Background The Human papillomavirus vaccine (HPV) is an essential tool for the prevention of HPV-related cancers. In Puerto Rico, the Secretary of Health established a school entry requirement of at least one dose of HPV vaccination in girls and boys aged 11 and 12 years, taking effect in August 2018. Our study aimed to examine parents’ and guardians’ views of unvaccinated children about the process of implementation of the new HPV vaccination school entry policy in Puerto Rico and identify potential barriers and facilitators related to the implementation of this requirement. Methods During April through November 2019, we conducted three focus groups (n = 12) and eight in-depth semi-structured interviews with parents of children aged 11 and 12 who had not yet initiated the HPV vaccine series. The interview topics addressed were: perception of vaccination, HPV vaccine and it is inclusion as new school entry requirement practice, procedure of the sources of information, influencers, and willingness to change. The interviews were recorded and transcribed by our staff members. We identified emergent themes through thematic analysis. Results The participants’ perspective on the HPV vaccine school requirement was mixed. Lack of information of the HPV vaccines and lack of communication about the school-entry requirement were the themes most mentioned in the interviews. Moreover, previous negative experiences from friends or family members and adverse effects deterred some participants from vaccinating their kids. We discussed barriers in the process of soliciting an exemption. Conclusion Most barriers mentioned by study participants are modifiable. Information about the HPV vaccine mandate’s implementation and educational materials regarding HPV vaccine safety need to be provided to address parents’ concerns related to the vaccine’s side effects. Schools (teachers, principal directors, and administrative staff), the government, and parent organizations need to be part of these efforts. This multilevel approach will help to improve disseminating information about HPV vaccination to clarify doubts and misinformation among parents.

Background: Human papillomavirus vaccine (HPV) is an important tool for prevention of HPV- related cancers. In Puerto Rico, the Secretary of Health established a school entry requirement of at least 1 dose of HPV vaccination in girls and boys aged 11 and 12 years taking effect in August 2018. Our study aims to examine parents’ views and opinions of the process of implementing the new HPV vaccination school entry policy in Puerto Rico, and understand barriers and facilitators related to this HPV immunization policy. Methods: Three focus group (n=12) and eight in-depth semi-structured interviews were performed, along with a survey. The interviews were recorded and transcript by our staff members. Through a thematic analysis were identified emergent themes. Results: Lack of information in relation to the policy were the theme most mentioned in the interviews. Moreover, participants expressed that previous negative experiences, from friends or family member, adverse effect and the lack of communication from school and healthcare providers deter them from the decision of vaccinated their kids. Barriers in the process of soliciting an exemption was discussed. Conclusion: Most barriers mentioned by participants who express hesitation about vaccinating their kids with the HPV vaccine, are modifiable providing parents information about the mandate’s implementation, and educational materials that address their concerns related to the vaccine’s side effects. Implementation of this efforts, however, need to consider impacting the school (teachers, principal directors, and administrative staff), the government and parents. This multilevel approach will help to improve the dissemination of information about HPV vaccination in order to clarify doubts and misinformation among hesitant parents.

Introduction: Puerto Rico Libre de Enfermedades Prevenibles (Puerto Rico Free of Preventable Diseases) was an online, community-based initiative consisting of eight educational training programs regarding school entry vaccines, including HPV vaccine as the most recent requirement. The Community Advisory Board of the HPV-PIVac study (CAB-PIVac) developed this activity in response to barriers identified on school personnel by the HPV-PIVac study: lack of knowledge about the HPV vaccine and its school entry requirement and need for training. In February 2020, CAB-PIVac members collected data through a self-administrated survey to identify potential topics. After several meetings, members identified the topics and resources for these webinar series. Our purpose is to present how the integration of community members into an ongoing research study allowed rapid response to developing an educative initiative to impact school staff concerning preventable diseases and the HPV vaccine. Methods: Eight webinars in four weeks were transmitted in-live through the Zoom platform from June 26 to July 17, 2020. They were on-demand until July 24, 2020. Theme per week: World without vaccine: COVID-19; Teenager vaccine in School; Future free of HPV-related cancer; and Legal aspects of vaccination for the school-entry. The participants received via email an evaluation form to assess the impact of these webinars. Using data from the registration form, we collected the following participants' characteristics: sex, age, education sector, and role in the school. We performed a thematic analysis collecting all the messages posted in the Q & A section of each webinar to identify the topics in which the participants had doubts or more interest. Results: A unique participation of 954 participants were registered, and the range of involvement on the education webinars was 588 to 780 participants. Based on the type of education, 28.8% were private, and 70.9% were from public education. Most of the participants were females (89.6%) and with an average age of 42 years (range: 21 -74). Of the participants who reported their role at their schools (n=648), 31.4% were school nurses, followed by the school director (22.7%). Twelve percent of the participants were teachers. The evaluation was satisfactory (99.7%) considering the tools offered and the clear information presented. The thematic analysis results showed that the two topics discussed in the Q &A section were the immunization registry (problems with system access) and the vaccination series (age to initiate the series). Conclusion: This initiative was developed and performed in less than five months. Many national and international organizations, coalitions, and government agencies are working to achieve the same goal: eradicated HPV-related cancers and strengthen the awareness for HPV prevention. Involve these community members in the research is crucial to secure how the results of the investigation studies could impact the community quickly and accurately. Citation Format: Diana T. Medina-Laabes, VOCES PR Coalition, JAC-HPV PIVAC PR, Omayra Salgado Cruz, Roxana Soto Abreu, Olga L. Diaz Miranda, Marta M. Sánchez Aracil, Vivian Colón-López. A Puerto Rico free of preventable diseases: An online education intervention for school staff during the COVID-19 pandemic era in Puerto Rico [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-027.

Introduction: Implementation of school-entry policies for vaccination for human papillomavirus (HPV) vaccination (HPV-PIVac study) is a five-year prospective study started in 2018 to evaluate the implementation of the HPV vaccine as a requirement for school entry in Puerto Rico. As part of these study efforts, we organized a Community Advisory Board (CAB) whose members are from government and private organizations, coalitions, and community-based organizations working for HPV prevention. As part of the preliminary results of the HPV-PIVac study presented to the CAB, key informant interviews demonstrated the lack of knowledge and the need to train school staff on the HPV vaccine and its school policy. CAB members worked on an educational initiative about vaccines to respond to these barriers, called Puerto Rico Libre de Enfermedades Prevenibles (Puerto Rico Free of Preventable Diseases). As a first step, a needs assessment survey was conducted to identify the most significant topics of interest and need issues about vaccines and the new HPV vaccine school requirement in this population. Methods: In February 2020, CAB members distributed a self-administration survey during the 2019-2020 Education Congress, an event in which teaching and non-teaching staff from the island's private education sector assisted in continuing education training. Data collection was gathered by convenience sampling. The survey collected the following variables: knowledge of the HPV school-entry policy, knowledge of HPV infection and the HPV vaccine, confidence in talking to parents about the HPV vaccine, and information of interest about the HPV vaccine. Results: A total of 76 participants were recruited. The largest number of participants (73%) were teachers, and 19% were school directors. At least 61% of the participants were unaware of the HPV vaccine as a requirement to enter school. We identified an insufficient knowledge of the following items: HPV-related cancers (43%) and HPV vaccine series (32%). Only 21% of school personnel reported been prepared to talk to parents about the HPV vaccine. According to the participants' responses, the top five information about HPV that they were interested in were: (1) Side effects of the vaccine; (2) Effectiveness of the vaccine, (3) Safety of the vaccine; (4) Messages to give to parents; and (5) Information on HPV vaccination policy. Conclusion: Through the need assessment, we were able to identify topics that should be addressed as information about the HPV vaccination series, HPV-associated cancers, HPV vaccine school entry policy, safety and effectiveness of the HPV vaccine. Based on this data, we developed an educational curriculum for the initiative. The collaboration of the different members of the CAB was essential to carry out this first step. Citation Format: VOCES PR Coalition, Josheili S. Llavona, Diana T. Medina Laabes, Omayra Salgado Cruz, JAC-HPV-PIVac PR, Roxana Soto Abreu, Olga L. Diaz Miranda, Marta M. Sánchez Aracil, Vivian Colón-López. Community coalition and academic need assessment: Our first step for the development of an educational intervention on HPV vaccination targeting school staff during pandemic era in Puerto Rico [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-029.