Development of a Behavioral Intervention, Increasing HPV Vaccine Uptake-Delivered in Dental Settings (HPV Vaccine Uptake-DDS).
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We developed a behavioral intervention designed to address barriers faced by dental practitioners promoting the Human Papillomavirus vaccine to eligible patients. Guided by the Behavior Change Wheel; our approach included a rapid literature review and interviews with dental practitioners to identify and understand these barriers. We then applied the Capability, Opportunity, Motivation and Behavior model and the Theoretical Domains Framework to identify and specify draft intervention functions which were mapped to the Behavior Change Technique Taxonomy. These functions target key barriers, in particular, lack of knowledge of HPV/HPV vaccine, lack of self-efficacy to promote the HPV vaccine, and fears about potential negative consequences of doing so. To assess initial acceptability of our intervention and inform refinements, we surveyed parents/guardians of vaccine-eligible patients under age 18, as well as vaccine-eligible patients aged 18-26. We also conducted stakeholder conversations and timed the delivery of the intervention. The final HPV Vaccine Uptake-DDS intervention includes didactic training, scripted text and tailored messages embedded within a clinical decision support (CDS) tool designed for chairside use, and performance feedback to practitioners. Preliminary findings suggest the intervention is time-efficient and acceptable to practitioners and patients/parents/guardians. Although funding for our real-world efficacy trial has been cut, we are committed to securing support for such a trial. If HPV Vaccine Uptake-DDS is demonstrated to be effective, it could lead to greater HPV vaccine uptake thereby contributing to the prevention of oropharyngeal cancers.