||5R21CA238170-02 Interpret this number
||Cincinnati Childrens Hosp Med Ctr
||Increasing HPV Vaccination Rates Through Virtual Immersive Communication Training on Recommending Immunizations: an Efficacy Study of Victori
Despite strong evidence the human papillomavirus (HPV) vaccine is effective in preventing certain anogenital
cancers, only 69% of adolescent females and 63% of males in the U.S. have initiated the series. Research has
demonstrated that the leading predictor of parents’ decision to vaccinate their child against HPV is a strong
recommendation from physicians. Recent interventions have focused on improving physicians’
recommendations through education about national recommendations via presentations, webinars, electronic health record
alerts, and quality improvement incentives. Despite the rigorous and innovative methods used, these studies
have resulted in variable effects, perhaps, in part, because of the lack of immersive, deliberate practice of
communicating vaccine recommendations. Our research team’s long-term goal is to increase HPV vaccination
rates in adolescents, which will decrease rates of HPV-associated cancers and pre-cancers. The objective of
this application is to evaluate the effectiveness of a novel virtual reality intervention, Virtual Immersive
Communication Training on Recommending Immunizations (VICTORI), designed to enhance the strength of
physicians’ HPV vaccine recommendations through deliberate practice. We will evaluate whether VICTORI
improves HPV vaccine initiation and completion rates among 11 to 17-year-old patients, as well as improves
physicians’ HPV vaccine attitudes, self-efficacy, and strength of recommendation. Our hypothesis is that the
implementation of VICTORI will be positively associated with an increase in vaccine initiation and completion rates,
and that this association will be mediated by improvements in physician attitudes, self-efficacy, and strength of
recommendation. The rationale for the proposed research is that an evaluation of VICTORI will inform effective
and scalable strategies to train physicians to provide strong vaccine recommendations, resulting in increased
HPV vaccine rates and ultimately lower rates of HPV-associated cancers. To achieve our objective, we will
accomplish these specific aims: (1) evaluate VICTORI for acceptability and feasibility, and (2) conduct a single-
site intervention assessing the efficacy of VICTORI in increasing HPV vaccine rates. The proposed research is
significant because it is the first step in determining the effect of deliberate practice using virtual reality
simulations to increase HPV vaccine initiation and completion rates. The approach is innovative because it is the first
rigorous effort to develop and evaluate the efficacy of virtual reality as a training platform to teach best-practice
communication skills related to HPV vaccine counseling. The expected outcome of this work is successful
implementation of VICTORI, designed to increase strong HPV vaccination recommendations by physicians,
which in turn will increase HPV vaccination rates.
Impact of a Virtual Reality Curriculum on Human Papillomavirus Vaccination: A Pilot Trial.
, Ollberding N.J.
, Meisman A.R.
, DeBlasio D.J.
, Pero M.B.
, Davis D.
, Cruse B.
, Klein M.D.
, Kahn J.A.
, Rosen B.L.
American journal of preventive medicine, 2022 Nov; 63(5), p. 865-873.
Usability matters for virtual reality simulations teaching communication.
, Meisman A.
, Rosen B.L.
Medical education, 2020 Nov; 54(11), p. 1067-1068.