Human papillomavirus (HPV) affects nearly 85% of sexually active adults during their lifetime and is responsible for HPV-related cancers in both males and females. Although the HPV vaccine can prevent up to 90% of these cancers, vaccination rates remain low, particularly among college students. Recently, video has emerged as a powerful intervention for shaping public opinion and behaviour toward health-related topics; however, most interventions have primarily focused on adolescents, their parents and females. The primary objective of this study is to develop a video-based intervention, informed by input from a diverse group of stakeholders and evaluate its preliminary effectiveness in promoting HPV vaccination intention, attitudes toward vaccination, subjective norms, perceived behavioural control (PBC) and uptake of the first HPV vaccine dose among college students through a randomised controlled trial (RCT).
The study is guided by the Theory of Planned Behaviour. A Student Advisory Board of eight college students was established to provide insights and guidance across all phases, including the co-development of HPV and HPV vaccine-related videos with faculty mentors. A pilot RCT will then be conducted in which participants in the intervention group view the stakeholder-created videos, while those in the control group watch four Centers for Disease Control and Prevention (CDC)-based videos of comparable length and content. The effectiveness of the videos will be compared by measuring participants’ intentions, attitudes, subjective norms and PBC regarding the HPV vaccine between the intervention and control groups at baseline, immediately after the intervention and 2 months after implementing the intervention. The uptake of the first dose of the HPV vaccine will be assessed at the 2-month time point. Moderators, including message fatigue and processing fluency, participants’ satisfaction and intervention dose as well as confounding variables such as provider recommendation and encouragement will also be measured. A research team member responsible for data management and analysis will be blinded to the study condition/group allocation, while another team member will send reminder texts.
Ethical approval from the Michigan State University’s Biomedical and Health Institutional Review Board has been obtained (Study ID: STUDY00010264). The results will be disseminated to the broader public through public forums, social media and seminars organised by the college health centre, community resource centre and local health departments. Additionally, the findings will be shared with healthcare professionals through professional training and meetings, and with researchers via conferences and publications.
14 March 2025 submitted. Revised manuscript—V.1 27 September 2025.
Human papillomavirus (HPV) is a major global health concern linked to cancers. Although a safe and effective vaccine exists, HPV vaccination rates are still low among Asian American and Pacific Islander (AAPI) populations. Barriers such as limited awareness, cultural stigma and systemic inequities contribute to this gap. This systematic review and meta-analysis aims to compile current evidence on HPV vaccination behaviours and related factors among AAPIs to help develop culturally tailored interventions and public health strategies.
This review will include descriptive and correlational studies (quantitative, qualitative and mixed methods), examining HPV vaccination intention or uptake among AAPI populations in the USA from inception to December 2024. Randomised controlled trials and intervention studies will be excluded. Databases to be searched include PubMed, CINAHL, PsycINFO and Cochrane. Study screening, data extraction and quality assessment will be conducted independently by three reviewers using standardised tools. Risk of bias in non-randomised studies will be assessed using Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I), and the Critical Appraisal Skills Programme (CASP) checklist will be used for qualitative studies. Quantitative findings will be synthesised narratively and, where appropriate, through meta-analysis using random-effects models. Qualitative themes will be synthesised to contextualise quantitative results.
Ethics approval is not required for this protocol as it does not involve primary data collection. Findings will be disseminated via peer-reviewed publications and conference presentations. Findings of this systematic review and meta-analysis will provide critical insights for promoting HPV vaccination and reducing HPV-related cancer disparities among AAPIs.
CRD420251008431.