A cohort survey of the effect of an educational intervention on human papillomavirus vaccine-related knowledge and attitudes among pre-university female students in Singapore

Abstract

Introduction: Although cervical cancer is the 10th most common cancer among females in Singapore, it is a vaccinepreventable cancer. Human papillomavirus vaccines combined with regular Pap (papillomavirus) smears have been shown to reduce the mortality and morbidity associated with cervical cancer. We assessed the knowledge and attitudes towards cervical cancer, human papillomavirus and its vaccination amongst pre-university female students and assessed if a short educational presentation can improve this knowledge and acceptability of the vaccine. Methods: A cohort survey was carried out amongst 150 female students at Hwa Chong Junior College via questionnaires administered anonymously. Standardized educational presentations were carried out followed by post intervention questionnaires. Results: Almost all the students were aged between 15 and 19 years old (99.3%). At baseline, only 29% and 27% of the students had ever heard of human papillomavirus and its vaccines respectively. The most common source of information cited was from a family member or a friend (22.5%). Only 4% had been administered the human papillomavirus vaccine. Mean knowledge scores significantly improved from 4.95 to 8.61 out of 10 after the intervention. Of those who did not have the vaccine, only 31.3% were willing to consider the human papillomavirus vaccine pre-intervention, with a statistically significant improvement to 51.4% post intervention. Conclusion: Low awareness about human papillomavirus, its relationship to cervical cancer and its prevention is common, even amongst well-educated students. Most of them obtained the information from family and/or friends. A short educational presentation was able to improve the knowledge scores, and improve the acceptability of the human papillomavirus vaccine.

Impact of school-based educational interventions in middle adolescent populations (15-17yrs) on human papillomavirus (HPV) vaccination uptake and perceptions/knowledge of HPV and its associated cancers: A systematic review

“…Post-intervention, all fifteen studies reported a statistically significant improvement in their specific outcome measures including changes in knowledge, attitude and perception with regard to HPV vaccination and associated cancer prevention. All of the studies aimed to improve knowledge related to HPV risk and HPV vaccination while many focused on improving positive attitudes/perceptions regarding self-protection against acquirement of HPV 3,8,22,28,37,38,51,52,57,58 . Only 3 of the fifteen studies explored the actual effect of the intervention on HPV vaccination uptake 3,8,51 .…”

“…Six additional studies recorded 'intention to be vaccinated' against HPV after the intervention 22,28,37,38,56,57 . Four of the fifteen studies 3,8,51,52 explored the impact of the intervention on sexual behavior intention including condom use.…”

“…Four of the fifteen studies 3,8,51,52 explored the impact of the intervention on sexual behavior intention including condom use. Nine of the studies also specifically aimed to improve cervical cancer prevention, knowledge and attitude 28,37,38,[52][53][54][56][57][58] .…”

“…Other models or theories utilized through the studies included the Theory of Persuasion 37 and a thematic analysis based on Leventhal's Common Sense Model of lay illness representations 60 . However, eight of the studies 38,50,51,[53][54][55]57,58 did not provide any details of theoretical models that they used to guide them in the planning and development of their educational intervention. Their interventions were generally simplistic in nature with a brochure/pamphlet only 55,58 , DVD only 50 or a didactic presentation with a brochure/pamphlet 53,54,57 or without a brochure/pamphlet 38 .…”

“…The time required to deliver each educational intervention ranged from 10 minutes 57 to 120 minutes 22 . In most cases, the intervention was delivered by a professional with a nursing, healthcare or medical background 3,28,37,38,51,52,54,57 . Only 3 studies included active interventions which were conducted by school health and social care teachers or science teachers 8,22,50 .…”