{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T09:55:49Z","timestamp":1782899749322,"version":"3.54.5"},"reference-count":46,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T00:00:00Z","timestamp":1763251200000},"content-version":"unspecified","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"MSU Trifecta Facilitating Funds","award":["GA013811-TRIFC"],"award-info":[{"award-number":["GA013811-TRIFC"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,10,29]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"\n Introduction<\/jats:title>\n 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).<\/jats:p>\n <\/jats:sec>\n \n Methods and analysis<\/jats:title>\n 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\u2019 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\u2019 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.<\/jats:p>\n <\/jats:sec>\n \n Ethics and dissemination<\/jats:title>\n Ethical approval from the Michigan State University\u2019s 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.<\/jats:p>\n <\/jats:sec>\n \n Protocol version<\/jats:title>\n 14 March 2025 submitted. Revised manuscript\u2014V.1 27 September 2025.<\/jats:p>\n <\/jats:sec>\n \n Trial registration number<\/jats:title>\n \n NCT06397378<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-102235","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T05:40:40Z","timestamp":1763358040000},"page":"e102235","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Evaluating the preliminary effectiveness of a video-based intervention for HPV vaccination promotion among college students aged 18\u201326: study protocol for a pilot randomised controlled trial"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct06397378","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct06397378","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0774-8447","authenticated-orcid":false,"given":"ChengChing","family":"Liu","sequence":"first","affiliation":[{"name":"College of Nursing, Michigan State University, East Lansing, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela Chia-Chen","family":"Chen","sequence":"additional","affiliation":[{"name":"College of Nursing, Michigan State University, East Lansing, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Rhodes","sequence":"additional","affiliation":[{"name":"Department of Advertising and Public Relations, Michigan State University College of Communication Arts and Sciences, East Lansing, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Ewoldsen","sequence":"additional","affiliation":[{"name":"Department of Media and Information, Michigan State University College of Communication Arts and Sciences, East Lansing, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Arcoleo","sequence":"additional","affiliation":[{"name":"College of Nursing, Michigan State University, East Lansing, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,11,16]]},"reference":[{"key":"2025120413265353000_15.11.e102235.1","unstructured":"Centers for Disease Control and Prevention . Cancers caused by hpv. 2022. Available: https:\/\/www.cdc.gov\/hpv\/about\/cancers-caused-by-hpv.html"},{"key":"2025120413265353000_15.11.e102235.2","unstructured":"Centers for Disease Control and Prevention . Cancers Linked With HPV Each Year, 2025. Available: https:\/\/www.cdc.gov\/cancer\/hpv\/cases.html"},{"key":"2025120413265353000_15.11.e102235.3","unstructured":"Chesson H . Overview of Health Economic Models for HPV Vaccination of Mid-Adults in the United States, 2019. Available: https:\/\/medialibrary.uantwerpen.be\/oldcontent\/container39248\/files\/ANT307_Chesson_HPV_board_Overview%20of%20health%20economic%20models%20for%20hpv%20vaccination%20of%20mid%20adults.pdf"},{"key":"2025120413265353000_15.11.e102235.4","doi-asserted-by":"crossref","DOI":"10.1080\/21645515.2021.2016007","article-title":"Review of human papillomavirus (HPV) burden and HPV vaccination for gay, bisexual, and other men who have sex with men and transgender women in the United States","volume":"18","author":"Meites","year":"2022","journal-title":"Hum Vaccin Immunother"},{"key":"2025120413265353000_15.11.e102235.5","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1111\/phn.12893","article-title":"Review of Chinese young adults\u2019 human papillomavirus knowledge, attitudes, and vaccine acceptability","volume":"38","author":"Ou","year":"2021","journal-title":"Public Health Nurs"},{"key":"2025120413265353000_15.11.e102235.6","unstructured":"Centers for Disease Control and Prevention . Cancers caused by HPV are preventable, 2021. Available: https:\/\/www.cdc.gov\/hpv\/hcp\/protecting-patients.html"},{"key":"2025120413265353000_15.11.e102235.7","doi-asserted-by":"crossref","first-page":"2192","DOI":"10.1080\/07448481.2021.1965146","article-title":"Strategies to improve human papillomavirus (HPV) vaccination rates among college students","volume":"71","author":"Kessler","year":"2023","journal-title":"J Am Coll Health"},{"key":"2025120413265353000_15.11.e102235.8","doi-asserted-by":"crossref","first-page":"3090","DOI":"10.1080\/21645515.2021.1905469","article-title":"Human papillomavirus vaccine administration behaviors and influences among Arizona pharmacists and pharmacy interns","volume":"17","author":"Koskan","year":"2021","journal-title":"Hum Vaccin Immunother"},{"key":"2025120413265353000_15.11.e102235.9","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2023.56875","article-title":"Human Papillomavirus Vaccination Among Young Adults Before and During the COVID-19 Pandemic","volume":"7","author":"Sonawane","year":"2024","journal-title":"JAMA Netw Open"},{"key":"2025120413265353000_15.11.e102235.10","doi-asserted-by":"crossref","first-page":"466","DOI":"10.15585\/mmwr.mm7430a1","article-title":"Vaccination Coverage Among Adolescents Aged 13-17 Years - National Immunization Survey-Teen, United States, 2024","volume":"74","author":"Pingali","year":"2025","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025120413265353000_15.11.e102235.11","doi-asserted-by":"crossref","first-page":"2199","DOI":"10.1111\/jan.16575","article-title":"Effectiveness of Digital Education on Human Papillomavirus Knowledge, Vaccination Intent and Completion Rates in Adolescents and Young Adults: A Meta\u2010Analysis","volume":"81","author":"Sandi","year":"2025","journal-title":"J Adv Nurs"},{"key":"2025120413265353000_15.11.e102235.12","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0326694","article-title":"Organizational barriers in HPV vaccination uptake: A cross-sectional study among health sciences students","volume":"20","author":"Palena","year":"2025","journal-title":"PLoS One"},{"key":"2025120413265353000_15.11.e102235.13","doi-asserted-by":"crossref","DOI":"10.3390\/cancers17030344","article-title":"An Assessment of Young Adults\u2019 Awareness and Knowledge Related to the Human Papillomavirus (HPV), Oropharyngeal Cancer, and the HPV Vaccine","volume":"17","author":"Davis","year":"2025","journal-title":"Cancers (Basel)"},{"key":"2025120413265353000_15.11.e102235.14","doi-asserted-by":"crossref","DOI":"10.1186\/s12905-024-03279-6","article-title":"Evaluation of female university students\u2019 knowledge, attitudes, and practices toward human papillomavirus infection and vaccination. Multicenter cross-sectional study","volume":"24","author":"Mekonnen","year":"2024","journal-title":"BMC Womens Health"},{"key":"2025120413265353000_15.11.e102235.15","doi-asserted-by":"crossref","first-page":"3446","DOI":"10.1016\/j.vaccine.2017.05.025","article-title":"Prevalence of oral human papillomavirus by vaccination status among young adults (18\u201330 years old)","volume":"35","author":"Hirth","year":"2017","journal-title":"Vaccine (Auckl)"},{"key":"2025120413265353000_15.11.e102235.16","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0282811","article-title":"Maternal perceptions of vaccinating boys against human papillomavirus (HPV) in Seoul, South Korea: A descriptive exploratory qualitative study","volume":"18","author":"Choi","year":"2023","journal-title":"PLoS ONE"},{"key":"2025120413265353000_15.11.e102235.17","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0182266","article-title":"Human papillomavirus (HPV) vaccine knowledge, attitudes, and uptake in college students: Implications from the Precaution Adoption Process Model","volume":"12","author":"Barnard","year":"2017","journal-title":"PLoS One"},{"key":"2025120413265353000_15.11.e102235.18","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1177\/1090198119894589","article-title":"A Storytelling Intervention in a Mobile, Web-Based Platform: A Pilot Randomized Controlled Trial to Evaluate the Preliminary Effectiveness to Promote Human Papillomavirus Vaccination in Korean American College Women","volume":"47","author":"Kim","year":"2020","journal-title":"Health Educ Behav"},{"key":"2025120413265353000_15.11.e102235.19","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1176\/appi.ps.20240093","article-title":"Social Media\u2013Based Brief Video Interventions to Support Youths\u2019 Mental Health","volume":"76","author":"Amsalem","year":"2025","journal-title":"PS"},{"key":"2025120413265353000_15.11.e102235.20","doi-asserted-by":"crossref","first-page":"2586","DOI":"10.1080\/21645515.2020.1780846","article-title":"Social media and vaccine hesitancy: new updates for the era of COVID-19 and globalized infectious diseases","volume":"16","author":"Puri","year":"2020","journal-title":"Hum Vaccin Immunother"},{"key":"2025120413265353000_15.11.e102235.21","doi-asserted-by":"crossref","DOI":"10.1093\/heapro\/daaf023","article-title":"Social media and the spread of misinformation: infectious and a threat to public health","volume":"40","author":"Denniss","year":"2025","journal-title":"Health Promot Int"},{"key":"2025120413265353000_15.11.e102235.22","first-page":"1","article-title":"The Relation between Media Consumption and Misinformation at the Outset of the SARS-CoV-2 Pandemic in the US","volume":"1","author":"Jamieson","year":"2020","journal-title":"Harv Kennedy Sch Misinformation Rev"},{"key":"2025120413265353000_15.11.e102235.23","doi-asserted-by":"crossref","first-page":"8","DOI":"10.9734\/ajpr\/2021\/v7i130205","article-title":"Creditable Health Information? An Analysis of Human Papillomavirus Vaccine Messages on YouTube","volume":"7","author":"Chia-Chen Chen","year":"2021","journal-title":"AJPR"},{"key":"2025120413265353000_15.11.e102235.24","doi-asserted-by":"crossref","unstructured":"Walsh JP . Social media and moral panics: Assessing the effects of technological change on societal reaction. Int J Cult Stud 2020;23. doi:10.1177\/1367877920912257","DOI":"10.1177\/1367877920912257"},{"key":"2025120413265353000_15.11.e102235.25","unstructured":"Fox S . The social life of health information. Pew Internet and American Life Project, 2011. Available: http:\/\/www.pewinternet.org"},{"key":"2025120413265353000_15.11.e102235.26","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0267580","article-title":"A randomized controlled trial of a video intervention shows evidence of increasing COVID-19 vaccination intention","volume":"17","author":"Witus","year":"2022","journal-title":"PLoS ONE"},{"key":"2025120413265353000_15.11.e102235.27","doi-asserted-by":"crossref","unstructured":"Ajzen I . From intentions to action: a theory of planned behavior. In: Kuhl J , Beckmann J , eds. Action-control: from cognition to behavior. 1985: Springer\u2013Verlag. Available: https:\/\/doi.org\/10.1007\/978-3-642-69746-3_2","DOI":"10.1007\/978-3-642-69746-3_2"},{"key":"2025120413265353000_15.11.e102235.28","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1002\/hbe2.195","article-title":"The theory of planned behavior: Frequently asked questions","volume":"2","author":"Ajzen","year":"2020","journal-title":"Human Behav and Emerg Tech"},{"key":"2025120413265353000_15.11.e102235.29","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1016\/j.jiph.2020.04.009","article-title":"A longitudinal study using parental cognitions based on the theory of planned behavior to predict childhood influenza vaccination","volume":"13","author":"Wu","year":"2020","journal-title":"J Infect Public Health"},{"key":"2025120413265353000_15.11.e102235.30","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1080\/07448481.2016.1269771","article-title":"Using the Theory of Planned Behavior to predict HPV vaccination intentions of college men","volume":"65","author":"Catalano","year":"2017","journal-title":"J Am Coll Health"},{"key":"2025120413265353000_15.11.e102235.31","doi-asserted-by":"crossref","DOI":"10.3390\/vaccines10122026","article-title":"Predicting Vaccination Intention against COVID-19 Using Theory of Planned Behavior: A Systematic Review and Meta-Analysis","volume":"10","author":"Limbu","year":"2022","journal-title":"Vaccines (Basel)"},{"key":"2025120413265353000_15.11.e102235.32","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2024-085377","article-title":"Determining the intention of receiving the influenza vaccine: a cross-sectional survey among international and domestic college students in the USA","volume":"14","author":"Liu","year":"2024","journal-title":"BMJ Open"},{"key":"2025120413265353000_15.11.e102235.33","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0293130","article-title":"Using the Theory of Planned Behavior to determine COVID-19 vaccination intentions and behavior among international and domestic college students in the United States","volume":"19","author":"Liu","year":"2024","journal-title":"PLoS One"},{"key":"2025120413265353000_15.11.e102235.34","doi-asserted-by":"publisher","DOI":"10.1007\/s12160-012-9366-5"},{"key":"2025120413265353000_15.11.e102235.35","doi-asserted-by":"publisher","DOI":"10.1080\/07448480903221368"},{"key":"2025120413265353000_15.11.e102235.36","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.e7586","article-title":"SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials","volume":"346","author":"Chan","year":"2013","journal-title":"BMJ"},{"key":"2025120413265353000_15.11.e102235.37","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1093\/hcr\/hqad021","article-title":"Message fatigue beyond the health message context: a replication and further extension of So et al. (2017)","volume":"49","author":"Song","year":"2023","journal-title":"Hum Commun Res"},{"key":"2025120413265353000_15.11.e102235.38","unstructured":"Lumivero . NVivo (Version 14), 2023. Available: www.lumivero.com"},{"key":"2025120413265353000_15.11.e102235.39","unstructured":"Centers for Disease Control and Prevention . HPV Vaccination, 2024. Available: https:\/\/www.cdc.gov\/hpv\/vaccines\/?CDC_AAref_Val=https:\/\/www.cdc.gov\/hpv\/parents\/vaccinesafety.html"},{"key":"2025120413265353000_15.11.e102235.40","unstructured":"Chen AC-C , Todd M , Amresh A , et al . A pilot study of computerized, tailored intervention to promote hpv vaccination in mexican-heritage adolescents. Annual Worldwide Nursing Conference (WNC 2017); July 24, 2017:5. doi:10.5176\/2315-4330_WNC17.55 Available: https:\/\/commons.erau. edu\/publication\/857"},{"key":"2025120413265353000_15.11.e102235.41","unstructured":"Chen ACC , Todd M , Amresh A , et al . Tailored intervention for parents to promote their adolescents\u2019 vaccination against HPV. J Nurs Health Care 2019;4. Available: http:\/\/dl6.globalstf.org\/index.php\/jnhc\/article\/view\/1973"},{"key":"2025120413265353000_15.11.e102235.42","doi-asserted-by":"crossref","DOI":"10.1002\/nop2.70110","article-title":"Factors Associated With Adolescents\u2019 Human Papillomavirus Vaccination Intention: A Cross-Sectional Survey","volume":"11","author":"Chen","year":"2024","journal-title":"Nurs Open"},{"key":"2025120413265353000_15.11.e102235.43","doi-asserted-by":"crossref","first-page":"9","DOI":"10.3390\/youth5010009","article-title":"Application of the Health Belief Model to Understand the Factors Associated with Chinese International Students\u2019 HPV Vaccine Uptake","volume":"5","author":"Chen","year":"2025","journal-title":"Youth"},{"key":"2025120413265353000_15.11.e102235.44","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2013.10.009"},{"key":"2025120413265353000_15.11.e102235.45","first-page":"199","article-title":"An Intervention for HPV Risk Reduction Based on the Theory of Planned Behavior: An Exploratory Study with College-Aged Women","volume":"10","author":"Sweeney","year":"2015","journal-title":"Am J Sex Educ"},{"key":"2025120413265353000_15.11.e102235.46","doi-asserted-by":"crossref","first-page":"7421","DOI":"10.1016\/j.vaccine.2021.10.082","article-title":"Using the Theory of Planned behavior to identify correlates of HPV vaccination uptake among college students attending a rural university in Alabama","volume":"39","author":"Shah","year":"2021","journal-title":"Vaccine (Auckl)"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-102235","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T21:28:29Z","timestamp":1764883709000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-102235"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":46,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11,16]]},"published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1136\/bmjopen-2025-102235"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-102235","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]}}}