Engaging Communities in Preventing Human Papillomavirus-Related Cancers: Two Boot Camp Translations, Colorado, 2017-2018

"Community members are interested in learning more about HPV vaccination and in actively participating in message development for cancer prevention and other important public health topics."

Given persistent low human papillomavirus (HPV) vaccination rates, lack of knowledge, and attitudinal barriers, engaging people in developing community-specific messages that increase knowledge and encourage HPV vaccination could have the potential to address local concerns, be more culturally acceptable, increase risk perception, and spark discussions about vaccination. Carried out in Colorado, United States (US), the project detailed in this paper used Boot Camp Translation (BCT), a community-engaged translational research process for developing community-specific messages to increase HPV vaccination rates.

Designed to improve local uptake of evidence-based practices, BCT involves a diverse group of 10 to 12 community members who learn about the scientific evidence on a health topic and strategise together how to translate that evidence into messages for the local community. Following a kick-off meeting that includes an expert presentation on the topic, participants brainstorm to extract the essential concepts in current evidence and create a draft of key messages. Soon after the kick-off, a series of telephone and in-person meetings are held to refine messages, develop and design messaging materials, and plan dissemination within the community.

Reinforcing the idea that public health messages should be locally generated, discussions after an informational presentation differed between the 2 participating Colorado communities:

• The Mesa County group believed that vaccine hesitancy in Mesa County partially stemmed from the understanding of HPV as a sexually transmitted infection (STI) that young adolescents would not be exposed to yet. They focused on 2 populations: (i) parents of vaccine-eligible children aged 9-14 years - tagline developed was: "Don't let 'We'll wait' turn into 'too late'."; and (ii) young adults - tagline developed was: "Adulting is hard; cancer prevention is not". The group identified posters, social media, and educational materials for paediatric primary care settings as venues to deliver their messages.
• The Denver metropolitan area (Denver metro) group emphasised 2 barriers to HPV vaccination in their communities: that HPV information for parents is lacking, and that many preteens have insufficient health insurance. They focused on parents of children aged 8-13 with low health literacy and reduced access to health care. Rather than develop a tagline, the group integrated messages into an infographic of photographic images and text to explain the vaccine and call the selected audience to action. Delivery tactics for that group are social media venues and print education materials, including refrigerator magnets, to remind parents about follow-up dosing. This group agreed that messages would be most effective when delivered by peers in community locations that are frequented by parents, such as recreation centres, churches, food banks, and schools.

Messages for both groups direct readers to the #HPVFreeCO website.

The researchers conclude that messages developed through processes like BCT, which explores and incorporates community perspectives and voice, can be more accepted and effective than messages developed without community input. They argue that the effectiveness of messages developed through community-engaged approaches like BCT to increase HPV vaccination rates should be evaluated, which they plan to do.