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150. Evaluation of a novel mHealth tool to promote adolescent vaccination: The Vaccine Information for Teens App (VITA)

      Purpose

      Adolescent vaccination uptake goals are far from being met for several recommended vaccines, and, particularly, for HPV vaccine. Lack of knowledge about the vaccine and poor communication skills among vaccine providers pose a challenge to vaccine discussions, leading to poor uptake. Mobile health (mHealth) interventions have been shown to improve vaccine communication and increase vaccine uptake, but tools have not been explicitly designed to facilitate more effective patient-clinician communication at the point of care in the clinical setting. To address this need, we developed an innovative and interactive mobile app, the Vaccine Information for Teens App (VITA). The goal of this study was to pilot test and refine the VITA prototype and assess its acceptability for use in a primary care setting.

      Methods

      Semi-structured qualitative interviews were conducted with adolescents aged 11-17 years, parents, and clinicians, from 5 different pediatric primary care practices in New Haven, Connecticut. Participants were given access to VITA via mobile device or on the web through an URL or QR code. Interviews that explored perspectives on VITA were recorded, transcribed, and analyzed by two researchers using an iteratively developed codebook via the software Dedoose. Codes were organized into categories to uncover themes. Usability testing with adolescents and parents involved both qualitative and quantitative assessment by completing the following tasks: 1) Determine needed vaccines for specified age; 2) Access more information about a vaccine. The level of difficulty was scaled from 1 (very difficult) to 7 (very easy). Participants’ confidence in adolescent vaccination was also measured via the Vaccine Confidence Scale (VCS).

      Results

      The sample comprised 4 adolescents, 3 parents, 2 hospital-based clinicians, and 4 private practice clinicians. Adolescents were 75% males with a median age of 14 years; 33% of clinicians identified as females. The mean VCS score was 8.75+1.51 for parents and 7.53 +0.83 for adolescents. The major themes included: 1) usability of the app: participants found the app simple and user-friendly. However, some clinicians were concerned about the level of information and infographics for patients with low literacy. 2) early access to vaccine information: reviewing vaccine information in advance could improve patient-centered communication and agenda-setting. 3) adolescent participation: VITA empowers adolescents to discuss vaccines and overall health. 4) impact on vaccine uptake: it may serve as a time-saving supplemental resource to enhance understanding of vaccines and address specific concerns. Three adolescents and one parent completed the usability testing, which demonstrated a 75% success rate with Task 1 compared to 25% with Task 2, suggestive of potential challenges with app navigation.

      Conclusions

      The use of VITA may be acceptable and beneficial in the clinical setting allowing both clinicians and families to have more productive and efficient vaccine discussions. While the impact on vaccine-hesitant populations is less clear, it may enhance vaccine supporters’ confidence in their decision-making. Future work optimizing the app and assessing its acceptability in routine primary care and telehealth is needed.

      Sources of Support

      National Institute of Health/National Institute of Child Health and Human Development.