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HPV vaccination intervention

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Kaiwen Ni

on 17 May 2016

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Transcript of HPV vaccination intervention

Mass Media Intervention
Types of media

• Email
• Television
• Website
• Mobile app
• Radio announcement
• Newspaper articles/ newspaper
• Advertisement
• Leaflet
• Posters
• Pamphlet
• Mailers

HPV vaccination intervention
Group 13
Patient Reminder and Recall

5 RCTs studies and 3 prospective cohort studies have been included.

School-based Intervention
Eight studies with half are RCTs included
1. Background
2. Barriers
3. Interventions (
targeting on parents or young women

Mass media
4. Comparison
Cervical cancer is caused by persistent infection of high-risk HPV (Hansen, 2008 Nobel Prize)
- HPV types 16 and 18 account for roughly 70% of all cervical cancer
- Incubation time is years to decades
HPV infection is the most common STI worldwide

Natural immunity is likely to be weak, i.e. reinfection is common

Most HPV infection is harmless and clears within 12 months

Stokley S, Jeyarajah J, Yankey D, et al. Human papillomavirus vaccination coverage among adolescents, 2007-2013, and postlicensure vaccine safety monitoring, 2006-2014--United States. MMWR. Morbidity and mortality weekly report. 2014 Jul;63(29):620-4.


•Phone calls
•Text messages
•Private facebook messages

Smulian EA, Mitchell KR, Stokley S. Interventions to increase HPV vaccination coverage: A systematic review. Human vaccines & immunotherapeutics. 2016 Jan
Targeting : Mainly young adult (secondary/high school aged 12-16)
College students (18-26)
Methods for intervention
educational video/ lessons
fact sheet online/ paper based (CDC HPV vaccine information sheet)
educational slide presentation
question/answer session/self-quiz

Individual-based Intervention
All 5 studies provided information on transmission, prevalence and morbidity of HPV and availability of vaccines to protect children

Equivalent to HBM’s perceived susceptibility, severity, benefits and control

Most interventions were done before the licensure of the vaccine, which could have influenced parental decision

Social factors and influences seem to be more important in vaccination, which are not addressed in HBM
Individual-based Intervention
Evaluating Interventions
School-based Intervention--Cluster RCT
Adolescents 16 years old. invited to participate during the regular individual health interview with the school nurse
girls in the intervention group chose to have themselves vaccinated (
The 1st school-based educational cluster RCTs with targeting a diverse representative population of adolescents of both sex in a quite large sample
Also test for Health Belief Model

Literature Review
13 papers designed to address
vaccine hesitancy
Significant (10 papers): Increase parents’ knowledge and belief about HPV vaccine.
Non-significant (5 papers): Enhance parental intention to vaccinate their child.

1 RCT (2015) targets on

12-minute interactive computer-delivered media presentation and a motivational keychain to store a vaccine reminder card

Intervention Group:
Control Group:
Time-equivalent health promotion media presentation on physical activity and nutrition.
1. Intervention participants reported believing they were at risk for HPV and developing cervical cancer more than comparison participants
(p < .05)

2. Same number of participants between intervention and control group received first dose vaccine 7 months after the intervention.
Perceived Susceptibility

Media-based + school-based intervention
Media-based + interpersonal communication intervention
Media-based + recall/reminders intervention

: knowledge, belief and awareness
Non significant: behavioral change

Key Findings:
Behavioral Change

: thorough evaluation is needed to better understand
factors facilitating HPV vaccine uptake and compliance.
New issue. Insufficient studies.
Health Belief Model
Attempts to explain preventive health behaviors
Focusing on the attitudes
and beliefs of individuals
Barriers to HPV vaccination
Barriers to HPV vaccination in Hong Kong
1. Fu LY, Bonhomme LA, Cooper SC et al. Educational interventions to increase HPV vaccination acceptance: a systematic review. Vaccine. 2014 Apr 7;32(17):1901-20
2. Ferrer HB, Trotter C, Hickman M, Audrey S. Barriers and facilitators to HPV vaccination of young women in high-income countries: a qualitative systematic review and evidence synthesis. BMC public health. 2014 Jul 9;14(1):1.
3. Smulian EA, Mitchell KR, Stokley S. Interventions to increase HPV vaccination coverage: A systematic review. Human vaccines & immunotherapeutics. 2016.
4. Niccolai LM, Hansen CE. Practice-and Community-Based Interventions to Increase Human Papillomavirus Vaccine Coverage: A Systematic Review. JAMA pediatrics. 2015 Jul 1;169(7):686-92.
5. Wang, Linda DL, et al. "Psychosocial determinants of Chinese parental HPV vaccination intention for adolescent girls: preventing cervical cancer." Psycho‐Oncology 24.10 (2015): 1233-1240.
6. Hopfer S. Effects of a narrative HPV vaccination intervention aimed at reaching college women: A randomized controlled trial. Prevention Science. 2012 Apr 1;13(2):173-82.
7. Chao, Chun, et al. "A randomized intervention of reminder letter for human papillomavirus vaccine series completion." Journal of Adolescent Health 56.1 (2015): 85-90.
8. DiClemente RJ, Murray CC, Graham T, Still J. Overcoming barriers to HPV vaccination: A randomized clinical trial of a culturally-tailored, media intervention among African American girls. Human vaccines & immunotherapeutics. 2015 Sep 14:1-2.
9. Jarrett C, Wilson R, O’Leary M, Eckersberger E, Larson HJ. Strategies for addressing vaccine hesitancy–a systematic review. Vaccine. 2015 Aug 14;33(34):4180-90.
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