Reither, and Dr. Valerie Myers from Klein Buendel.

Bilingual Web App to Improve HPV Vaccine Uptake

Bilingual Web App to Improve HPV Vaccine Uptake

Dr. W. Gill Woodall, Klein Buendel Senior Scientist, presented findings from the Vacteens/Vacuna Adolescente Project at the virtual 33rd International Papillomavirus Conference & Basic Science, Clinical and Public Health Workshops (IPVC), July 20-24, 2020.

The uptake of HPV vaccine in the United States remains substantially below the Healthy People 2020 goal of 80% series completion, particularly for young adolescents, when immunogenic response to the vaccine is strongest. Physician and clinic-based interventions have shown some limited positive effect on vaccine uptake. However, parental barriers to HPV vaccination may be addressed by digital interventions, such as smartphone applications, that are tailored to their concerns. Potential parental barriers include confusion, uncertainty, and misinformation about HPV vaccine schedule, safety, and effectiveness.

A research project was conducted to test whether digital information delivered to parents in a community setting may be an effective way to help reach HPV vaccine uptake goals in the United States. Diffusion of Innovations Theory principles were used to guide the development of the Vacteens/Vacuna Adolescente mobile app in English and Spanish. The app was designed  to encourage HPV vaccination in New Mexico, an ethnically-diverse state with insufficient vaccine uptake. Parents and adolescents were recruited from pediatric clinics in New Mexico to a randomized trial evaluating the mobile web app, which focused on daughters (ages 11-14). Parents were randomized to receive either the Vacteens/VacunaAdolescente mobile web app or the usual and customary online HPV vaccination pamphlet from the U.S. Centers for Disease Control and Prevention. Adolescent vaccine records were collected for daughters at a 9-month assessment point. Vaccine uptake results from the trial found that parents who received the Vacteens/VacunaAdolescente web app were significantly more likely to have their daughters vaccinated.

This research was funded by grants from PCORI and the National Cancer Institute (CA210125; Dr. W. Gill Woodall, Principal Investigator). Dr. Woodall’s collaborators include Dr. Alberta Kong and Dr. Lance Chilton from the University of New Mexico, Dr. Greg Zimet from Indiana University, and Jeannyfer Reither, Dr. David Buller, and Dr. Valerie Myers from Klein Buendel.

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.

Collaborator Spotlight:
Dr. Alberta Kong

Collaborator Spotlight:
Dr. Alberta Kong

Dr. Alberta Kong has been collaborating with Dr. W. Gill Woodall from Klein Buendel for several years on research to prevent HPV – the Human Papillomavirus – by encouraging vaccination for adolescent girls and boys. They are currently working together on a four-year research project entitled “Web App Technology for Boys and Parents: Improving HPV Vaccine Uptake.” The project, which is funded by a grant from the National Cancer Institute to Klein Buendel (CA210125; W.G. Woodall, Principal Investigator), is creating and testing a mobile web app to accurately inform parents and adolescent boys about the HPV vaccination and address unique concerns about its safety and effectiveness for boys.

Dr. Kong specializes in adolescent health and infectious disease prevention. She is an Associate Professor with a primary appointment in the Department of Pediatrics, Division of Adolescent Medicine and a secondary appointment in the Department of Family and Community Medicine at the University of New Mexico (UNM) Health Sciences Center. She received her Medical Degree from the University of Arizona. Dr. Kong is one of only two Board Certified Adolescent Medicine Specialists in the state of New Mexico. In addition to practicing medicine, she teaches and mentors medical students, pediatric residents, graduate students, and junior faculty members.

According to her UNM bio, “Dr. Kong’s research interests relate to highly prevalent conditions such as sexually-transmitted infections and obesity that commonly affect adolescents. Her research ranges from observational studies to development and testing of interventions targeting behavior change to improve adolescent health outcomes. Regardless of the research design, she utilizes community engagement approaches to ensure that her research has real world applications that can contribute to clinical care of the population she serves.”

Among other research projects, Dr. Kong is the Principal Investigator on a study funded by the National Institutes of Health, National Heart Lung and Blood Institute (HL118734) investigating the efficacy of motivational interviewing approaches for overweight and obesity prevention and treatment through the use of school-based health centers.