Awareness, knowledge, social norms, and vaccination intentions among Khmer mother-daughter pairs.

Cervical cancer is caused by human papillomavirus (HPV) infection, which can be prevented by vaccination. Mothers play an important role in promoting vaccination and health education. However, Cambodian American mothers reported to have challenges to play a role as primary health educators due to lack of health knowledge and language and cultural gaps. Therefore, this study aims to understand the Cambodian American daughters' and mothers' awareness, knowledge and social norms of HPV vaccination and their health communication and vaccination decision-making.We conducted a pilot randomized clinical trial to promote HPV vaccination. In this study, we have only reported findings from baseline data examining individual, interpersonal and social determinants of HPV vaccination behavior among 19 dyads of Cambodian American mothers and daughters.Both mothers and daughters demonstrated low levels of awareness and knowledge. A significant relationship was found between the daughters' HPV vaccine decisions and their perception of their mothers' intention on HPV vaccination for them.Culturally and linguistically appropriate communication strategies such as storytelling or visual presentation approaches may be more effective than the current practice of using information-based written materials to promote HPV vaccination and health education among Cambodian Americans.

Using narrative intervention for HPV vaccine behavior change among Khmer mothers and daughters: A pilot RCT to examine feasibility, acceptability, and preliminary effectiveness.

PURPOSE: To develop a theory-guided culturally grounded narrative intervention to promote HPV vaccination behavior and examine the feasibility, acceptability, and preliminary effectiveness of the intervention among dyads of Cambodian American mothers and daughters. METHOD: The principles of community-based participatory research guided the development and evaluation and involved two phases: Phase 1: Development of storytelling narrative intervention videos which focused on a series of HPV vaccination-related messages and which integrated the narrative theory with the revised network episode model (rNEM); Phase 2: conducting the pilot RCT with 19 dyads of Khmer mothers and daughters aged from 14 to 17years to examine the feasibility and acceptability of the study. FINDINGS: Recruitment was completed in 7months with an overall retention of 84%. The acceptability of the intervention was high, as reflected by the number of positive comments on the narrative video. Preliminary data indicate that vaccine uptake at one-month follow-up was the same (2 vs. 2) between intervention and control groups. However, daughters in the narrative intervention group reported higher intention to receive HPV vaccination within one month compared to the control group (4 vs. 1). CONCLUSION: All the procedures to inform a full RCT were examined, including identification of eligible participants, recruitment, randomization, intervention adherence, and short-term follow-up. The positive preliminary outcomes and feedback support the feasibility and potential effectiveness of the theory-guided narrative intervention.