Evaluating a County-Sponsored Social Marketing Campaign to Increase Mothers' Initiation of HPV Vaccine for Their Preteen Daughters in a Primarily Rural Area

Routine vaccination against human papillomavirus (HPV), the main cause of cervical cancer, is recommended for 11-12-year-old girls, yet vaccine uptake is low. This study evaluates a social marketing campaign initiated by 13 North Carolina counties to raise awareness among parents and reduce barriers to accessing the vaccine in a primarily rural area. The 3-month campaign targeted mothers of girls ages 11-12 and health care practices serving preteen girls in 4 counties. Principles of social marketing were product (recommended vaccine against HPV), price (cost, perception of safety and efficacy, and access), promotion (posters, brochures, website, news releases, doctor's recommendation), and place (doctors' offices, retail outlets). We analyzed website traffic, hotline calls, and media placement; cross-sectional surveys of mothers and providers; and HPV immunization rates in intervention versus nonintervention counties. Of respondent mothers (n = 225), 82% heard or saw campaign messages or materials. Of respondent providers (n = 35), 94% used campaign brochures regularly or occasionally in conversations with parents. HPV vaccination rates within 6 months of campaign launch were 2% higher for 9-13-year-old girls in 2 of the 4 intervention counties compared to 96 nonintervention counties. This evaluation supports campaign use in other primarily rural and underserved areas.