International Journal of Behavioral Medicine

The Effects of Motivational Interviewing on Promoting Human Papillomavirus Vaccination Initiation and Completion Among South Asian Mother/Daughter Dyads: A Pilot Randomised Controlled Trial

Abstract Background Vaccination against HPV is an effective strategy for the prevention of HPV infection and cervical cancer. Nevertheless, the HPV vaccine uptake rate is low among ethnic minorities in Hong Kong. This study sought to assess the feasibility and acceptability of motivational interviewing among South Asian mother–daughter dyads and to preliminarily examine its effects on knowledge of HPV infection and vaccination, health beliefs, intention to have the daughters vaccinated, and initiation and completion of HPV vaccine series. Methods This was a pilot randomised controlled trial. Forty South Asian mothers with at least one daughter aged 9 to 17 years were recruited. The intervention group received a motivational interviewing intervention whereas the control group received usual care. Structured questionnaires were used to collect data on the participants’ characteristics and selected outcome variables. Bias-corrected Hedges’ g and rate difference together with their 95% confidence intervals were calculated to estimate the effect sizes of the intervention on the outcomes The acceptability was assessed via semi-structured interviews. Results A larger proportion of the daughters of the intervention group participants had received the first dose of HPV vaccine (95% [19 out of 20]) vs 0% [0 out of 20]). The intervention group showed greater improvement in knowledge at 3 months after the intervention (Hedges’ g = 0.77 (95%CI:0.13–1.41)). Most interviewees were satisfied with the intervention. Conclusion The intervention was feasible and acceptable. The intervention can help to increase South Asian mothers’ knowledge and to increase the initiation of HPV vaccine series by their daughters. Trial registration This study was registered at the Chinese Clinical Trial Registry (ChiCTR2100052751) on 5 November 2021.

Use of a Linguistically Appropriate Decision Aid for Cervical Cancer Screening of South Asian Ethnic Minority Women in Hong Kong: A Pilot Randomised Controlled Trial

Decision aids have been shown to be effective in assisting the decision-making process in healthcare settings. This study aimed to examine the feasibility and acceptability of a linguistically appropriate printed decision aid for cervical cancer screening in South Asian women and to preliminarily estimate its effects on decisional conflicts, clarity of values, risk perception, the screening decision and screening uptake. This was a pilot randomised controlled trial. Forty-eight South Asian women aged 25 to 64 years were recruited and allocated to either the intervention group or control group. The participants in the intervention group read a linguistically appropriate printed decision aid. All of the participants in the intervention group agreed that the decision aid was useful in aiding their decision-making. These participants showed significantly greater improvement in decisional conflicts, clarity of values and risk perceptions than those in the control group (all p < 0.05). The screening uptake rate was significantly higher in the intervention group than in the control group (p < 0.001). The decision aid was feasible and acceptable among South Asian women, and it resulted in reduced decisional conflict and increased screening uptake compared with usual care. To improve the convenience of using decision aids, they could be developed in various forms, such as printed and mobile application forms, to meet individual requirements. The trial was registered at the Chinese Clinical Trial Registry on 23 October 2021 (ChiCTR2100052225).

Increased Knowledge Mediates the Effect of Game Changers for Cervical Cancer Prevention on Diffusion of Cervical Cancer Screening Advocacy Among Social Network Members in a Pilot Trial

Abstract Background Game Changers for Cervical Cancer Prevention (GC-CCP), a peer-led, group advocacy training intervention, increased cervical cancer (CC) prevention advocacy not only among intervention recipients, but also their social network members (referred to as “alters”) who were targeted with advocacy in a pilot randomized controlled trial. We examined mediators and moderators of this effect on alter advocacy, to understand how and for whom the intervention had such an effect. Method Forty women (index participants) who had recently screened for CC enrolled and were randomly assigned to receive the GC-CCP intervention (n = 20) or the wait-list control (n = 20). Up to three alters from each participant (n = 103) were surveyed at baseline and month 6. Measures of CC-related cognitive constructs (knowledge, enacted stigma, and risk management self-efficacy), as well as extent of advocacy received from index participants, were assessed as mediators of the intervention effect on alter advocacy using multivariate regression analyses. Alter characteristics were examined as moderators. Results Increased CC-related knowledge partially mediated the intervention effect on increased alter engagement in CC prevention advocacy; those with greater gains in knowledge reported greater engagement in advocacy. No moderators of the intervention effect were identified. Conclusion The effect of GC-CCP on alter CC prevention advocacy is enhanced by increased alter knowledge pertaining to CC prevention, causes, and treatment and suggests this may be key for diffusion of intervention effects on increased CC prevention advocacy throughout a social network. Trial Registration NCT04960748 (registered on clinicaltrials.gov, 7/14/2021).

Refugee Women’s Receptiveness for Virtual Engagement on Reproductive Health During the COVID-19 Pandemic

Abstract Background Refugee women who leave their country due to persecution and violence have multiple barriers to sexual and reproductive health (SRH) services. The COVID-19 pandemic added an additional barrier to in-person reproductive health education, dialogue, and clinical care. This study aimed to assess the potential of using virtual group meetings as a forum for refugee women to learn about and discuss reproductive health concerns such as cervical cancer screening, family planning, childbirth, and postpartum care. Method We conducted semi-structured interviews with 36 refugee women and stakeholders to assess factors that impact refugee women’s receptiveness for virtual platforms to obtain information and engage in discussions on reproductive health. Thematic analysis was conducted using the software Dedoose. Results Openness to engage in virtual platforms varied by refugee community, women’s demographic, and life experience. The women’s involvement with local refugee groups facilitated their engagement with virtual platforms. Furthermore, individuals’ family structure and marital relationship, along with literacy and English proficiency, and access to and familiarity with technology impacted engagement. Virtual groups needed to mirror confidentiality and women expressed a strong preference that groups were all-women. Conclusion Refugee women are receptive to virtual groups on SRH when they are offered in a culturally appropriate manner that considers the living situations and access to technology after arrival to the USA. Findings from this study provide a framework to develop and tailor effective virtual or hybrid virtual-in-person programs for women in refugee communities.