Development of the NowIKnow Mobile Application to Promote Completion of HPV Vaccine Series Among Young Adult Women

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Objective:To identify salient beliefs about human papillomavirus (HPV) vaccine completion among young adult women who live in economically disadvantaged urban communities and to describe the integration of those beliefs into the development of a mobile health (mHealth) application to promote vaccine completion.Design:Theory-based, community-informed, mHealth application development process.Setting:Two federally supported family planning clinics in a large metropolitan area in the Northeastern region of the United States.Participants:Thirty-five young adult women ages 18 to 26 years who lived in economically disadvantaged communities.Methods:Participants completed a baseline survey and postclinic survey after they received the first doses of the HPV vaccine. Results informed the content of the application with additional input from a community advisory board and provider advisory board.Results:One third of participants had prior sexually transmitted infections, but fewer than half used condoms during most recent intercourse. Most participants (n = 30 and 32 [86% and 91%]) had correct knowledge about HPV and cervical cancer, and most (n = 31, 89%) intended to get the next dose of the HPV vaccine. Twelve salient beliefs about HPV vaccine completion were identified and used to develop the NowIKnow mHealth application. The application includes information, motivational content, a discussion forum, and vaccine completion reminders.Conclusion:Theory-based research and user-centered design can be systematically integrated into the development of mHealth applications. With content tailored to the target population, use of this novel intervention has the potential to reduce cancer disparities by reaching disadvantaged young adult women.

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