Abstract
Background: Although human papillomavirus (HPV) vaccination has effectively prevented HPV-related cancers and infections since 2006 (Rosenblum et al., 2022; Semprini et al., 2025), uptake remains suboptimal (Franco et al., 2019; Guo et al., 2025; Han et al., 2025). Behavioral clinical trials have increasingly sought to enhance HPV uptake, yet few have examined overall trends. This study examined trends and characteristics of behavioral HPV vaccine trials between 2006 and 2025.
Methods: We searched ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform, and the International Standard Randomized Controlled Trial Number for behavioral HPV vaccination trials registered between 2006 and 2025. Inclusion criteria were behavioral trials aimed to increase HPV vaccination with at least one relevant outcome (intention, acceptance, or uptake). Two researchers independently screened, extracted, and coded data, with disagreements resolved by team consensus. Using Stata, data were analyzed by study design, intervention target, demographic characteristics, intervention type, level, setting, geographic region, and outcomes.
Results: Of 663 trials screened, 183 met the inclusion criteria. Behavioral HPV vaccine clinical trials have steadily increased, mainly registered on ClinicalTrials.gov (92.3%, n=169) and conducted in the United States (75.8%, n= 141). However, in the past five years, U.S.- based trials have slightly declined, while trials conducted in other countries have increased. Most trials were completed (57%, n=105), employed randomized controlled designs (78.7%, n= 144), and targeting general populations (52%, n=96), with the remaining focused on vulnerable group (48%, n=87), primarily youth aged 9-14 years (77%, n=141) and including all sexes (69%, n=126). Most common settings were clinics and digital devices (31%, n=57 each), typically at a single population level (e.g., parents; 51%, n=94). Typical interventions included provider training for HPV vaccine recommendations (24%, n=44), and mobile device reminders for parents (22%, n=40), with outcomes mostly measuring HPV vaccine uptake (71%, n=130).
Conclusions: Behavioral trials show promising trends but remain largely U.S.- based. While trials were nearly evenly split between general and vulnerable populations, indicating some progress toward equity, future research should expand focus on at-risk groups and enhance global implementation to strengthen the impact.
Notes
References:
Franco, M., Mazzucca, S., Padek, M., & Brownson, R. C. (2019). Going beyond the individual: How state-level characteristics relate to HPV vaccine rates in the United States. BMC public health, 19(1), Article 246. https://doi.org/10.1186/s12889-019-6566-y
Guo, Y., Liu, X., Nicholas, S., Maitland, E., & Liu, R. (2025). Revisiting global HPV vaccination behavior and its determinants: A comprehensive review. Risk management and healthcare policy, 18, 2675–2689. https://doi.org/10.2147/RMHP.S524223
Han, J., Zhang, L., Chen, Y., Zhang, Y., Wang, L., Cai, R., Li, M., Dai, Y., Dang, L., Chen, H., & Zhu, L. (2025). Global HPV vaccination programs and coverage rates: A systematic review. eClinicalMedicine, 84, Article 103290. https://doi.org/10.1016/j.eclinm.2025.103290
Rosenblum, H. G., Lewis, R. M., Gargano, J. W., Querec, T. D., Ungar, E. R., & Markowitz, L. E. (2022). Human papillomavirus vaccine impact and effectiveness through 12 years after vaccine introduction in the United States, 2003 to 2018. Annals of Internal Medicine, 175(7), 918-926. https://doi.org/10.7326/M21-3798
Semprini, J., Devine, J., & Reimer, R. (2025). Quantifying the impact of introducing HPV vaccines in 2006 on 25-29-year-old cervical cancer incidence in 2022. JNCI cancer spectrum, 9(3), Article pkaf059. https://doi.org/10.1093/jncics/pkaf059
Sigma Membership
Alpha Psi
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Systematic Review
Research Approach
Other
Keywords:
Public and Community Health, Implementation Science, Health Equity or Social Determinants of Health, Human Papillomavirus Vaccines
Recommended Citation
Suwannawat, Jutamas; Whaley, Megan; Kao, Tsui-Sui Annie; and Chen, Angela Chia-Chen, "Trends and Characteristics of Behavioral Trials on HPV Vaccination: A Systematic Review (2006-2025)" (2026). International Nursing Research Congress (INRC). 155.
https://www.sigmarepository.org/inrc/2026/presentations_2026/155
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
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All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-18
Trends and Characteristics of Behavioral Trials on HPV Vaccination: A Systematic Review (2006-2025)
Toronto, Ontario, Canada
Background: Although human papillomavirus (HPV) vaccination has effectively prevented HPV-related cancers and infections since 2006 (Rosenblum et al., 2022; Semprini et al., 2025), uptake remains suboptimal (Franco et al., 2019; Guo et al., 2025; Han et al., 2025). Behavioral clinical trials have increasingly sought to enhance HPV uptake, yet few have examined overall trends. This study examined trends and characteristics of behavioral HPV vaccine trials between 2006 and 2025.
Methods: We searched ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform, and the International Standard Randomized Controlled Trial Number for behavioral HPV vaccination trials registered between 2006 and 2025. Inclusion criteria were behavioral trials aimed to increase HPV vaccination with at least one relevant outcome (intention, acceptance, or uptake). Two researchers independently screened, extracted, and coded data, with disagreements resolved by team consensus. Using Stata, data were analyzed by study design, intervention target, demographic characteristics, intervention type, level, setting, geographic region, and outcomes.
Results: Of 663 trials screened, 183 met the inclusion criteria. Behavioral HPV vaccine clinical trials have steadily increased, mainly registered on ClinicalTrials.gov (92.3%, n=169) and conducted in the United States (75.8%, n= 141). However, in the past five years, U.S.- based trials have slightly declined, while trials conducted in other countries have increased. Most trials were completed (57%, n=105), employed randomized controlled designs (78.7%, n= 144), and targeting general populations (52%, n=96), with the remaining focused on vulnerable group (48%, n=87), primarily youth aged 9-14 years (77%, n=141) and including all sexes (69%, n=126). Most common settings were clinics and digital devices (31%, n=57 each), typically at a single population level (e.g., parents; 51%, n=94). Typical interventions included provider training for HPV vaccine recommendations (24%, n=44), and mobile device reminders for parents (22%, n=40), with outcomes mostly measuring HPV vaccine uptake (71%, n=130).
Conclusions: Behavioral trials show promising trends but remain largely U.S.- based. While trials were nearly evenly split between general and vulnerable populations, indicating some progress toward equity, future research should expand focus on at-risk groups and enhance global implementation to strengthen the impact.
Description
This research summarizes two decades of behavioral clinical trials on HPV vaccination from 2006-2025, revealing promising trends and key characteristics. The findings highlight the importance of expanding research to at-risk population and strengthening global implementation.