Quasi-experimental evaluation of a social media campaign to promote HPV vaccination in Bauchi state, Nigeria
- 1George Washington University
Abstract
Cervical cancer is the leading cause of cancer death in women in 26 countries, including in sub-Saharan African countries. Cervical and other cancer risks can be greatly reduced through timely HPV vaccination and early screening. But it continues to pose a significant public health challenge in LMICs such as Nigeria. This study reports on the implementation and evaluation of a pair of social media behavior change campaigns to increase HPV vaccination amongst girls ages 9-14 and reduce vaccine hesitancy amongst girls and their parents in Bauchi state, Nigeria. The primary objectives are to conduct a quasi-experimental evaluation of the social media campaign; to examine the effect of higher versus lower levels of campaign exposure on HPV vaccination and related outcomes; to determine whether the social media campaign followed its planned theory of change; and to identify which social media messages were most effective in promoting HPV vaccination. We implemented an HPV vaccination social media promotion campaign, using videos designed to encourage parents to vaccinate their daughters, at scale in Bauchi state on the Meta and TikTok social media platforms. We used a quasi-experimental design, a heavy-up approach, that experimentally manipulated the level of social media content delivered in Bauchi. We used the Virtual Lab platform, an open-source platform that uses social media to recruit participants using advertising and creates panels of respondents for data collection through an online survey, and also collected social media metrics including impressions and engagement. The campaign was effective in increasing HPV vaccination rates from 69% at baseline to 86% at endline over 2 campaign phases that spanned approximately 3 months. Based on GEE modeling, we found that higher levels of engagement with the campaign were associated with higher vaccination rates at midline and endline. Pro-vaccine attitudes and reduced vaccine hesitancy also predicted higher vaccination rates. Also, the campaign produced additional HPV vaccinations at low cost: Adjusted for campaign exposure cost of $0.81 per additional vax in campaign phase 1, $2.10 per vax in phase 2, and $2.40 for the total campaign period. Evidence from this study indicates that social media may be an effective strategy to promote HPV vaccination at low cost. Future rigorous trials using experimental methods are needed to further evaluate social media to promote HPV vaccination.
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BibTeX
@misc{evans2026quasiexperimental,
title = {{Quasi-experimental evaluation of a social media campaign to promote HPV vaccination in Bauchi state, Nigeria}},
author = {W. D. Evans and A. Ulasevich and I. S. Mohammed Gimba and S. Francis and J. Szabo and S. O'Sullivan and D. Bernard},
howpublished = {medRxiv},
year = {2026},
month = nov,
doi = {10.64898/2026.11.11.26367870},
url = {https://www.medrxiv.org/content/10.64898/2026.11.11.26367870v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Quasi-experimental evaluation of a social media campaign to promote HPV vaccination in Bauchi state, Nigeria
AU - W. D. Evans
AU - A. Ulasevich
AU - I. S. Mohammed Gimba
AU - S. Francis
AU - J. Szabo
AU - S. O'Sullivan
AU - D. Bernard
PY - 2026
DA - 2026/11/11
PB - medRxiv
DO - 10.64898/2026.11.11.26367870
UR - https://www.medrxiv.org/content/10.64898/2026.11.11.26367870v1
AB - Cervical cancer is the leading cause of cancer death in women in 26 countries, including in sub-Saharan African countries. Cervical and other cancer risks can be greatly reduced through timely HPV vaccination and early screening. But it continues to pose a significant public health challenge in LMICs such as Nigeria. This study reports on the implementation and evaluation of a pair of social media behavior change campaigns to increase HPV vaccination amongst girls ages 9-14 and reduce vaccine hesitancy amongst girls and their parents in Bauchi state, Nigeria. The primary objectives are to conduct a quasi-experimental evaluation of the social media campaign; to examine the effect of higher versus lower levels of campaign exposure on HPV vaccination and related outcomes; to determine whether the social media campaign followed its planned theory of change; and to identify which social media messages were most effective in promoting HPV vaccination. We implemented an HPV vaccination social media promotion campaign, using videos designed to encourage parents to vaccinate their daughters, at scale in Bauchi state on the Meta and TikTok social media platforms. We used a quasi-experimental design, a heavy-up approach, that experimentally manipulated the level of social media content delivered in Bauchi. We used the Virtual Lab platform, an open-source platform that uses social media to recruit participants using advertising and creates panels of respondents for data collection through an online survey, and also collected social media metrics including impressions and engagement. The campaign was effective in increasing HPV vaccination rates from 69% at baseline to 86% at endline over 2 campaign phases that spanned approximately 3 months. Based on GEE modeling, we found that higher levels of engagement with the campaign were associated with higher vaccination rates at midline and endline. Pro-vaccine attitudes and reduced vaccine hesitancy also predicted higher vaccination rates. Also, the campaign produced additional HPV vaccinations at low cost: Adjusted for campaign exposure cost of $0.81 per additional vax in campaign phase 1, $2.10 per vax in phase 2, and $2.40 for the total campaign period. Evidence from this study indicates that social media may be an effective strategy to promote HPV vaccination at low cost. Future rigorous trials using experimental methods are needed to further evaluate social media to promote HPV vaccination.
ER -