Testing an HPV Vaccine Decision Aid for 27- to 45-Year-Old Adults in the United States: A Randomized Trial

Erika L. Thompson, Justin Luningham, Sarah A. Alkhatib, Jessica Grace, Idara N. Akpan, Ellen M. Daley, Gregory D. Zimet and Christopher W. Wheldon
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Erika L. Thompson: Department of Quantitative and Qualitative Health Sciences, University of Texas School of Public Health San Antonio, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
Justin Luningham: Department of Population and Community Health, College of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
Sarah A. Alkhatib: Department of Population and Community Health, College of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
Jessica Grace: Department of Population and Community Health, College of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
Idara N. Akpan: Department of Population and Community Health, College of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
Ellen M. Daley: College of Public Health, University of South Florida, Tampa, FL, USA
Gregory D. Zimet: Department of Pediatrics, Indiana University School of Medicine and Zimet Research Consulting LLC, Indianapolis, IN, USA
Christopher W. Wheldon: Department of Social & Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA

Medical Decision Making, 2025, vol. 45, issue 2, 192-204

Abstract: Background In the United States, human papillomavirus (HPV) vaccination among 27- to 45-y-olds (mid-adults) is recommended based on shared clinical decision making with a health care provider. We developed a patient decision aid tool to support the implementation of this mid-adult HPV vaccination guideline. The purpose of this study was to evaluate the effect of a patient decision aid tool for HPV vaccination, HPV DECIDE, compared with an information fact sheet among mid-adults who have not received the HPV vaccine. Method Participants were recruited between December 2023 and January 2024. We used a randomized Solomon, 4-group, pretest/posttest design with mid-adults aged 27 to 45 y who were unvaccinated for HPV and balanced based on sex ( n = 612). The primary outcome was decisional conflict. Intermediate outcomes included knowledge, behavioral expectancies, self-efficacy, and perceived risk. Variables were measured using validated scales. Pretest sensitization was not present; intervention and control groups were compared. Fixed-effects inverse-variance weighting was used to pool effect estimates and determine meta-analytic statistical significance across tests with and without pretest controls. Results Participants in the intervention group had significantly lower total decisional conflict scores (B = −3.58, P = 0.007) compared with the control group. Compared with the control group, participants in the intervention group showed higher knowledge (B = 0.48, P = 0.020), greater intention to receive (B = 0.196, P = 0.049) and discuss the HPV vaccine (B = 0.324, P ≤ 0.001), and greater self-efficacy about HPV vaccine decision making (B = 3.28, P = 0.043). There were no statistically significant results for perceived risks of HPV infection. Conclusions The HPV DECIDE tool for mid-adult HPV vaccination shows promise for immediate reductions in decisional conflict and improvement in knowledge, intentions, and self-efficacy about the HPV vaccine. Future studies are warranted to evaluate the effectiveness of this patient decision aid tool in real-world settings. Highlights Shared clinical decision making is recommended for HPV vaccination with mid-adults. A patient decision aid for HPV vaccination reduced decisional conflict for mid-adults. The HPV vaccine patient decision aid was acceptable to mid-adults.

Keywords: HPV vaccine; decision aid; decision making; adults (search for similar items in EconPapers)
Date: 2025
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:45:y:2025:i:2:p:192-204

DOI: 10.1177/0272989X241305142

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