Purpose: This qualitative research aimed to create a developmentally and gender-appropriate game-based intervention to promote Human Papillomavirus (HPV) vaccination in adolescents. <br/>Background: Ranking as the most common sexually transmitted infection, about 80 million Americans are currently infected by HPV, and it continues to increase with an estimated 14 million new cases yearly. Certain types of HPV have been significantly associated with cervical, vaginal, and vulvar cancers in women; penile cancers in men; and oropharyngeal and anal cancers in both men and women. Despite HPV vaccination being one of the most effective methods in preventing HPV-associated cancers, vaccination rates remain suboptimal in adolescents. Game-based intervention, a novel medium that is popular with adolescents, has been shown to be effective in promoting health behaviors. <br/>Methods: Sample/Sampling. We used purposeful sampling to recruit eight adolescent-parent dyads (N = 16) which represented both sexes (4 boys, 4 girls) and different racial/ethnic groups (White, Black, Latino, Asian American) in the United States. The inclusion criteria for the dyads were: (1) a child aged 11-14 years and his/her parent, and (2) ability to speak, read, write, and understand English. Procedure. After eligible families consented to their participation, semi-structured interviews (each 60-90 minutes long) were conducted with each adolescent-parent dyad in a quiet and private room. Each dyad received $50 to acknowledge their time and effort. Measure. The interview questions consisted of two parts: (a) those related to game design, functioning, and feasibility of implementation; (b) those related to theoretical constructs of the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB). Data analysis. The interviews were audio-recorded with permission and manually transcribed into textual data. Two researchers confirmed the verbatim transcription. We use pre-developed codes to identify each participant’s responses and organize data and develop themes based on the HBM and TPB constructs. After the analysis was completed, three researchers in the team reviewed the results and discussed the discrepancies until a consensus is reached.<br/>Results: The findings suggested that the most common motivating factors for adolescents’ HPV vaccination were its effectiveness, benefits, convenience, affordable cost, reminders via text, and recommendation by a health care provider. Regarding the content included in the HPV game, participants suggested including information about who and when should receive the vaccine, what is HPV and the vaccination, what are the consequences if infected, the side effects of the vaccine, and where to receive the vaccine. The preferred game design elements were: 15 minutes long, stories about fighting or action, option to choose characters/avatars, motivating factors (i.e., rewards such as allowing users to advance levels and receive coins when correctly answering questions), use of a portable electronic device (e.g., tablet) to deliver the education. Participants were open to multiplayer function which assists in a facilitated conversation about HPV and the HPV vaccine. Overall, the participants concluded enthusiasm for an interactive yet engaging game-based intervention to learn about the HPV vaccine with the goal to increase HPV vaccination in adolescents. <br/>Implications: Tailored educational games have the potential to decrease the stigma of HPV and HPV vaccination, increasing communication between the adolescent, parent, and healthcare provider, as well as increase the overall HPV vaccination rate.

Objective: This study looked at three key variables of fear of COVID-19, preventative behaviors, and vaccination intent among college students in the United Sates. In addition, the three key variables were compared between genders, age groups, race groups, and over time to see if there were any significant findings. <br/>Method: This longitudinal study consisted of two anonymous online surveys administered on REDCap before and after a COVID-19 vaccine became available. <br/>Results: The findings suggested positive correlations between students’ fear of COVID-19 and their preventative behaviors with the passing of time. Hispanic/Latino participants had significantly higher fear of COVID-19 scores compared to Non-Hispanic Whites and other races at Wave I and II. Participants between 25 and 30 years old had a marginally greater difference fear of COVID-19 score compared to those less than 25. Females had significantly higher mean preventative behavior score than males at Wave II. There was a significant association between race/ethnicity groups and vaccination intent. <br/>Conclusion: Knowing why different groups do not engage in recommended preventative behaviors or receive vaccinations can tell us more about what tailored interventions may need to be developed and implemented to promote health and wellbeing in this population. Further research needs to be done regarding race, gender, and age and how these different groups of college students are responding to COVID-19 and why.

“College Students' Perceived Risk of COVID-19 Infection, Protective Behaviors, and Vaccination Intent” is a thesis project based on research conducted from the end of 2020 to the beginning of 2021. This project investigated various protective behavior factors against the Coronavirus (COVID-19) based on gender, race/ethnicity, and financial difficulty of college students in the United States. The plan for this thesis project was to send out two surveys through Amazon Mturk to a group of 500 college students. The first survey further narrowed down the sample size to include only the participants who met the eligibility factors. A second larger survey was sent to this sample which included the data for this research project. This paper will explore the topics of perceived risk of becoming infected with COVID-19, preventive behaviors, vaccination intent based on gender, race/ethnicity, and financial difficulty.

The purpose of this study was to examine the effect of the comprehensive HPV educational video, “What is HPV?” on the vaccination intent of young adults. The study also aimed to collect information regarding knowledge, attitudes, and beliefs that influence vaccination and related health behaviors. The sample included 215 participants between the ages of 18-26 who had not received any HPV vaccine, were able to read and comprehend English, and had consented for participation through Amazon Mechanical Turk. After they completed the baseline survey (T0), participants were randomly assigned to two study conditions. The intervention group (n = 104) watched the “What is HPV?” video, and the control group (n = 111) read the CDC HPV Fact Sheet. Both groups then completed a post-intervention survey (T1). The analysis results show that the vaccination intent among participants in the intervention group significantly increased following the intervention (59.6% to 71.2%), while vaccination intent significantly decreased for the control group (65.8% to 55%) following the intervention. The results also show a significant difference in the changes in vaccination intent for the two intervention groups. The most change in vaccination intent following the intervention came from the group who was undecided in the initial survey. The findings of the study suggested that a brief HPV educational video that provides the most updated evidence while using non-stigmatizing language and tone has the potential to increase young adults’ vaccination intent to prevent HPV-related cancers and diseases. The findings also suggested that effective HPV education is key to combating negative attitudes and misinformation about HPV vaccines.

Introduction. Human papillomavirus (HPV) is the most common sexually transmitted infections globally. HPV is responsible for several health concerns including genital warts, cancer of the cervix, vulva, penis, anus, and oropharynx. In China, HPV infection accounts for 69.1% of invasive cervical cancer. Currently, there is no treatment for HPV infection, but HPV vaccination has been proven to be effective against HPV-related diseases. Given the highest rate of contracting HPV and suboptimal vaccination rate in college students including international students in the U.S., it is important to investigate key factors associated with vaccine uptake among Chinese international students. Purpose. This study aimed to investigate knowledge and awareness of HPV and the vaccine, attitudes, and vaccination intention in this population. We conducted a cross-sectional online survey via REDCap. Methods. Participants who were (1) Chinese international student at Arizona State University; (2) 18 and older; (3) able to read, speak and write in Chinese or English were recruited from Arizona State University. Descriptive statistics (mean, standard deviation, frequency) and inferential statistics (Chi-square test, independent t-test) were conducted using SPSS 26.0. Results. One hundred and ten participants were included in this study (56.4% female, mean age = 24, SD = 3.7). Female students had significantly higher HPV vaccination rate than males (p = 0.000). The mean knowledge score was 8.09 (SD = 1.35); female students were more likely to receive HPV education than males (p = 0.001). The most common source of education was friends (50.7%). Three most common perceived risks were not being sexually active, being male, and not having any physical signs and symptoms. The three most common facilitators were infection prevention, access to vaccination, and ability to afford vaccination. The three most common barriers were the cost, safety, and efficacy of HPV vaccine. In conclusion, gender disparities exist among Chinese<br/>international students’ HPV vaccine uptake and HPV related education. Implication. Although Chinese international students possess moderate to high level of knowledge about HPV and HPV vaccines, they lack education from credible sources. Culturally and gender appropriate education is needed in order to address barriers of getting HPV vaccination.