A systematic review of interventions to promote HPV vaccination globally

Abstract

Background Despite the human papillomavirus (HPV) vaccine being a safe, effective cancer prevention method, its uptake is suboptimal in the United States (U.S.). Previous research has found a variety of intervention strategies (environmental and behavioral) to increase its uptake. The purpose of the study is to systematically review the literature on interventions that promote HPV vaccination from 2015 to 2020. Methods We updated a systematic review of interventions to promote HPV vaccine uptake globally. We ran keyword searches in six bibliographic databases. Target audience, design, level of intervention, components and outcomes were abstracted from the full-text articles in Excel databases. Results Of the 79 articles, most were conducted in the U.S. (72.2%) and in clinical (40.5%) or school settings (32.9%), and were directed at a single level (76.3%) of the socio-ecological model. Related to the intervention type, most were informational (n = 25, 31.6%) or patient-targeted decision support (n = 23, 29.1%). About 24% were multi-level interventions, with 16 (88.9%) combining two levels. Twenty-seven (33.8%) reported using theory in intervention development. Of those reporting HPV vaccine outcomes, post-intervention vaccine initiation ranged from 5% to 99.2%, while series completion ranged from 6.8% to 93.0%. Facilitators to implementation were the use of patient navigators and user-friendly resources, while barriers included costs, time to implement and difficulties of integrating interventions into the organizational workflow. Conclusions There is a strong need to expand the implementation of HPV-vaccine promotion interventions beyond education alone and at a single level of intervention. Development and evaluation of effective strategies and multi-level interventions may increase the uptake of the HPV vaccine among adolescents and young adults.

Facilitators and barriers of HPV vaccination: a qualitative study in rural Georgia

“…Using the P3 Model in our study and the subsequent findings, allowed for consideration of multi-level interventions for increasing HPV vaccination. Research has shown numerous programs that promote HPV vaccination operate at a single level [ 59 ]. Mostly focusing on either the patient or provider levels and a lack of focus on including facilitators and barriers at the practice level [ 60 – 62 ].…”

Primary Prevention of Cancer

“…125 Several reviews have found multilevel approaches effective when targeting parent psychosocial factors (knowledge, beliefs, outcome expectations, intentions, using informational text included with reminders) and behaviors, clinician recommendation, and patient-targeted and provider-targeted clinic systems (e.g., dashboards and reminder systems). [126][127][128][129][130][131] State-wide policy interventions (including formalized requirements and school mandates) have been few. Community-based interventions to increase uptake via partnerships, involving community health workers, have shown promise.…”

“…Many of these multilevel approaches have targeted racially and ethnically minoritized populations to address health disparities. [119][120][121][122][123][124][125][126][127][128][129][130]132,133…”

“…Community-based interventions to increase uptake via partnerships, involving community health workers, have shown promise. Many of these multilevel approaches have targeted racially and ethnically minoritized populations to address health disparities 119–130,132,133 …”

Effectiveness of a School- and Primary Care–Based HPV Vaccination Intervention

“…To date, too few interventions have included a multilevel approach, despite research showing its effectiveness, or indeed have reported their effect on VC. 19 The PrevHPV research program was launched in 2018 to improve HPV acceptability and VC in France. It used the Integrated Behavior Change Model as the theoretical background.…”