#HPVFreeDC: Combining Peer Education and Social Media to Increase HPV Vaccination Rates Pilot
Amari Pearson-Fields, PhD, MPH1 and Tasha B. Moses, MPA2
1District
Background & Challenge
of Columbia Department of Health, Community Health Administration, Cancer and Chronic Disease Bureau, 2Strategic Management Solutions, LLC
Human papillomavirus (HPV) has been linked to the development of
anogenital cancers. According to the Centers for Disease Control and
Prevention (CDC), 96% of cervical cancers, 51% of vulvar, 64% of vaginal, 36%
of penile, 93% of anal and 63% of oropharyngeal cancers are linked to HPV.
These cancers are almost entirely preventable by administration of the HPV
vaccine. The District of Columbia (DC) was an early adopter of policies
mandating HPV vaccination for school attendance. NIS-Teen data for 2015
reported 76.5% of girls and 73.0% of boys received the 1st dose; 58.8% and
Goals & Objectives
The HPV Ambassador Program is a project of the DC Comprehensive Cancer Control
Program (CCCP) and the DC Cancer Action Partnership (CAP) that seeks to 1.) Accelerate
HPV vaccination uptake and compliance among youth ages 11-18 in DC and 2.) Empower
youth to discuss and convey the importance of getting vaccinated against HPV as a means
of preventing cancer with members of their peer group.
Project Overview
The CCCP and the CAP sought to implement a pilot intervention to increase demand for the HPV
vaccine among youth ages 11-18 in the District using a peer-to-peer and social media approach.
The program encompasses three components:
 A Peer-to-Peer Training Curriculum to train and empower youth ages 14-18 to educate and
discuss HPV, the vaccine and the importance of getting the vaccine to prevent cancer with
members of their peer group. The curriculum is comprised of five modules on HPV,
Correlation between HPV & Cancer, HPV Vaccines, Vaccine Safety Concerns and Community
Outreach.
 Trained HPV Ambassadors serve as the program’s “boots on the ground”. The HPV
Ambassadors will perform outreach to and engage their peers in a variety of settings.
 The #HPVFreeDC Social Media Campaign expands the program’s reach within those receiving
peer led education. Bandages with the logo #HPVFreeDC and HPV information cards with and
instructions on how to promote the hashtag are provided to Vaccines for Children (VFC)
providers.
This program, coupled with provider education, will create a synergistic impact leading increased
rates of HPV dose completion and reduced vaccination missed opportunities.
40.9% of girls and boys respectively received the 3rd dose. Although HPV
vaccination rates in DC are higher than the national average, the rates lag
behind other vaccines, suggesting that missed opportunities for HPV
vaccination exist. DC is testing an intervention to increase demand for the
HPV vaccine and dose completion among youth ages 11-18 using a peer-topeer education, outreach and social media approach. The HPV Ambassadors
Program intervention pilot will complement parental and provider targeted
interventions occurring in DC.
Methods
A STI-focused HPV curriculum was
adapted to apply a cancer prevention
frame. The curriculum includes five
modules on topics to include HPV and
Cancer, the HPV Vaccine, Vaccine Safety
Concerns and Community Outreach and
utilizes activities such as role-play
exercises, to reinforce concepts. Preand post-test evaluations are used to
gauge knowledge acquisition.
During Phase One of the project, two
pilot trainings have were held a total of
12 youth recruited to provide peer-topeer education within their sphere of
influence. Additionally, four VFC health
centers, representing more than 30
clinics, were recruited to distribute
#HPVFreeDC bandages and educational
materials encouraging social media
posts using #HPVFreeDC. Tracking was
established to monitor hashtag
utilization.
Phase One Results
Initial evaluation results from the pilot showed a
30% increase in knowledge acquisition as a result of
the training. After the training, participants stated
they felt prepared and excited to hit the field and
provide outreach to their friends, families and more
importantly, their peers. Further, participants who
had not received the vaccine prior to the training
expressed eagerness in being vaccinated.
Lessons Learned
Key lessons learned throughout the pilot phase
include:
• Collaborate with the Immunization registry to
target schools with low compliance and schoolbased health centers.
• Obtain buy-in from school staff and
administrators and work with them to plan
trainings and activities to coincide with school
schedules;
• Identify a champion to support program
promotion.
• Recruit youth that have already been trained in
as peer ambassadors. The knowledge base and
experience of these youth truncates timeframe
for implementation.
Next Steps
Acknowledgements
Phase Two of the pilot project will be used to address and build on lessons-learned during Phase One.
Phase Two evaluation will measure program success in increasing HPV dose completion and reducing
missed opportunities. Post-test and 6-month follow-up data on vaccine uptake will be collected from
youth trained as HPV Ambassadors. Additionally, data from 2016 school-based HPV vaccination
coverage and completion rates is being reviewed to establish a baseline from which to set goals for 2017
and beyond. Schools with low coverage and completion rates will be prioritized. DOH-managed school
based health centers at high schools with low compliance will be leveraged to increase vaccination. Data
from the immunization registry will be used to monitor vaccine increase for priority schools. VFC
provider “booster” trainings and provider vaccine usage feedback and assessment will be used to
improve clinical performance.
We gratefully acknowledge the curriculum developers
Romico Davis, Nicole Offer, Chidozie Onyima, Danyell S.
Wilson, PhD.
This project was supported by the Preventive Health and
Health Services Block Grant (1NB01OT009095-01), funded
by the Centers for Disease Control and Prevention (CDC).
Its contents are solely the responsibility of the authors and
do not necessarily represent the official views of the CDC
or the Department of Health and Human Services.