Educational interventions to increase HPV vaccination acceptance: A systematic review

Abstract

Background The Human papillomavirus (HPV) vaccine has been available for protection against HPV-associated cervical cancer and genital warts since 2006. Nonetheless, uptake has varied among countries and populations within countries. Studies have found that individuals’ knowledge and attitudes toward the vaccine are associated with immunization uptake. The purpose of the current review is to summarize and evaluate the evidence for educational interventions to increase HPV vaccination acceptance. Methods We searched the databases of PubMed and Web of Science for English-language articles describing educational interventions designed to improve HPV vaccination uptake, intention or attitude. Results We identified 33 studies of HPV vaccination educational interventions: 7 tested the effectiveness of interventions with parents, 8 with adolescents or young adults, and 18 compared the effectiveness of different message frames in an educational intervention among adolescents, young adults or their parents. Most studies involved populations with higher educational attainment and most interventions required participants to be literate. The minority of studies used the outcome of HPV vaccine uptake. Well-designed studies adequately powered to detect change in vaccine uptake were rare and generally did not demonstrate effectiveness of the tested intervention. Conclusions There is not strong evidence to recommend any specific educational intervention for wide-spread implementation. Future studies are required to determine the effectiveness of culturally-competent interventions reaching diverse populations.

School-based HPV immunization of young adolescents: Effects of two brief health interventions

“…While educational interventions are helpful to increase acceptance in adolescent and young adult samples, education interventions among parental samples of adolescents are mixed. 3 Hence, our messages may not have effectively impacted intention and vaccine receipt because parents had a more significant concern that needed to be addressed. Future research is needed to assess whether message sidedness interventions targeting multiple health beliefs or tailored specifically to the meet the parents' health belief concerns regarding HPV vaccination increase intentions and uptake.…”

“…2 Interventions that have attempted to increase HPV immunization have had mixed results and many have necessarily used vaccine intent, rather than vaccine receipt, as the primary outcome. 3 In addition, most interventions have targeted vaccination intent for girls and young women using a variety of samples, including adolescents, college-enrolled women and parents of the college aged women. 3 Across all groups, low rates of HPV vaccine initiation and series completion have been widely reported in the context of traditional settings, such as physician offices, where logistical and financial barriers may present obstacles to immunization.…”

“…3 In addition, most interventions have targeted vaccination intent for girls and young women using a variety of samples, including adolescents, college-enrolled women and parents of the college aged women. 3 Across all groups, low rates of HPV vaccine initiation and series completion have been widely reported in the context of traditional settings, such as physician offices, where logistical and financial barriers may present obstacles to immunization. 4 School-based health centers (SBHCs) in the US represent an alternative to primary care settings for immunization because most children aged 14 years are in school 5 and SBHCs minimize common obstacles (e.g., parents missing work).…”

Interventions to Improve HPV Vaccine Uptake: A Systematic Review

“…Fu et al reviewed 33 articles describing educational interventions and concluded that no specific strategy merited recommendation. 20 However, the included studies did not consistently report postintervention vaccination rates, complicating interpretation of intervention success. Niccolai et al reviewed 14 community and clinic interventions and found several successes.…”

Predictors of Human Papillomavirus Vaccine uptake or intent among parents of preadolescents and adolescents

“…Various educational strategies in healthcare practice or community settings have shown to be effective in improving parental HPV vaccine knowledge and uptake. [25,26] Although educating parents plays a key role in their decision-making process, the impact of the parentprovider relationship and strength of provider recommendation on HPV vaccination uptake or intent has not been fully examined. [12] …”