Could a simple text message help prevent a cancer diagnosis? Naomi Lee hopes so.
With $435,000 in funding from Merck & Co., Lee, an associate professor in the Department of Chemistry and Biochemistry at NAU, is developing a text message campaign that will raise awareness of the human papillomavirus (HPV) vaccine among historically underserved Arizonans, including people from rural and Native American backgrounds who suffer from some of the highest rates of cancers caused by the virus.
“I’ve seen a major disparity between Indigenous people and other groups when it comes to cancers overall, and especially HPV-associated cancers,” Lee said. “We know younger individuals are getting the vaccine at higher rates, but older Indigenous women have the highest cervical cancer rates in the nation. A lot of my research centers on questions about what’s driving that. Are they getting vaccinated? If not, why aren’t they?”
Over the next six months, Lee will work with the healthcare organization MedStar, University of Arizona cancer researcher Celina Valencia and a handful of NAU undergraduate students to develop text messages and send them to a group of Arizonans who have no record of HPV vaccination. MedStar’s Phoenix branch has worked with Indigenous communities on various research projects for more than 30 years, and the rest of the research group is composed almost entirely of Indigenous women. Lee said the team’s collective background and experience will prove pivotal to the project’s recruitment success.
Members of the research team developed this video for those who want to learn more about HPV and cervical cancer.
Using Tango gift cards as enticement, they’ll ask some participants to fill out surveys to find out what they know about HPV and how they feel about vaccines—one at the beginning of the campaign and another at the end. Participants also will have the option to chat with researchers, sharing their questions and concerns about the virus and the vaccine. (Another group will only participate passively; Lee and her team will send that group information about HPV and the vaccine without prompting them to take any action.) In the second half of 2026, the research group will analyze the outcome of the campaign using data from the survey.
“We’re doing pre- and post-campaign surveys to see if attitudes changed and if knowledge has increased,” Lee said. “The surveys could also help us understand the barriers people face. In my previous research, I’ve found it’s often about lack of access: It takes too long to drive to a clinic, there are too many job or childcare responsibilities to take time off, or they can’t commit to more than one appointment to complete the vaccine series.”
Learning about barriers to access could be crucial in the fight against HPV-associated cancers—including oral cancer in men, which is three to four times more common than cervical and other HPV-associated cancers in women.
“If access is the main reason why some rural communities aren’t getting vaccinated, that’s actually promising news, because protection against HPV-associated cancers is getting easier,” Lee said. “The Department of Health and Human Services has new guidelines encouraging people to self-test for HPV, and a new study is suggesting that just one dose of the HPV vaccine may be enough.”
Lee said this is only a pilot study, with just 250 Arizonans in the Flagstaff, Phoenix and Tucson areas taking part. But if the pilot proves successful, Lee hopes to reach more people via text message in the future, again leveraging MedStar’s Arizona community connections to clear up people’s apprehensions about the HPV shots.
“Celina and I have been working in this field long enough to know some of the misconceptions people have about HPV and cervical cancer,” Lee said. “People are suspicious of some ingredients in the vaccine that they can’t pronounce. As a biochemist, I can tell them exactly what those ingredients are, what they do and why they’re important for the vaccine.”
In the future, Lee also hopes to quell healthcare providers’ misgivings about the vaccines and provide them with updated information—ensuring both patient and provider are equipped with the information they need to stay healthy.
“We’re building partnerships with health facilities to do a separate study on healthcare workers and what they do and don’t know,” Lee said. “With the new recommendations coming out, providers might have questions about what they mean, who they come from and how they can help patients who live in underserved areas.”
Interested in participating in this study? For more information, visit the project website.
Jill Kimball | NAU Communications
(928) 523-2282 | jill.kimball@nau.edu