MSU Researcher Takes the Sting Out of Vaccinations With Digital Games and Stories

When it’s time for youth to be vaccinated against the cancer-causing human papillomavirus, or HPV, Angela Chia-Chen Chen says that conversations about the vaccination are typically limited to the parents or caregivers and the clinicians. The patient, the young person getting the injection, is often left out — meaning they are also likely uninformed.

Knowing this, Chen, the inaugural McLaren Greater Lansing Endowed Chair for Behavioral Mental Health Nursing Education at the MSU College of Nursing, who is known for creatively addressing health disparities in behavioral and mental well-being, translated medical information about HPV and the vaccine into her patients’ language — digital games and stories.

Much of Chen’s work is focused on improving mental and behavioral health among vulnerable youth and families through technology-centered prevention programs. Her innovative, theory-based interventions improve understanding and communications about the HPV vaccine and help to reduce hesitancy among youth and their parents through joint decision-making.

The digital games and stories are unique cancer prevention strategies.

“These two projects focus on the HPV vaccine using different technologies to address the issue among different populations,” Chen said.

The short digital game, co-designed by children and caregivers with Chen’s interdisciplinary team, facilitates learning through a fun and engaging tool that is also easy to use in the busy clinical setting.

“For the games study, our pilots include dyads of teens and caregivers (who are usually their moms),” she added. “The child is the primary player. We offer the games at four MSU pediatric clinics here in the Greater Lansing area. Unvaccinated children ages 11 to 14 and their caregivers in the intervention group play this health game in the waiting room before they see providers, when they would likely be gaming on their phone.”

Another advantage of using waiting room time for the HPV game is that children and their caregivers are getting information that helps them have a meaningful conversation with the health care provider during the short clinical visit. This optimizes teachable moments and reduces missed opportunities — a clinic visit when a child’s vaccination is due, but is not ultimately administered.

“I am a health care provider,” Chen said. “And I believe patients and families should always be informed and engaged in the decision-making process for their own health.”

The digital stories also help people make more informed decisions about teen health care, especially as it relates to the cancer prevention benefits of the HPV vaccine. Four different stories have been co-created with Vietnamese immigrant moms. The stories are two to three minutes long and have been tested in the community with promising results. Many of those mothers have language, cultural and financial barriers and do not know how to navigate the complex health care system or understand vaccination practices in the United States.

“Storytelling has been a traditional cultural practice for many minority and marginalized communities,” Chen said. “It’s been a way to communicate and pass important cultural values and traditions to the next generation. Now, thanks to technology, we can record those culturally specific stories and add pictures and voices that are unique to them. Our research team works with Vietnamese immigrant mothers, community advisory boards, advocacy groups and health care providers to develop these stories that help educate parents about why it is important to vaccinate their kids.”

Chen sees patients through MSU Health Care. She earned her bachelor of science degree in nursing from the National Taiwan University in Taipei, Taiwan, and gained a master’s in psychosocial and community health nursing from the University of Washington. She also received a postmaster’s certification as a Psychiatric/Mental Health Nurse Practitioner and completed her doctorate at the University of Washington.

Because of her groundbreaking research and excellence as a Psychiatric/Mental Health Nurse Practitioner, Chen has received several national awards and has been inducted as a fellow in the American Academy of Nurse Practitioners.