Asian Journal of Research in Nursing and Health

Aims: To develop a developmentally and gender appropriate game-based intervention to promote Human Papillomavirus (HPV) vaccination in adolescents.

Study Design:  Qualitative interview.

Place and Duration of Study: Participants were recruited from communities in Arizona, United States in 2019.

Methodology: Sample: eight parent-child dyads representing different adolescent’s gender (4 boys, 4 girls aged 11-14) and racial/ethnic groups in the U.S. were recruited through purposive sampling. After receiving consents and assents, we conducted semi-structured interviews (60-90 minutes each) with each dyad at a quiet and private room. Each dyad received $50 for their time and effort. The interview questions consisted of two parts: (a) questions related to game design, functioning, and feasibility of implementation; (b) questions related to theoretical constructs of the Health Belief Model and the Theory of Planned Behavior. The interviews were audio recorded with permission, transcribed into textual data, and analyzed using NVivo 12. We organized data and developed themes based on the theories and game design/development categories. Three researchers reviewed the results and discussed the discrepancies until reaching a consensus.

Results: Our findings suggested that the most common motivating factors for adolescents’ HPV vaccination were vaccine effectiveness, benefits, convenience, affordable cost, provider’s recommendation, and reminder for the 2^nd shot. Recommendations for the game content and design: (1) Content: information about HPV and vaccine (e.g., consequences if infected, side effects of the vaccine), who, when and where to receive the vaccine. (2) Game design: 15 minutes or shorter, fighting/action storyline, option to choose characters/avatars, reward mechanism, and delivered by portable device (e.g., tablet).

Conclusion: Our findings inform a game-based intervention that incorporates key concepts of HPV and vaccine, and desired game features for adolescents and their parents. The long-term goal is to promote HPV vaccination in adolescents to prevent cancers.