CClinicalTrials.gg
CompletedNCT06738355Updated Jun 5, 2026

PREVENT Pilot HPV - Related Cancers Trial

An interventional study of PREVENT in HPV Vaccination, Uptake Vaccination and Series Completion, sponsored by University of Utah. Completed at 1 site in United States. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-06-05.

Sponsored by University of Utah · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
335
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study will serve as one of the first to develop and test the effectiveness of strategies to promote HPV vaccination among diverse rural parents and caregivers of children ages 9-17 years in the Mountain West. Once implemented into practice, our intervention could significantly reduce disparities in the burden of HPV-associated cancers among rural populations in the United States.

The proposed study will assess the feasibility of clinic-based outreach to increase vaccination rates for HPV at four community clinics in rural counties in Washington.

Read the detailed description

This is a randomized, pilot study two human papillomavirus (HPV) vaccination patient reminder intervention arms that will take place in rural clinics operated by Sea Mar Community Health Centers.

The PREVENT PILOT study will administer a three-arm, patient-randomized controlled trial that will assess the feasibility of clinic-based outreach to increase vaccination rates. The study arms will consist of automated reminders, automated plus live reminders, and usual care. Parents/caregivers of children and adolescents selected for the trial will be chosen using established study criteria applied to the electronic health records linked to state immunization registries. As a minimal-risk study, for the intervention only, the investigators will apply for a waiver of informed consent. The PILOT study will be delivered as part of standard care, and patients will be unaware they are in the trial. Delivered vaccination messages will include opt-out choices.

Parents/caregivers (P/C) of children and adolescents (C/A) will be sent any number of reminders to encourage parents to obtain an HPV vaccine for their age-eligible C/A. Reminders may include text messages, automated phone calls, mailed letters, live calls, or patient navigation. Reminders will be delivered by a vendor (automated reminders) or clinic staff (live reminders). Reminders will be delivered in English and Spanish, and interpreter services may be used for live reminders to the small proportion of patients who speak languages other than English or Spanish.

The primary objective of this pilot study is the feasibility of the trial, which will be assessed by the number of patients randomized to the study intervention. Other secondary outcome measures include the correctness of the randomization, successful receipt of a text message intervention, the proportion of participants who responded to the text intervention, and the proportion of participants who were successfully contacted.

During active study recruitment, the investigators will convene a meeting of our data safety monitor board every six months. The investigators will disseminate study findings and research products in accordance with our dissemination plan. The study findings will serve as a basis for a larger multi-level trial of HPV vaccination in rural communities.

02

Conditions studied

  • HPV Vaccination
  • Uptake Vaccination
  • Series Completion

Keywords

  • Humans
  • Adolescent
  • Child
  • Male
  • Female
  • Caregivers
  • Parents
  • Hispanic or Latino
  • Rural Population
  • Health Personnel
  • United States
  • Vaccination
  • Papillomavirus Vaccines
  • Papillomavirus Vaccines / administration & dosage
  • Human Papillomavirus Viruses
  • Papillomavirus Infections
  • Papillomavirus Infections / prevention & control
  • Cancer / prevention & control
  • Incidence
  • Text Messaging
  • Reminder Systems / instrumentation
  • Social Norms
  • Vaccination Refusal
  • Health Knowledge, Attitudes, Practice
  • Health Promotion / methods
  • Motivation
  • Communication
  • Patient Acceptance of Health Care
  • Parents / education
  • Religion
  • Religiosity
  • Stakeholder Participation
  • Participatory Approach
  • Qualitative Research
  • Quantitative Research
  • Randomized Control Trial
  • Surveys and Questionnaires
03

In context

Papillomavirus Infections

495 studies on the registry are indexed under Papillomavirus Infections; 125 are open to participants now.

This study's enrollment of 335 is above the median of 202 across 332 interventional studies indexed under Papillomavirus Infections.

Browse Papillomavirus Infections studies →

Lead sponsor

University of Utah is the lead sponsor of 969 studies on the registry; 178 are open to participants now.

Of its 107 completed or terminated interventional studies of FDA-regulated products, 62 (58%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  1. Parents/Caregivers (P/C) of children/adolescents (C/A) ages 9-17 years of age (i.e., age-eligible for HPV vaccination);
  2. P/C with active clinic patients (i.e., have been seen in the clinic in the last 12 months); and
  3. P/C who speak either English or Spanish.

Exclusion criteria

Exclusion Criteria:

  1. P/C of C/A with previous excluding HPV vaccination history (e.g., completed vaccination, or not due);
  2. P/C of C/A with clinical conditions that influence the CDC HPV vaccination recommendations (e.g., pregnancy);
  3. P/C of C/A with other factors that would influence CDC HPV recommendations; and
  4. P/C that does not speak Spanish or English.
05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Sequential assignment
Masking
Double (Participant, Care provider)
Enrollment
335 participants (actual)

Study arms

  • Experimental
    Automated Intervention (Auto)

    Auto intervention participants will be eligible for outreach delivered using automated phone calls, text, or email messages with the mode, frequency, timing of reminders, and message content. Automated outreach may also include innovative communication strategies, such as text-linked videos, P/C, or patient narratives. Auto outreach to P/C will invite P/Cs to attend free HPV vaccination visits and emphasize family-friendly hours.

    Behavioral: PREVENT

  • Experimental
    Automated Intervention Plus (Auto-Plus)

    Auto-Plus intervention participants will be eligible for automated reminders, plus additional P/C prompts for patients who do not undergo vaccination within three weeks. These prompts may be delivered via live phone call outreach or patient navigation. Activities selected from a list of possible options from the National HPV Vaccination Roundtable and our ranking of the effectiveness of language- and culturally-tailored intervention materials.

    Behavioral: PREVENT

  • No intervention
    Usual Care (UC)

    The UC group will not receive tailored reminders but will only receive opportunistic vaccine reminders that are delivered during clinic visits or MyChart EHR-based patient portal reminders.

Interventions

  • BehavioralPREVENT

    The proposed study will assess the feasibility of an RCT for clinic-based outreach to increase vaccination rates for HPV at community clinics in rural counties. The study is a pilot trial that will assign adult parent/caregiver participants to a timeline for receiving the vaccination messaging intervention. Auto and Auto-Plus intervention arms may use some of the same components (automated calls, live calls, text messages, emails, and mailings).

06

What researchers measure

Primary outcomes

  1. Number of Participants Correctly Randomized

    To assess the feasibility of the study intervention. This outcome measure will report the count of participants who were correctly randomized according to the study protocol.

    Time frame: up to 1 day after randomization

Secondary outcomes

  1. Number of Participants Who Responded to the Text Intervention

    To assess the feasibility of the study intervention. This outcome measure will report the number of participants who responded to the text-based intervention, as defined by the study protocol.

    Time frame: up to 1 month after randomization

  2. Proportion of Participants Successfully Contacted

    To assess the feasibility of the study intervention. This outcome measure will report the proportion of participants who were successfully contacted out of the total number of attempted contacts.

    Time frame: up to 1 day

07

Study locations

1 site
  • Sea Mar Community Health Centers
    Seattle, Washington 98108, United States
08

References and documents

Publications

  • Saslow D, Andrews KS, Manassaram-Baptiste D, Loomer L, Lam KE, Fisher-Borne M, Smith RA, Fontham ET; American Cancer Society Guideline Development Group. Human papillomavirus vaccination guideline update: American Cancer Society guideline endorsement. CA Cancer J Clin. 2016 Sep;66(5):375-85. doi: 10.3322/caac.21355. Epub 2016 Jul 19. PubMed 27434803 ↗
  • Tabak RG, Duggan K, Smith C, Aisaka K, Moreland-Russell S, Brownson RC. Assessing Capacity for Sustainability of Effective Programs and Policies in Local Health Departments. J Public Health Manag Pract. 2016 Mar-Apr;22(2):129-37. doi: 10.1097/PHH.0000000000000254. PubMed 25946700 ↗
  • Brownson RC, Reis RS, Allen P, Duggan K, Fields R, Stamatakis KA, Erwin PC. Understanding administrative evidence-based practices: findings from a survey of local health department leaders. Am J Prev Med. 2014 Jan;46(1):49-57. doi: 10.1016/j.amepre.2013.08.013. PubMed 24355671 ↗
  • Shea CM, Jacobs SR, Esserman DA, Bruce K, Weiner BJ. Organizational readiness for implementing change: a psychometric assessment of a new measure. Implement Sci. 2014 Jan 10;9:7. doi: 10.1186/1748-5908-9-7. PubMed 24410955 ↗
  • Wutich A, Bernard HR. Sharing qualitative data & analysis. With whom and how widely?: A response to 'Promises and pitfalls of data sharing in qualitative research'. Soc Sci Med. 2016 Nov;169:199-200. doi: 10.1016/j.socscimed.2016.09.041. Epub 2016 Sep 30. No abstract available. PubMed 27720554 ↗
  • Patton MQ. Qualitative research and evaluation methods. Thousand Oaks, CA: Sage Publications, Inc.; 2002
  • Malterud K, Siersma VD, Guassora AD. Sample Size in Qualitative Interview Studies: Guided by Information Power. Qual Health Res. 2016 Nov;26(13):1753-1760. doi: 10.1177/1049732315617444. Epub 2016 Jul 10. PubMed 26613970 ↗
  • Silverman D. Qualitative Research: A practical handbook. Thousand Oaks, CA: Sage Publications, Inc.; 2010.
  • Nonzee NJ, Baldwin SB, Cui Y, Singhal R. Disparities in parental human papillomavirus (HPV) vaccine awareness and uptake among adolescents. Vaccine. 2018 Feb 28;36(10):1243-1247. doi: 10.1016/j.vaccine.2017.08.046. Epub 2017 Sep 28. PubMed 28967520 ↗
  • Choi Y, Eworuke E, Segal R. What explains the different rates of human papillomavirus vaccination among adolescent males and females in the United States? Papillomavirus Res. 2016 Dec;2:46-51. doi: 10.1016/j.pvr.2016.02.001. Epub 2016 Mar 4. PubMed 29074185 ↗
  • Warner EL, Ding Q, Pappas L, Bodson J, Fowler B, Mooney R, Kirchhoff AC, Kepka D. Health Care Providers' Knowledge of HPV Vaccination, Barriers, and Strategies in a State With Low HPV Vaccine Receipt: Mixed-Methods Study. JMIR Cancer. 2017 Aug 11;3(2):e12. doi: 10.2196/cancer.7345. PubMed 28801303 ↗
  • Garcia AA, Zuniga JA, Lagon C. A Personal Touch: The Most Important Strategy for Recruiting Latino Research Participants. J Transcult Nurs. 2017 Jul;28(4):342-347. doi: 10.1177/1043659616644958. Epub 2016 Apr 25. PubMed 27114390 ↗
  • Kim SY, Chen S, Hou Y, Zeiders KH, Calzada EJ. Parental socialization profiles in Mexican-origin families: Considering cultural socialization and general parenting practices. Cultur Divers Ethnic Minor Psychol. 2019 Jul;25(3):439-450. doi: 10.1037/cdp0000234. Epub 2018 Nov 1. PubMed 30382707 ↗
  • Coronado GD, Petrik A, Spofford M, Talbot J, Do HH, Sanchez J, Kapka T, Taylor V. Perceptions of under and overutilization of cervical cancer screening services at Latino-serving community health centers. J Community Health. 2013 Oct;38(5):915-8. doi: 10.1007/s10900-013-9701-1. PubMed 23728821 ↗
  • Jackson ML, Henrikson NB, Grossman DC. Evaluating Washington State's immunization information system as a research tool. Acad Pediatr. 2014 Jan-Feb;14(1):71-6. doi: 10.1016/j.acap.2013.10.002. PubMed 24369871 ↗
  • Maneesriwongul W, Dixon JK. Instrument translation process: a methods review. J Adv Nurs. 2004 Oct;48(2):175-86. doi: 10.1111/j.1365-2648.2004.03185.x. PubMed 15369498 ↗
  • Centers for Disease Control and Prevention. Human Papillomavirus (HPV). Educational Materials. Available from: https://www.cdc.gov/hpv/hcp/educational-materials.html.
  • Moorhead SA, Hazlett DE, Harrison L, Carroll JK, Irwin A, Hoving C. A new dimension of health care: systematic review of the uses, benefits, and limitations of social media for health communication. J Med Internet Res. 2013 Apr 23;15(4):e85. doi: 10.2196/jmir.1933. PubMed 23615206 ↗
  • Pew Research Center. Mobile Fact Sheet. Available from: https://www.pewresearch.org/internet/fact-sheet/mobile/
  • Tiro JA, Sanders JM, Pruitt SL, Stevens CF, Skinner CS, Bishop WP, Fuller S, Persaud D. Promoting HPV Vaccination in Safety-Net Clinics: A Randomized Trial. Pediatrics. 2015 Nov;136(5):850-9. doi: 10.1542/peds.2015-1563. Epub 2015 Oct 19. PubMed 26482674 ↗
  • Calo WA, Gilkey MB, Malo TL, Robichaud M, Brewer NT. A content analysis of HPV vaccination messages available online. Vaccine. 2018 Nov 26;36(49):7525-7529. doi: 10.1016/j.vaccine.2018.10.053. Epub 2018 Oct 23. PubMed 30366803 ↗
  • Nan X, Madden K, Richards A, Holt C, Wang MQ, Tracy K. Message Framing, Perceived Susceptibility, and Intentions to Vaccinate Children Against HPV Among African American Parents. Health Commun. 2016 Jul;31(7):798-805. doi: 10.1080/10410236.2015.1005280. Epub 2015 Dec 8. PubMed 26646190 ↗
  • Mroz S, Zhang X, Williams M, Conlon A, LoConte NK. Working to Increase Vaccination for Human Papillomavirus: A Survey of Wisconsin Stakeholders, 2015. Prev Chronic Dis. 2017 Sep 28;14:E85. doi: 10.5888/pcd14.160610. PubMed 28957034 ↗
  • Thompson JH, Davis MM, Michaels L, Rivelli JS, Castillo ML, Younger BM, Castro M, Reich SL, Coronado GD. Developing Patient-Refined Messaging for a Mailed Colorectal Cancer Screening Program in a Latino-Based Community Health Center. J Am Board Fam Med. 2019 May-Jun;32(3):307-317. doi: 10.3122/jabfm.2019.03.180026. PubMed 31068395 ↗
  • National Heart Lung and Blood Institute. Research dissemination and implementation (R18) grants2011 01/09/2012. Available from: http://www.nhlbi.nih.gov/funding/policies/dissemination&implementationR18.htm.
  • Glasgow RE, Klesges LM, Dzewaltowski DA, Estabrooks PA, Vogt TM. Evaluating the impact of health promotion programs: using the RE-AIM framework to form summary measures for decision making involving complex issues. Health Educ Res. 2006 Oct;21(5):688-94. doi: 10.1093/her/cyl081. Epub 2006 Aug 31. PubMed 16945984 ↗
  • Glasgow RE, Wagner EH, Schaefer J, Mahoney LD, Reid RJ, Greene SM. Development and validation of the Patient Assessment of Chronic Illness Care (PACIC). Med Care. 2005 May;43(5):436-44. doi: 10.1097/01.mlr.0000160375.47920.8c. PubMed 15838407 ↗
  • Glasgow RE, Ory MG, Klesges LM, Cifuentes M, Fernald DH, Green LA. Practical and relevant self-report measures of patient health behaviors for primary care research. Ann Fam Med. 2005 Jan-Feb;3(1):73-81. doi: 10.1370/afm.261. PubMed 15671195 ↗
  • Glasgow RE, Klesges LM, Dzewaltowski DA, Bull SS, Estabrooks P. The future of health behavior change research: what is needed to improve translation of research into health promotion practice? Ann Behav Med. 2004 Feb;27(1):3-12. doi: 10.1207/s15324796abm2701_2. PubMed 14979858 ↗
  • National Cancer Institute. How do RE-AIM elements relate to planning? 2011 01/05/2012. Available from: http://cancercontrol.cancer.gov/IS/reaim/faq.html#define.
  • Glasgow RE. RE-AIMing research for application: ways to improve evidence for family medicine. J Am Board Fam Med. 2006 Jan-Feb;19(1):11-9. doi: 10.3122/jabfm.19.1.11. PubMed 16492000 ↗
  • Thompson JH, Davis MM, Leo MC, Schneider JL, Smith DH, Petrik AF, Castillo M, Younger B, Coronado GD. Participatory Research to Advance Colon Cancer Prevention (PROMPT): Study protocol for a pragmatic trial. Contemp Clin Trials. 2018 Apr;67:11-15. doi: 10.1016/j.cct.2018.02.001. Epub 2018 Feb 9. PubMed 29408304 ↗
  • Westfall JM, Zittleman L, Sutter C, Emsermann CB, Staton EW, Van Vorst R, Dickinson LM; Community Advisory Council. Testing to prevent colon cancer: results from a rural community intervention. Ann Fam Med. 2013 Nov-Dec;11(6):500-7. doi: 10.1370/afm.1582. PubMed 24218373 ↗
  • Norman N, Bennett C, Cowart S, Felzien M, Flores M, Flores R, Haynes C, Hernandez M, Rodriquez MP, Sanchez N, Sanchez S, Winkelman K, Winkelman S, Zittleman L, Westfall JM. Boot camp translation: a method for building a community of solution. J Am Board Fam Med. 2013 May-Jun;26(3):254-63. doi: 10.3122/jabfm.2013.03.120253. PubMed 23657693 ↗
  • Satcher, D. (2005). Methods in community-based participatory research for health. John Wiley & Sons.
  • SeaMar Community Health Centers (Clinica de la Comunidad). Report to the Community2018 02/26/2019. Available from: https://seamar.org/seamar-downloads/Annual-Report2018.pdf
  • Coronado GD, Golovaty I, Longton G, Levy L, Jimenez R. Effectiveness of a clinic-based colorectal cancer screening promotion program for underserved Hispanics. Cancer. 2011 Apr 15;117(8):1745-54. doi: 10.1002/cncr.25730. Epub 2010 Nov 8. PubMed 21472722 ↗
  • Edwards BK, Ward E, Kohler BA, Eheman C, Zauber AG, Anderson RN, Jemal A, Schymura MJ, Lansdorp-Vogelaar I, Seeff LC, van Ballegooijen M, Goede SL, Ries LA. Annual report to the nation on the status of cancer, 1975-2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer. 2010 Feb 1;116(3):544-73. doi: 10.1002/cncr.24760. PubMed 19998273 ↗
  • Parker E, Margolis LH, Eng E, Henriquez-Roldan C. Assessing the capacity of health departments to engage in community-based participatory public health. Am J Public Health. 2003 Mar;93(3):472-6. doi: 10.2105/ajph.93.3.472. PubMed 12604498 ↗
  • Thompson B, Coronado G, Snipes SA, Puschel K. Methodologic advances and ongoing challenges in designing community-based health promotion programs. Annu Rev Public Health. 2003;24:315-40. doi: 10.1146/annurev.publhealth.24.100901.140819. Epub 2001 Nov 6. PubMed 12471272 ↗
  • University of Washington. Developing and Sustaining Community Based Participatory Research Partnerships: A Skill Building Curriculum2012 04/21/2012 Available from: http://depts.washington.edu/ccph/cbpr/u1/u11.php.
  • University of Washington School of Public Health and Community Medicine. Community-based research principles. Available from: http://sphcm.washington.edu/research/community.htm.
  • Byrd TL, Wilson KM, Smith JL, Coronado G, Vernon SW, Fernandez-Esquer ME, Thompson B, Ortiz M, Lairson D, Fernandez ME. AMIGAS: a multicity, multicomponent cervical cancer prevention trial among Mexican American women. Cancer. 2013 Apr 1;119(7):1365-72. doi: 10.1002/cncr.27926. Epub 2012 Dec 21. PubMed 23280399 ↗
  • Thompson B, Carosso EA, Jhingan E, Wang L, Holte SE, Byrd TL, Benavides MC, Lopez C, Martinez-Gutierrez J, Ibarra G, Gonzalez VJ, Gonzalez NE, Duggan CR. Results of a randomized controlled trial to increase cervical cancer screening among rural Latinas. Cancer. 2017 Feb 15;123(4):666-674. doi: 10.1002/cncr.30399. Epub 2016 Oct 27. PubMed 27787893 ↗
  • Duggan C, Coronado G, Martinez J, Byrd TL, Carosso E, Lopez C, Benavides M, Thompson B. Cervical cancer screening and adherence to follow-up among Hispanic women study protocol: a randomized controlled trial to increase the uptake of cervical cancer screening in Hispanic women. BMC Cancer. 2012 May 6;12:170. doi: 10.1186/1471-2407-12-170. PubMed 22559251 ↗
  • Coronado GD, Rivelli JS, Fuoco MJ, Vollmer WM, Petrik AF, Keast E, Barker S, Topalanchik E, Jimenez R. Effect of Reminding Patients to Complete Fecal Immunochemical Testing: A Comparative Effectiveness Study of Automated and Live Approaches. J Gen Intern Med. 2018 Jan;33(1):72-78. doi: 10.1007/s11606-017-4184-x. Epub 2017 Oct 10. PubMed 29019046 ↗
  • Coronado GD, Burdick T, Petrik A, Kapka T, Retecki S, Green B. Using an Automated Data-driven, EHR-Embedded Program for Mailing FIT kits: Lessons from the STOP CRC Pilot Study. J Gen Pract (Los Angel). 2014 Jan 5;2:1000141. doi: 10.4172/2329-9126.1000141. PubMed 25411657 ↗
  • Kepka DL, Ulrich AK, Coronado GD. Low knowledge of the three-dose HPV vaccine series among mothers of rural Hispanic adolescents. J Health Care Poor Underserved. 2012 May;23(2):626-35. doi: 10.1353/hpu.2012.0040. PubMed 22643612 ↗
  • Kepka DL, Coronado GD, Rodriguez HP, Thompson B. Development of a radionovela to promote HPV vaccine awareness and knowledge among Latino parents. Public Health Rep. 2012 Jan-Feb;127(1):130-8. doi: 10.1177/003335491212700118. No abstract available. PubMed 22298937 ↗
  • Ayres S, Gee A, Kim S, Hashibe M, Praag A, Kaiser D, Chang CP, Brandt HM, Kepka D. Human Papillomavirus Vaccination Knowledge, Barriers, and Recommendations Among Healthcare Provider Groups in the Western United States. J Cancer Educ. 2022 Dec;37(6):1816-1823. doi: 10.1007/s13187-021-02047-6. Epub 2021 Jul 8. PubMed 34236651 ↗
  • Brandt HM, Kepka D, Kirchhoff AC, Daniel CL, Bhatt NS. Human papillomavirus (HPV) vaccination is cancer prevention for childhood cancer survivors. Cancer. 2022 Jan 15;128(2):237-239. doi: 10.1002/cncr.33920. Epub 2021 Oct 4. PubMed 34606629 ↗
  • Kepka D, Christini K, McGough E, Wagner A, Del Fiol G, Gibson B, Ayres S, Brandt HM, Mann S, Petrik AF, Coronado GD. Successful Multi-Level HPV Vaccination Intervention at a Rural Healthcare Center in the Era of COVID-19. Front Digit Health. 2021 Aug 19;3:719138. doi: 10.3389/fdgth.2021.719138. eCollection 2021. PubMed 34713184 ↗
  • Kepka D, Ding Q, Bodson J, Warner EL, Mooney K. Latino Parents' Awareness and Receipt of the HPV Vaccine for Sons and Daughters in a State with Low Three-Dose Completion. J Cancer Educ. 2015 Dec;30(4):808-12. doi: 10.1007/s13187-014-0781-0. PubMed 25572463 ↗
  • Warner EL, Lai D, Carbajal-Salisbury S, Garza L, Bodson J, Mooney K, Kepka D. Latino Parents' Perceptions of the HPV Vaccine for Sons and Daughters. J Community Health. 2015 Jun;40(3):387-94. doi: 10.1007/s10900-014-9949-0. PubMed 25269400 ↗
  • Kepka D, Warner EL, Kinney AY, Spigarelli MG, Mooney K. Low human papillomavirus (HPV) vaccine knowledge among Latino parents in Utah. J Immigr Minor Health. 2015 Feb;17(1):125-31. doi: 10.1007/s10903-014-0003-1. PubMed 24609357 ↗
  • Warner EL, Ding Q, Pappas LM, Henry K, Kepka D. White, affluent, educated parents are least likely to choose HPV vaccination for their children: a cross-sectional study of the National Immunization Study - teen. BMC Pediatr. 2017 Dec 1;17(1):200. doi: 10.1186/s12887-017-0953-2. PubMed 29191180 ↗
  • Islam JY, Gruber JF, Kepka D, Kunwar M, Smith SB, Rothholz MC, Brewer NT, Smith JS. Pharmacist insights into adolescent human papillomavirus vaccination provision in the United States. Hum Vaccin Immunother. 2019;15(7-8):1839-1850. doi: 10.1080/21645515.2018.1556077. Epub 2019 Feb 6. PubMed 30550369 ↗
  • Elam-Evans LD, Yankey D, Singleton JA, Sterrett N, Markowitz LE, Williams CL, Fredua B, McNamara L, Stokley S. National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13-17 Years - United States, 2019. MMWR Morb Mortal Wkly Rep. 2020 Aug 21;69(33):1109-1116. doi: 10.15585/mmwr.mm6933a1. PubMed 32817598 ↗
  • Vogelaar I, van Ballegooijen M, Schrag D, Boer R, Winawer SJ, Habbema JD, Zauber AG. How much can current interventions reduce colorectal cancer mortality in the U.S.? Mortality projections for scenarios of risk-factor modification, screening, and treatment. Cancer. 2006 Oct 1;107(7):1624-33. doi: 10.1002/cncr.22115. PubMed 16933324 ↗
  • Hopfer S, Garcia S, Duong HT, Russo JA, Tanjasiri SP. A Narrative Engagement Framework to Understand HPV Vaccination Among Latina and Vietnamese Women in a Planned Parenthood Setting. Health Educ Behav. 2017 Oct;44(5):738-747. doi: 10.1177/1090198117728761. Epub 2017 Aug 30. PubMed 28854812 ↗
  • Szilagyi PG, Humiston SG, Gallivan S, Albertin C, Sandler M, Blumkin A. Effectiveness of a citywide patient immunization navigator program on improving adolescent immunizations and preventive care visit rates. Arch Pediatr Adolesc Med. 2011 Jun;165(6):547-53. doi: 10.1001/archpediatrics.2011.73. PubMed 21646588 ↗
  • Vanderpool RC, Stradtman LR, Brandt HM. Policy opportunities to increase HPV vaccination in rural communities. Hum Vaccin Immunother. 2019;15(7-8):1527-1532. doi: 10.1080/21645515.2018.1553475. Epub 2019 Jan 4. PubMed 30608894 ↗
  • Brandt HM, Pierce JY, Crary A. Increasing HPV vaccination through policy for public health benefit. Hum Vaccin Immunother. 2016 Jun 2;12(6):1623-5. doi: 10.1080/21645515.2015.1122145. Epub 2015 Dec 15. PubMed 26669416 ↗
  • Khuwaja SS, Peck JL. Increasing HPV Vaccination Rates Using Text Reminders: An Integrative Review of the Literature. J Pediatr Health Care. 2022 Jul-Aug;36(4):310-320. doi: 10.1016/j.pedhc.2022.02.001. Epub 2022 Mar 11. PubMed 35288016 ↗
  • Francis DB, Cates JR, Wagner KPG, Zola T, Fitter JE, Coyne-Beasley T. Communication technologies to improve HPV vaccination initiation and completion: A systematic review. Patient Educ Couns. 2017 Jul;100(7):1280-1286. doi: 10.1016/j.pec.2017.02.004. Epub 2017 Feb 6. PubMed 28209248 ↗
  • Hou SI, Fernandez ME, Parcel GS. Development of a cervical cancer educational program for Chinese women using intervention mapping. Health Promot Pract. 2004 Jan;5(1):80-7. doi: 10.1177/1524839903257311. PubMed 14965438 ↗
  • Byrd TL, Wilson KM, Smith JL, Heckert A, Orians CE, Vernon SW, Fernandez-Esquer ME, Fernandez ME. Using intervention mapping as a participatory strategy: development of a cervical cancer screening intervention for Hispanic women. Health Educ Behav. 2012 Oct;39(5):603-11. doi: 10.1177/1090198111426452. Epub 2012 Mar 1. PubMed 22388451 ↗
  • Fernandez ME, Gonzales A, Tortolero-Luna G, Partida S, Bartholomew LK. Using intervention mapping to develop a breast and cervical cancer screening program for Hispanic farmworkers: Cultivando La Salud. Health Promot Pract. 2005 Oct;6(4):394-404. doi: 10.1177/1524839905278810. PubMed 16210681 ↗
  • Warner EL, Fowler B, Martel L, Kepka D. Improving HPV Vaccination Through a Diverse Multi-state Coalition. J Community Health. 2017 Oct;42(5):911-920. doi: 10.1007/s10900-017-0334-7. PubMed 28393294 ↗
  • Bartholomew LK, Parcel GS, Kok G. Intervention mapping: a process for developing theory- and evidence-based health education programs. Health Educ Behav. 1998 Oct;25(5):545-63. doi: 10.1177/109019819802500502. PubMed 9768376 ↗
  • Paskett ED, Krok-Schoen JL, Pennell ML, Tatum CM, Reiter PL, Peng J, Bernardo BM, Weier RC, Richardson MS, Katz ML. Results of a Multilevel Intervention Trial to Increase Human Papillomavirus (HPV) Vaccine Uptake among Adolescent Girls. Cancer Epidemiol Biomarkers Prev. 2016 Apr;25(4):593-602. doi: 10.1158/1055-9965.EPI-15-1243. PubMed 27196093 ↗
  • Fridman A, Gershon R, Gneezy A. COVID-19 and vaccine hesitancy: A longitudinal study. PLoS One. 2021 Apr 16;16(4):e0250123. doi: 10.1371/journal.pone.0250123. eCollection 2021. PubMed 33861765 ↗
  • Santibanez TA, Singleton JA, Santibanez SS, Wortley P, Bell BP. Socio-demographic differences in opinions about 2009 pandemic influenza A (H1N1) and seasonal influenza vaccination and disease among adults during the 2009-2010 influenza season. Influenza Other Respir Viruses. 2013 May;7(3):383-92. doi: 10.1111/j.1750-2659.2012.00374.x. Epub 2012 May 9. PubMed 22568588 ↗
  • Arda B, Durusoy R, Yamazhan T, Sipahi OR, Tasbakan M, Pullukcu H, Erdem E, Ulusoy S. Did the pandemic have an impact on influenza vaccination attitude? A survey among health care workers. BMC Infect Dis. 2011 Apr 7;11:87. doi: 10.1186/1471-2334-11-87. PubMed 21473763 ↗
  • Halperin BA, MacKinnon-Cameron D, McNeil S, Kalil J, Halperin SA. Maintaining the momentum: key factors influencing acceptance of influenza vaccination among pregnant women following the H1N1 pandemic. Hum Vaccin Immunother. 2014;10(12):3629-41. doi: 10.4161/21645515.2014.980684. PubMed 25668670 ↗
  • Quinn SC, Parmer J, Freimuth VS, Hilyard KM, Musa D, Kim KH. Exploring communication, trust in government, and vaccination intention later in the 2009 H1N1 pandemic: results of a national survey. Biosecur Bioterror. 2013 Jun;11(2):96-106. doi: 10.1089/bsp.2012.0048. Epub 2013 Apr 25. PubMed 23617721 ↗
  • Meyer AF, Borkovskiy NL, Brickley JL, Chaudhry R, Franqueira A, Furst JW, Hinsch DM, McDonah MR, Myers JF, Petersen RE, Finney Rutten LJ, Wilson PM, Jacobson RM. Impact of Electronic Point-of-Care Prompts on Human Papillomavirus Vaccine Uptake in Retail Clinics. Am J Prev Med. 2018 Dec;55(6):822-829. doi: 10.1016/j.amepre.2018.06.027. Epub 2018 Oct 19. PubMed 30344033 ↗
  • Henrikson NB, Zhu W, Baba L, Nguyen M, Berthoud H, Gundersen G, Hofstetter AM. Outreach and Reminders to Improve Human Papillomavirus Vaccination in an Integrated Primary Care System. Clin Pediatr (Phila). 2018 Nov;57(13):1523-1531. doi: 10.1177/0009922818787868. Epub 2018 Jul 13. PubMed 30003794 ↗
  • Larson HJ, Clarke RM, Jarrett C, Eckersberger E, Levine Z, Schulz WS, Paterson P. Measuring trust in vaccination: A systematic review. Hum Vaccin Immunother. 2018 Jul 3;14(7):1599-1609. doi: 10.1080/21645515.2018.1459252. Epub 2018 May 10. PubMed 29617183 ↗
  • Karafillakis E, Simas C, Jarrett C, Verger P, Peretti-Watel P, Dib F, De Angelis S, Takacs J, Ali KA, Pastore Celentano L, Larson H. HPV vaccination in a context of public mistrust and uncertainty: a systematic literature review of determinants of HPV vaccine hesitancy in Europe. Hum Vaccin Immunother. 2019;15(7-8):1615-1627. doi: 10.1080/21645515.2018.1564436. Epub 2019 Feb 20. PubMed 30633623 ↗
  • Holman DM, Benard V, Roland KB, Watson M, Liddon N, Stokley S. Barriers to human papillomavirus vaccination among US adolescents: a systematic review of the literature. JAMA Pediatr. 2014 Jan;168(1):76-82. doi: 10.1001/jamapediatrics.2013.2752. PubMed 24276343 ↗
  • Fu LY, Bonhomme LA, Cooper SC, Joseph JG, Zimet GD. Educational interventions to increase HPV vaccination acceptance: a systematic review. Vaccine. 2014 Apr 7;32(17):1901-20. doi: 10.1016/j.vaccine.2014.01.091. Epub 2014 Feb 14. PubMed 24530401 ↗
  • Succi RCM. Vaccine refusal - what we need to know. J Pediatr (Rio J). 2018 Nov-Dec;94(6):574-581. doi: 10.1016/j.jped.2018.01.008. Epub 2018 Apr 12. PubMed 29654748 ↗
  • Saxena K, Marden JR, Carias C, Bhatti A, Patterson-Lomba O, Gomez-Lievano A, Yao L, Chen YT. Impact of the COVID-19 pandemic on adolescent vaccinations: projected time to reverse deficits in routine adolescent vaccination in the United States. Curr Med Res Opin. 2021 Dec;37(12):2077-2087. doi: 10.1080/03007995.2021.1981842. Epub 2021 Oct 4. PubMed 34538163 ↗
  • Ryan G, Gilbert PA, Ashida S, Charlton ME, Scherer A, Askelson NM. Challenges to Adolescent HPV Vaccination and Implementation of Evidence-Based Interventions to Promote Vaccine Uptake During the COVID-19 Pandemic: "HPV Is Probably Not at the Top of Our List". Prev Chronic Dis. 2022 Mar 31;19:E15. doi: 10.5888/pcd19.210378. PubMed 35358035 ↗
  • Patel Murthy B, Zell E, Kirtland K, Jones-Jack N, Harris L, Sprague C, Schultz J, Le Q, Bramer CA, Kuramoto S, Cheng I, Woinarowicz M, Robison S, McHugh A, Schauer S, Gibbs-Scharf L. Impact of the COVID-19 Pandemic on Administration of Selected Routine Childhood and Adolescent Vaccinations - 10 U.S. Jurisdictions, March-September 2020. MMWR Morb Mortal Wkly Rep. 2021 Jun 11;70(23):840-845. doi: 10.15585/mmwr.mm7023a2. PubMed 34111058 ↗
  • Santoli JM, Lindley MC, DeSilva MB, Kharbanda EO, Daley MF, Galloway L, Gee J, Glover M, Herring B, Kang Y, Lucas P, Noblit C, Tropper J, Vogt T, Weintraub E. Effects of the COVID-19 Pandemic on Routine Pediatric Vaccine Ordering and Administration - United States, 2020. MMWR Morb Mortal Wkly Rep. 2020 May 15;69(19):591-593. doi: 10.15585/mmwr.mm6919e2. PubMed 32407298 ↗
  • Ateev Mehrotra et al., The Impact of COVID-19 on Outpatient Visits in 2020: Visits Remained Stable, Despite a Late Surge in Cases (Commonwealth Fund, Feb. 2021)
  • Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19). For Healthcare Professionals. Preserve Supplies. https://www.cdc.gov/coronavirus/2019-ncov/hcp/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fhealthcare-facilities%2Findex.html
  • Mann S, Christini K, Chai Y, Chang CP, Hashibe M, Kepka D. Vaccine hesitancy and COVID-19 immunization among rural young adults. Prev Med Rep. 2022 Aug;28:101845. doi: 10.1016/j.pmedr.2022.101845. Epub 2022 Jun 2. PubMed 35669235 ↗
  • Bar-On YM, Flamholz A, Phillips R, Milo R. SARS-CoV-2 (COVID-19) by the numbers. Elife. 2020 Apr 2;9:e57309. doi: 10.7554/eLife.57309. PubMed 32228860 ↗
  • Piltch-Loeb R, Silver DR, Kim Y, Norris H, McNeill E, Abramson DM. Determinants of the COVID-19 vaccine hesitancy spectrum. PLoS One. 2022 Jun 1;17(6):e0267734. doi: 10.1371/journal.pone.0267734. eCollection 2022. PubMed 35648748 ↗
  • Williams CL, Walker TY, Elam-Evans LD, Yankey D, Fredua B, Saraiya M, Stokley S. Factors associated with not receiving HPV vaccine among adolescents by metropolitan statistical area status, United States, National Immunization Survey-Teen, 2016-2017. Hum Vaccin Immunother. 2020 Mar 3;16(3):562-572. doi: 10.1080/21645515.2019.1670036. Epub 2019 Oct 25. PubMed 31584312 ↗
  • Uva JL, Wagner VL, Gesten FC. Emergency department reliance among rural children in Medicaid in New York State. J Rural Health. 2012 Spring;28(2):152-61. doi: 10.1111/j.1748-0361.2011.00377.x. Epub 2011 Apr 27. PubMed 22458316 ↗
  • DeGuzman PB, Huang G, Lyons G, Snitzer J, Keim-Malpass J. Rural Disparities in Early Childhood Well Child Visit Attendance. J Pediatr Nurs. 2021 May-Jun;58:76-81. doi: 10.1016/j.pedn.2020.12.005. Epub 2020 Dec 25. PubMed 33370620 ↗
  • Zablotsky B, Black LI. Prevalence of Children Aged 3-17 Years With Developmental Disabilities, by Urbanicity: United States, 2015-2018. Natl Health Stat Report. 2020 Feb;(139):1-7. PubMed 32510313 ↗
  • Walker TY, Elam-Evans LD, Yankey D, Markowitz LE, Williams CL, Fredua B, Singleton JA, Stokley S. National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13-17 Years - United States, 2018. MMWR Morb Mortal Wkly Rep. 2019 Aug 23;68(33):718-723. doi: 10.15585/mmwr.mm6833a2. PubMed 31437143 ↗
  • Glenn BA, Tsui J, Coronado GD, Fernandez ME, Savas LS, Taylor VM, Bastani R. Understanding HPV vaccination among Latino adolescent girls in three U.S. regions. J Immigr Minor Health. 2015 Feb;17(1):96-103. doi: 10.1007/s10903-014-9996-8. PubMed 24557745 ↗
  • Mohammed KA, Subramaniam DS, Geneus CJ, Henderson ER, Dean CA, Subramaniam DP, Burroughs TE. Rural-urban differences in human papillomavirus knowledge and awareness among US adults. Prev Med. 2018 Apr;109:39-43. doi: 10.1016/j.ypmed.2018.01.016. Epub 2018 Jan 31. PubMed 29378268 ↗
  • Shell R, Tudiver F. Barriers to cancer screening by rural Appalachian primary care providers. J Rural Health. 2004 Fall;20(4):368-73. doi: 10.1111/j.1748-0361.2004.tb00051.x. PubMed 15551854 ↗
  • Peterson CE, Silva A, Holt HK, Balanean A, Goben AH, Dykens JA. Barriers and facilitators to HPV vaccine uptake among US rural populations: a scoping review. Cancer Causes Control. 2020 Sep;31(9):801-814. doi: 10.1007/s10552-020-01323-y. Epub 2020 Jun 14. PubMed 32537702 ↗
  • Casey MM, Thiede Call K, Klingner JM. Are rural residents less likely to obtain recommended preventive healthcare services? Am J Prev Med. 2001 Oct;21(3):182-8. doi: 10.1016/s0749-3797(01)00349-x. PubMed 11567838 ↗
  • Yabroff KR, Lawrence WF, King JC, Mangan P, Washington KS, Yi B, Kerner JF, Mandelblatt JS. Geographic disparities in cervical cancer mortality: what are the roles of risk factor prevalence, screening, and use of recommended treatment? J Rural Health. 2005 Spring;21(2):149-57. doi: 10.1111/j.1748-0361.2005.tb00075.x. PubMed 15859052 ↗
  • Koopman RJ, Mainous AG 3rd, Geesey ME. Rural residence and Hispanic ethnicity: doubly disadvantaged for diabetes? J Rural Health. 2006 Winter;22(1):63-8. doi: 10.1111/j.1748-0361.2006.00009.x. PubMed 16441338 ↗
  • United States Department of Agriculture. Rural America At a Glance: 2018 Edition. Economic Research Service. Economic Information Bulletin 200. November 2018.
  • Newcomer SR, Freeman RE, Albers AN, Murgel S, Thaker J, Rechlin A, Wehner BK. Missed opportunities for human papillomavirus vaccine series initiation in a large, rural U.S. state. Hum Vaccin Immunother. 2022 Jan 31;18(1):2016304. doi: 10.1080/21645515.2021.2016304. Epub 2022 Feb 4. PubMed 35119342 ↗
  • Centers for Disease Control and Prevention. Human Papillomavirus (HPV). Cancers Caused by HPV. . Available from: https://www.cdc.gov/hpv/parents/cancer.html
  • Kepka D, Spigarelli MG, Warner EL, Yoneoka Y, McConnell N, Balch A. Statewide analysis of missed opportunities for human papillomavirus vaccination using vaccine registry data. Papillomavirus Res. 2016 Dec;2:128-132. doi: 10.1016/j.pvr.2016.06.002. PubMed 27540595 ↗
  • Centers for Disease Control and Prevention. HPV-Associated Cancers Rates by Race and Ethnicity. 2019. Atlanta
  • Bruno DM, Wilson TE, Gany F, Aragones A. Identifying human papillomavirus vaccination practices among primary care providers of minority, low-income and immigrant patient populations. Vaccine. 2014 Jul 16;32(33):4149-54. doi: 10.1016/j.vaccine.2014.05.058. Epub 2014 Jun 2. PubMed 24886959 ↗
  • Katz ML, Reiter PL, Heaner S, Ruffin MT, Post DM, Paskett ED. Acceptance of the HPV vaccine among women, parents, community leaders, and healthcare providers in Ohio Appalachia. Vaccine. 2009 Jun 19;27(30):3945-52. doi: 10.1016/j.vaccine.2009.04.040. Epub 2009 May 3. PubMed 19389447 ↗
  • Vanderpool RC, Dressler EV, Stradtman LR, Crosby RA. Fatalistic beliefs and completion of the HPV vaccination series among a sample of young Appalachian Kentucky women. J Rural Health. 2015 Spring;31(2):199-205. doi: 10.1111/jrh.12102. Epub 2015 Jan 14. PubMed 25640763 ↗
  • Blumling AA, Thomas TL, Stephens DP. Researching and Respecting the Intricacies of Isolated Communities. Online J Rural Nurs Health Care. 2013;13(2):Blumling. PubMed 24817833 ↗
  • Head KJ, Vanderpool RC, Mills LA. Health care providers' perspectives on low HPV vaccine uptake and adherence in Appalachian Kentucky. Public Health Nurs. 2013 Jul;30(4):351-60. doi: 10.1111/phn.12044. Epub 2013 Apr 8. PubMed 23808860 ↗
  • Henley SJ, Anderson RN, Thomas CC, Massetti GM, Peaker B, Richardson LC. Invasive Cancer Incidence, 2004-2013, and Deaths, 2006-2015, in Nonmetropolitan and Metropolitan Counties - United States. MMWR Surveill Summ. 2017 Jul 7;66(14):1-13. doi: 10.15585/mmwr.ss6614a1. PubMed 28683054 ↗
  • Centers for Disease Control and Prevention. TeenVaxView. Vaccination Coverage among Adolescents (13 - 17 Years). . Available from: https://www.cdc.gov/vaccines/imz-managers/coverage/teenvaxview/data-reports/index.html
  • U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. Healthy People 2030. Increase the proportion of adolescents who get recommended doses of the HPV vaccine - IID-08. Available from: https://health.gov/healthypeople/objectives-and-data/browse-objectives/vaccination/increase-proportion-adolescents-who-get-recommended-doses-hpv-vaccine-iid-08.
  • Centers for Disease Control and Prevention. How Many Cancers Are Linked with HPV Each Year? Available from: https://www.cdc.gov/cancer/hpv/statistics/cases.htm.

Individual participant data

Plan to share: Undecided — A plan for sharing IDP that maintains participant anonymity has not yet been developed.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 5, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06738355
Lead sponsor
University of Utah
Collaborators
Kaiser Permanente, University of Arizona, Sea Mar Community Health Centers, National Cancer Institute (NCI)
Responsible party
Sponsor
First posted
Dec 17, 2024
Start date
May 17, 2025
Primary completion
Aug 12, 2025
Completion
Aug 12, 2025
Last update
Jun 5, 2026

Study contacts

Deanna Kepka, PhD, MPH
principal investigator · Study Principal Investigator

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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