The effectiveness of a religiously framed HPV vaccination message among Christian parents of unvaccinated adolescents in the United States

Background: The uptake of the human papillomavirus (HPV) vaccines has been controversial among religious parents due to beliefs that their children are expected to practice sexual purity and so do not need protection from a sex-related infection. Also, if at all they get infected in the future, God can protect them from sickness without a vaccine. Yet, most HPV vaccination messages are secular, lacking spiritual themes. This study compared the effectiveness of the Centers for Disease Control and Prevention (CDC) Vaccine Information Statement (VIS) on HPV with our intervention message- a scripture-embedded HPV vaccination message (using a randomized controlled trial design) on vaccination intention. Methods: The study was conducted online. Participants were 342 Christian parents (from any denomination) of unvaccinated adolescents aged 11-17 years. The intervention message used the Cognitive Metaphor Theory to map the constructs of the Biblical story of Noah and the Ark to HPV vaccination. We framed Noah as the parents, the flood as HPV, and the ark as the vaccination. Multiple linear regression was used to analyze the changes in vaccination intention before and after the intervention. Results: Our findings showed that parents who received the scripture-embedded message reported a higher intention to vaccinate their children than those who received the CDC VIS (β= 0.31, 95% confidence interval [95%CI] = 0.11-0.52; p=0.003). Conclusion: Our findings support the need for equitable messaging regarding HPV vaccination. Faith-based messaging interventions that seek to increase HPV vaccination should be framed to address religious anti-vaccination beliefs