Mapping the Landscape of HPV Vaccine Communication: An Umbrella Review Introduction

Given the vital role of HPV vaccination in preventing cancer-causing infections and precancers, how to effectively communicate it to the public to optimize its adoption has gained increasing attention from public health and communication researchers. In the span of 17 years since the Advisory Committee on Immunization Practices (ACIP) recommended the vaccine, the body of research on HPV vaccine communication has quickly scaled up. The vibrant growth of the literature, while contributing to the expanding knowledge repertoire, makes it challenging for researchers and practitioners to get a comprehensive view of the insights that have been generated, gaps that may exist, and opportunities that can be built on. In view of this challenge and need, our umbrella review aims to map out the landscape of vaccine communication research by examining 78 systematic reviews and meta-analyses. We ask two overarching questions: 1) What do we know about the effectiveness of HPV vaccine communication from these systematic and/or meta-analytic reviews? 2) How has this area of research been informed by and contributing to theory development?

To answer the first question, we first need to extract the underlying conceptions of “communication,” which encompasses myriad aspects and conjures up different understandings among researchers. For example, research synthesists have examined vaccine communication in terms of the influence of message strategies (e.g., Levy et al., 2022; Niccolai et al., 2022), psychological processes (e.g., Cunningham et al., 2014; Zhao et al., 2021), technologies or channels (e.g., Francis et al., 2017; Ortiz et al., 2019), and interpersonal relationships (e.g., Acampora et al., 2020; Newman et al., 2018). Our first research question, therefore, seeks to identify the perspectives or foci with which vaccine communication researchers have examined “communication,” as reflected in the scope and focus delimited by their included primary research.

RQ1: What communicative foci have defined the extant HPV vaccine communication research?

Building on the results from RQ1, we will seek to derive knowledge claims about the effectiveness of vaccine communication that the extant literature has converged on, as well as the potential Page 41 problems and gaps that it has revealed. We propose the second set of research questions under each focus of communication identified from RQ1:

RQ2a: What are the major patterns of findings regarding the effectiveness of communication in promoting HPV vaccination?

RQ2b: What are the notable divergencies in extant findings that can be observed within and across these research syntheses?

Given the importance of theory use and development to the healthy growth of any research area, including HPV vaccine communication, we examine and reflect on theory application and guidance that can be discerned from these research syntheses. Hence, we ask:

RQ3: To what extent is the extant literature informed by and reflective of theory development?

Method

A literature search of titles and abstracts was performed in eight databases: Communication and Mass Media Complete, PsycINFO, Scopus, Medline, Academic Premier, Web of Science, and Epistemonikos. Keywords involving communication, vaccine, and outcomes related to vaccine adoption were used. Deduplication and screening processes were carried out via Covidence (https://www.covidence.org/), resulting in a final pool of 78 systematic reviews and meta-analyses. The full coding scheme has been developed and finalized based on the processes of coder training and establishing inter-coder reliabilities. The average pairwise percentage among the three coders ranged from .89 to .95. Additionally, Krippendorff’s alphas ranged from .70 to .90.

Preliminary Findings

The 78 systematic reviews and/or meta-analyses were published between 2007 and 2023, which examined primary studies ranging from 1982 to 2022. Coding of communicative foci has been completed, which shows that vaccine communication has been approached as message strategies (43.6%, k = 34), as psychological processes (61.5%, k = 48), as interpersonal relationships (38.5%, k =30), and as technological aids or channels (6.4%, k = 5). Detailed coding and interpretation of the literature are under way. The full paper is anticipated to be completed by April 2024.