Abstract
The objective of this review was to synthesize existing evidence on mobile health (mHealth) interventions geared at improving HPV related knowledge, HPV vaccination intent and HPV vaccination uptake. Between November and December 2019, systematic searches were performed in the databases PubMed, Ebsco/CINAHL, Ebsco/PsycINFO, and Clarivate Analytics/Web of Science Social Science Citation Index (SSCI). We identified 805 articles of which 92 were eligible for inclusion after abstract screening. 19 articles met the inclusion criteria of the review based on full article review and all but one of the included interventions were conducted in the United States. mHealth interventions ranged from text messages, phone calls to interactive voice recordings and software on tablets. All four interventions which attempted to improve HPV knowledge and vaccination intent, reported positive findings, however, only two interventions reported statistically significant improvements between intervention and control groups. 14 interventions reported an increase in HPV vaccination uptake and vaccination series completion among the intervention groups; including when mHealth interventions were compared to control groups or non-mHealth interventions. Some factors noted in the successful interventions included frequency of messages, combinations of multiple interventions including in-person education session, written educational materials, texts alongside call or emails; tailored messages as well as participant's intent to vaccinate at baseline. mHealth interventions potentially show promise as tools in improving short-term vaccination knowledge, intent, and uptake of HPV vaccination. There is however a need to refine components which can promote mHealth interventions' success as well as for the evaluation of such interventions in different contexts and over time.
Highlights
The Human Papillomavirus (HPV) is the most common sexually transmitted infection (STI) and most sexually active adults will contract this STI at some point in their lives (Forman et al, 2012)
We identified 805 ar ticles of which 92 were eligible for inclusion after abstract screening. 19 articles met the inclusion criteria of the review based on full article review and all but one of the included interventions were conducted in the United States. mobile health (mHealth) interventions ranged from text messages, phone calls to interactive voice recordings and soft ware on tablets
As countries attempt to address the low uptake of vaccinations, including HPV, there is a greater interest in digital technologies, including mHealth, as a possible solution (Dumit et al, 2018; Francis et al, 2017; Oliver-Williams et al, 2017a)
Summary
The Human Papillomavirus (HPV) is the most common sexually transmitted infection (STI) and most sexually active adults will contract this STI at some point in their lives (Forman et al, 2012). The virus has direct causal links to cancer of the cervix, vulva, vagina, anus, penis, and oropharynx (Marur et al, 2010; Munoz, 2000; zur Hausen, 2009, 1991). This link is well researched in the case of cervical cancer, where approximately 90% of cervical cancers are attributed to HPV infections (de Martel et al, 2017). By 2018, 81 countries had revised their immunization policies and integrated HPV vaccines into the national immunization program (WHO, 2018). While uptake is higher in high-income countries, which first implemented HPV vaccinations, reported rates still vary greatly between countries (Gallagher et al, 2018)
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