NCT03972813

Brief Summary

Within low, middle, and upper income countries, low vaccine coverage results from both obstacles to vaccine access and low confidence in vaccine programs. Thus, it is critical to determine how best to enhance trust in vaccines as increasing numbers of vaccines are recommended for use. Even though the context accompanying the initial roll-out of a vaccine can have a large impact on people's perceptions of the vaccine and the corresponding disease, it is not clear how to best introduce a vaccine to increase public confidence and enhance uptake. The US roll-out of the human papillomavirus (HPV) vaccine framed HPV as a sexually transmitted infection, which proved to be an impediment to efforts to increase vaccine uptake \>10 years after its introduction. This study will use an educational experiment, where parents of children will be exposed to information about the HPV vaccination in different ways. Parents will be introduced to the HPV vaccine through different scenarios with varying emphases (i.e., age at vaccination, types of transmission, type of cancer prevention). The aim will be to determine how the framing of the HPV vaccination across several dimensions affects short-term willingness to receive it.

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,021

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started May 2019

Shorter than P25 for not_applicable

Geographic Reach
1 country

1 active site

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

May 28, 2019

Completed
2 days until next milestone

First Submitted

Initial submission to the registry

May 30, 2019

Completed
5 days until next milestone

First Posted

Study publicly available on registry

June 4, 2019

Completed
3 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 31, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

August 31, 2019

Completed
5 months until next milestone

Results Posted

Study results publicly available

January 13, 2020

Completed
Last Updated

January 15, 2025

Status Verified

January 1, 2025

Enrollment Period

3 months

First QC Date

May 30, 2019

Results QC Date

December 6, 2019

Last Update Submit

January 13, 2025

Conditions

Keywords

HPV VaccinesChina

Outcome Measures

Primary Outcomes (1)

  • To Determine How the Framing of the HPV Vaccination Across Several Dimensions Affects Short-term Willingness to Receive it

    Immediately after the experimental component, parents will respond to the question "If you had a daughter, how willing would you be to give your daughter an HPV vaccine at 12 years of age?" This will be assessed on a 5-point scale from "not at all willing" (1) to "very willing" (5). The proportion of parents who select "somewhat" (4) or "very willing" (5) will be tallied as the primary outcome measure.

    same day as intervention

Secondary Outcomes (1)

  • To Determine How the Framing of the HPV Vaccination Across Several Dimensions Affects Sustained Willingness to Receive it

    3 years

Study Arms (18)

cervical cancer - sexually transmitted (STD) - standard

EXPERIMENTAL

The Human Papilloma Virus (HPV) causes cervical cancer. HPV is a sexually transmitted disease. Currently, safe and effective HPV vaccines are available for women 9-45 years of age in China.

Behavioral: Information about STDsBehavioral: Standard age informationBehavioral: Cervical cancer

cervical cancer - STD - 12 years old (y.o.)

EXPERIMENTAL

The Human Papilloma Virus (HPV) causes cervical cancer. HPV is a sexually transmitted disease. Currently, safe and effective HPV vaccines are available for women 9-45 years of age in China. The transition between grade school and middle school is a particularly good time to think about the HPV vaccine.

Behavioral: Information about STDsBehavioral: Recommendation for children 12 years oldBehavioral: Cervical cancer

cervical cancer - STD - 18 y.o.

EXPERIMENTAL

The Human Papilloma Virus (HPV) causes cervical cancer. HPV is a sexually transmitted disease. Currently, safe and effective HPV vaccines are available for women 9-45 years of age in China. The transition between high school and college or work is a particularly good time to think about the HPV vaccine.

Behavioral: Information about STDsBehavioral: Recommendation for children 18 years oldBehavioral: Cervical cancer

cervical cancer - infectious - standard

EXPERIMENTAL

The Human Papilloma Virus (HPV) causes cervical cancer. HPV is an infectious disease. Currently, safe and effective HPV vaccines are available for women 9-45 years of age in China.

Behavioral: Information about infectious diseaseBehavioral: Standard age informationBehavioral: Cervical cancer

cervical cancer - infectious - 12 y.o.

EXPERIMENTAL

The Human Papilloma Virus (HPV) causes cervical cancer. HPV is an infectious disease. Currently, safe and effective HPV vaccines are available for women 9-45 years of age in China. The transition between grade school and middle school is a particularly good time to think about the HPV vaccine.

Behavioral: Information about infectious diseaseBehavioral: Recommendation for children 12 years oldBehavioral: Cervical cancer

cervical cancer - infectious - 18 y.o.

EXPERIMENTAL

The Human Papilloma Virus (HPV) causes cervical cancer. HPV is an infectious disease. Currently, safe and effective HPV vaccines are available for women 9-45 years of age in China. The transition between high school and college or work is a particularly good time to think about the HPV vaccine.

Behavioral: Information about infectious diseaseBehavioral: Recommendation for children 18 years oldBehavioral: Cervical cancer

cervical cancer - blank - standard

EXPERIMENTAL

The Human Papilloma Virus (HPV) causes cervical cancer. Currently, safe and effective HPV vaccines are available for women 9-45 years of age in China.

Behavioral: Standard age informationBehavioral: Cervical cancerBehavioral: Blank information about communicability

cervical cancer - blank - 12 y.o.

EXPERIMENTAL

The Human Papilloma Virus (HPV) causes cervical cancer. Currently, safe and effective HPV vaccines are available for women 9-45 years of age in China. The transition between grade school and middle school is a particularly good time to think about the HPV vaccine.

Behavioral: Recommendation for children 12 years oldBehavioral: Cervical cancerBehavioral: Blank information about communicability

cervical cancer - blank - 18 y.o.

EXPERIMENTAL

The Human Papilloma Virus (HPV) causes cervical cancer. Currently, safe and effective HPV vaccines are available for women 9-45 years of age in China. The transition between high school and college or work is a particularly good time to think about the HPV vaccine.

Behavioral: Recommendation for children 18 years oldBehavioral: Cervical cancerBehavioral: Blank information about communicability

many cancers - STD - standard

EXPERIMENTAL

The Human Papilloma Virus (HPV) causes cancers all over the body, from the head to the reproductive system. HPV is a sexually transmitted disease. Currently, safe and effective HPV vaccines are available for women 9-45 years of age in China.

Behavioral: Broadened information about cancersBehavioral: Information about STDsBehavioral: Standard age information

many cancers - STD - 12 y.o.

EXPERIMENTAL

The Human Papilloma Virus (HPV) causes cancers all over the body, from the head to the reproductive system. HPV is a sexually transmitted disease. Currently, safe and effective HPV vaccines are available for women 9-45 years of age in China. The transition between grade school and middle school is a particularly good time to think about the HPV vaccine.

Behavioral: Broadened information about cancersBehavioral: Information about STDsBehavioral: Recommendation for children 12 years old

many cancers - STD - 18 y.o.

EXPERIMENTAL

The Human Papilloma Virus (HPV) causes cancers all over the body, from the head to the reproductive system. HPV is a sexually transmitted disease. Currently, safe and effective HPV vaccines are available for women 9-45 years of age in China. The transition between high school and college or work is a particularly good time to think about the HPV vaccine.

Behavioral: Broadened information about cancersBehavioral: Information about STDsBehavioral: Recommendation for children 18 years old

many cancers - infectious - standard

EXPERIMENTAL

The Human Papilloma Virus (HPV) causes cancers all over the body, from the head to the reproductive system. HPV is an infectious disease. Currently, safe and effective HPV vaccines are available for women 9-45 years of age in China.

Behavioral: Broadened information about cancersBehavioral: Information about infectious diseaseBehavioral: Standard age information

many cancers - infectious - 12 y.o.

EXPERIMENTAL

The Human Papilloma Virus (HPV) causes cancers all over the body, from the head to the reproductive system. HPV is an infectious disease. Currently, safe and effective HPV vaccines are available for women 9-45 years of age in China. The transition between grade school and middle school is a particularly good time to think about the HPV vaccine.

Behavioral: Broadened information about cancersBehavioral: Information about infectious diseaseBehavioral: Recommendation for children 12 years old

many cancers - infectious - 18 y.o.

EXPERIMENTAL

The Human Papilloma Virus (HPV) causes cancers all over the body, from the head to the reproductive system. HPV is an infectious disease. Currently, safe and effective HPV vaccines are available for women 9-45 years of age in China. The transition between high school and college or work is a particularly good time to think about the HPV vaccine.

Behavioral: Broadened information about cancersBehavioral: Information about infectious diseaseBehavioral: Recommendation for children 18 years old

many cancers - blank - standard

EXPERIMENTAL

The Human Papilloma Virus (HPV) causes cancers all over the body, from the head to the reproductive system. Currently, safe and effective HPV vaccines are available for women 9-45 years of age in China.

Behavioral: Broadened information about cancersBehavioral: Standard age informationBehavioral: Blank information about communicability

many cancers - blank - 12 y.o.

EXPERIMENTAL

The Human Papilloma Virus (HPV) causes cancers all over the body, from the head to the reproductive system. Currently, safe and effective HPV vaccines are available for women 9-45 years of age in China. The transition between grade school and middle school is a particularly good time to think about the HPV vaccine.

Behavioral: Broadened information about cancersBehavioral: Recommendation for children 12 years oldBehavioral: Blank information about communicability

many cancers - blank - 18 y.o.

EXPERIMENTAL

The Human Papilloma Virus (HPV) causes cancers all over the body, from the head to the reproductive system. Currently, safe and effective HPV vaccines are available for women 9-45 years of age in China. The transition between high school and college or work is a particularly good time to think about the HPV vaccine.

Behavioral: Broadened information about cancersBehavioral: Recommendation for children 18 years oldBehavioral: Blank information about communicability

Interventions

Caregivers receive information that HPV causes more than just cervical cancer.

many cancers - STD - 12 y.o.many cancers - STD - 18 y.o.many cancers - STD - standardmany cancers - blank - 12 y.o.many cancers - blank - 18 y.o.many cancers - blank - standardmany cancers - infectious - 12 y.o.many cancers - infectious - 18 y.o.many cancers - infectious - standard

Caregivers learn that HPV is an STD.

cervical cancer - STD - 12 years old (y.o.)cervical cancer - STD - 18 y.o.cervical cancer - sexually transmitted (STD) - standardmany cancers - STD - 12 y.o.many cancers - STD - 18 y.o.many cancers - STD - standard

Caregivers learn that HPV is infectious (but information that it is an STD is omitted).

cervical cancer - infectious - 12 y.o.cervical cancer - infectious - 18 y.o.cervical cancer - infectious - standardmany cancers - infectious - 12 y.o.many cancers - infectious - 18 y.o.many cancers - infectious - standard

Caregivers are prompted to get their child vaccinated when the child is 12 years old.

cervical cancer - STD - 12 years old (y.o.)cervical cancer - blank - 12 y.o.cervical cancer - infectious - 12 y.o.many cancers - STD - 12 y.o.many cancers - blank - 12 y.o.many cancers - infectious - 12 y.o.

Caregivers are prompted to get their child vaccinated when the child is 18 years old.

cervical cancer - STD - 18 y.o.cervical cancer - blank - 18 y.o.cervical cancer - infectious - 18 y.o.many cancers - STD - 18 y.o.many cancers - blank - 18 y.o.many cancers - infectious - 18 y.o.

Caregivers are given information about when the HPV vaccination can be given in China, but no additional recommendations.

cervical cancer - blank - standardcervical cancer - infectious - standardcervical cancer - sexually transmitted (STD) - standardmany cancers - STD - standardmany cancers - blank - standardmany cancers - infectious - standard
Cervical cancerBEHAVIORAL

Caregivers are told that HPV causes cervical cancer.

cervical cancer - STD - 12 years old (y.o.)cervical cancer - STD - 18 y.o.cervical cancer - blank - 12 y.o.cervical cancer - blank - 18 y.o.cervical cancer - blank - standardcervical cancer - infectious - 12 y.o.cervical cancer - infectious - 18 y.o.cervical cancer - infectious - standardcervical cancer - sexually transmitted (STD) - standard

Caregivers are not given any information on how HPV is spread.

cervical cancer - blank - 12 y.o.cervical cancer - blank - 18 y.o.cervical cancer - blank - standardmany cancers - blank - 12 y.o.many cancers - blank - 18 y.o.many cancers - blank - standard

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Parents of children 2-18 years old.

You may not qualify if:

  • None

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Shanghai CDC

Shanghai, 200336, China

Location

Related Publications (1)

  • Huang Z, Ji M, Ren J, Sun X, Boulton ML, Zikmund-Fisher BJ, Wagner AL. Effect of the framing of HPV vaccination on parents' willingness to accept an HPV vaccine. Vaccine. 2022 Feb 7;40(6):897-903. doi: 10.1016/j.vaccine.2021.12.051. Epub 2022 Jan 4.

MeSH Terms

Conditions

Vaccination Refusal

Condition Hierarchy (Ancestors)

Treatment RefusalTreatment Adherence and ComplianceHealth BehaviorBehavior

Limitations and Caveats

Note: Due to the COVID-19 pandemic, collection of data on the secondary outcome was stopped. Accordingly, the grant associated with this clinical trial had a change in scope.

Results Point of Contact

Title
Abram Wagner
Organization
University of Michigan

Study Officials

  • Abram L Wagner, PhD, MPH

    University of Michigan

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
PREVENTION
Intervention Model
FACTORIAL
Model Details: In this educational intervention, there are three dimensions of variability: cancer messaging, communicability messaging, and age messaging. For cancer messaging there are two possibilities: one message focused more on cervical cancer, one message on cancer in general. For communicability, one message will have information on sexual transmission, a second on infectiousness in general, and a third will have no information about communicability. For age, one will mention that the vaccine is available for 9-45 year olds, the second will mention that and additionally recommend children 11 years old to receive the vaccine, and the third will recommend children 18 years old to receive the vaccine.
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Research Assistant Professor

Study Record Dates

First Submitted

May 30, 2019

First Posted

June 4, 2019

Study Start

May 28, 2019

Primary Completion

August 31, 2019

Study Completion

August 31, 2019

Last Updated

January 15, 2025

Results First Posted

January 13, 2020

Record last verified: 2025-01

Data Sharing

IPD Sharing
Will share

The dataset will be uploaded to a public repository after each wave of data collection is complete.

Shared Documents
STUDY PROTOCOL, ANALYTIC CODE
Time Frame
Wave 1 (aim 1): data available end of 2019
Access Criteria
The data is freely and publicly available
More information

Locations