Intervention Strategies to Overcome HPV Vaccine Hesitancy Among Hispanic Immigrants in the USA: A Video-Based Approach
Abstract
:1. Introduction
2. Materials and Methods
2.1. Ethical Approval
2.2. Phase 1a: Focus Groups
2.3. Phase 1b: Video Creation
2.4. Phase 2: Assessing Effectiveness of Interventional Videos
2.5. Statistical Analysis
3. Results
3.1. Phase 1a: Focus Group Results
3.2. Phase 1b: Video Creation
3.3. Phase 2: Survey Results
3.3.1. Sociodemographic Characteristics
3.3.2. Attitudinal Data
4. Discussion
4.1. Community Engagement
4.2. Translating Community Feedback into Successful Educational Interventions
4.3. Limitations of Our Study
4.4. Implications for Health Communication
4.5. Implications for Public Health Policy, Insurance, and Government
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
HI | Hispanic Immigrant |
HPV | Human Papilloma Virus |
HBM | Health Belief Model |
CDC | Centers for Disease Control and Prevention |
CFA | Confirmatory Factor Analysis |
TLI | Tucker–Lewis Index |
CFI | Comparative Fit Index |
RMSEA | Root Mean Square Error of Approximation |
SRMSR | Standardized Root Mean Square Residual |
References
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Section | Focus Group Questions |
---|---|
Vaccine Attitudes and Awareness | 1. What are your general feelings about vaccines? 2. Are you familiar with the HPV Vaccine? How likely are you to get your kids vaccinated? |
Trust and Concerns in Vaccine Communication | 3. Who is the ideal person to communicate health information concerning vaccines? 4. What makes you more or less trusting of that individual? 5. Do you worry about providing documentation when you visit a healthcare provider? 6. Do you fear vaccines based on a lack of information? If so, what information is missing? |
Specific Concerns and Influences on HPV Vaccination | 7. Are there any concerns you have specific to HPV vaccination that we have not covered above? 8. How much do your religious views impact your decisions about the HPV vaccine? 9. Besides going to a medical doctor, who do you go to for treatments? |
Effective Communication Strategies for HPV Vaccine Education | 10. We are planning to produce educational materials (in the form of short videos) to help Spanish-speaking immigrants better understand the HPV vaccine. Based on what you have shared, we would like a little more feedback on what you think would be most effective for these videos. 11. Who should be the person speaking? 12. What kind of information would be helpful? 13. What format do you think is best (someone just relaying information to you vs. watching a conversation between a doctor and patient vs. a conversation between two parents)? 14. What makes you most comfortable listening to the information? |
Emergent Theme | Example Quote |
---|---|
What Information is needed? | |
Disease information | “And if there is a video on the complexity of the Papilloma issue, I think there are several factors that should be included, such as at least how it is acquired, who is directly affected, how to prevent it, what are the best, that is, the best resources to use for the vaccine”. (group 1) |
Video Decision: | Included a video titled, “What is HPV?” that details the characteristics of the virus, how it is transmitted, and the consequences of infection. |
Benefits/effectiveness of the vaccine | “Like for example…what percentage of effectiveness does it have [and] to know how much that vaccine affects them or how much that vaccine can help them or how much it can benefit them?” (group 2) |
Video Decision: | Included a video titled, “How Do I Prevent HPV?” that explains how vaccines function to prevent disease, specifically highlighting the HPV vaccine. Additionally, we included a video titled, “Where did the Vaccine Come From?” that highlighted the long-term protection from and prevention of HPV-related cancers and consequences that the vaccine provides. |
Side effects of the vaccine | “What are the effects? And after the vaccine? What is going to happen, tell us if the child is going to have a fever or something?” (group 1) |
Video Decision: | Included a video titled, “Are there Side Effects of Getting Vaccinated?” that explains how safe the HPV vaccine is and what common side effects are seen. |
Vaccine origin and manufacture | “How did it originate? How was it created? Who created it? Which laboratories?” (group 1) |
Video Decision: | Included a video titled, “Where did the Vaccine Come From?” that highlighted both the approval process of the vaccine and safety statistics, as well as the long-term protection from and prevention of HPV-related cancers and consequences that the vaccine provides. |
How and when to administer | “One question I have is what would be the right age to give the vaccine? Because we are talking about an age range that is possible, but as she explained to us it’s for a child of eight or nine years old. But we see that it is not necessary [for them] because they will not have the same concern we have about sexual relations. So what would be the right age to administer the vaccine?” (group 1) |
Video Decision: | Included a video titled, “At What Age Should I Vaccinate My Children Against HPV?” that states the recommended age range and then explains why that age range is appropriate given the need to prevent infection prior to being sexually active. |
Who should give the information? | |
Medical Professionals/Research Scientists | “That you have the credentials to be able to prove what you’re saying…Because if they offer you a vaccine and they don’t know what it is, they haven’t studied it or they don’t know what it is, how are you going to trust that person? That’s what it’s like to have the basis, uh, to have studied. It doesn’t matter if it is a doctor or a nurse, but someone related to the field of the vaccine. Someone who knows how to clarify doubts”. (group 1) |
Video Decision: | We chose to include an expert who is a university professor of microbiology to explain how HPV is transmitted. |
Government/Center for Disease Control (CDC) | “As an example. This information comes from CDC”. (group 1) |
Video Decision: | We chose to highlight the statement on the HPV vaccine directly from the Center for Disease Control and Prevention (CDC). We also highlighted the role of the US Food and Drug Administration (FDA) in the approval process of the vaccine. |
Testimonials | “The experience of someone who’s been through it tells you about it, too. It helps, because you say hey, it’s real. It’s not nothing but a story. Like at the beginning of COVID when everybody started dying. Hey, let’s get vaccinated”. (group 1) |
Video Decision: | We included a video, titled “Testimonials” highlighting three native Spanish-speaking women talking about their own experiences with the vaccine and their children. |
Medical Professionals/Research Scientists | “That you have the credentials to be able to prove what you’re saying…Because if they offer you a vaccine and they don’t know what it is, they haven’t studied it or they don’t know what it is, how are you going to trust that person? That’s what it’s like to have the basis, uh, to have studied. It doesn’t matter if it is a doctor or a nurse, but someone related to the field of the vaccine. Someone who knows how to clarify doubts”. (group 1) |
What format is appropriate? | |
Engaging content | “Show pictures and make it didactic. How do you say, more fun? Fun is not just standing up and talking and giving a talk and that, because no, that’s not the idea. But doing, showing you the images, showing you the dialogues all of that kind of stuff, but talking to you directly”. (group 1) |
Video Decision: | We chose to use a whiteboard animation application, “Video Scribe”, to create videos with animation, embedded videos of people, and both on-screen and voice-over text |
Direct Communication | “Someone to talk to me directly, like this, to tell it all like it is. The information, the side effects”. (group 1) |
Video Decision: | We used first-person format where all videos, and people in them, are talking directly to the viewer. |
Short | “Imagine three min each with one for each point, it would be better”. Another speaker said, “Because I don’t have 20 min. Right, I don’t know about you guys, but we’re busy. We as dads don’t have time”. (both group 1) |
Video Decision: | All videos (except “Testimonials”) were under 3 ½ min. The testimonial video was just under 8 min. |
Engaging content | “Show pictures and make it didactic. How do you say, more fun? Fun is not just standing up and talking and giving a talk and that, because no, that’s not the idea. But doing, showing you the images, showing you the dialogues all of that kind of stuff, but talking to you directly”. (group 1) |
Other: | |
Language Barrier | “Sometimes we don’t take the interest, sometimes they put you a translator, but the translator doesn’t tell you things well as the doctor can tell you”. (group 2) |
Video Decision: | All videos were filmed entirely in Spanish by native speakers or non-native speakers who have spent two years or more immersed in a Spanish-speaking environment. This includes all on-screen text, voice-over text, and person dialogue. |
Means | Standard Deviations | t | p | |
---|---|---|---|---|
Pre-HPV vaccine intent | 14.73 | 3.89 | −1.94 | 0.053 |
Post-HPV vaccine intent | 14.89 | 3.68 | ||
Pre-HPV vaccine attitude | 14.90 | 4.18 | −13.61 | <0.001 |
Post-HPV vaccine attitude | 16.13 | 4.05 |
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Aduse-Poku, I.; Ardon, D.A.; Call, A.B.; Davis, S.C.; Evans, P.; Johanson, S.; Larson, R.J.; Rencher, J.; Woolley, I.A.; Poole, B.D.; et al. Intervention Strategies to Overcome HPV Vaccine Hesitancy Among Hispanic Immigrants in the USA: A Video-Based Approach. Vaccines 2025, 13, 574. https://doi.org/10.3390/vaccines13060574
Aduse-Poku I, Ardon DA, Call AB, Davis SC, Evans P, Johanson S, Larson RJ, Rencher J, Woolley IA, Poole BD, et al. Intervention Strategies to Overcome HPV Vaccine Hesitancy Among Hispanic Immigrants in the USA: A Video-Based Approach. Vaccines. 2025; 13(6):574. https://doi.org/10.3390/vaccines13060574
Chicago/Turabian StyleAduse-Poku, Isaiah, Diego A. Ardon, Alexis B. Call, Spencer C. Davis, Preston Evans, Spencer Johanson, Ruth J. Larson, James Rencher, Isaac A. Woolley, Brian D. Poole, and et al. 2025. "Intervention Strategies to Overcome HPV Vaccine Hesitancy Among Hispanic Immigrants in the USA: A Video-Based Approach" Vaccines 13, no. 6: 574. https://doi.org/10.3390/vaccines13060574
APA StyleAduse-Poku, I., Ardon, D. A., Call, A. B., Davis, S. C., Evans, P., Johanson, S., Larson, R. J., Rencher, J., Woolley, I. A., Poole, B. D., & Jensen, J. L. (2025). Intervention Strategies to Overcome HPV Vaccine Hesitancy Among Hispanic Immigrants in the USA: A Video-Based Approach. Vaccines, 13(6), 574. https://doi.org/10.3390/vaccines13060574