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. 2024 Nov 19:48:102931.
doi: 10.1016/j.pmedr.2024.102931. eCollection 2024 Dec.

Feasibility of interventions to increase HPV vaccination acceptability and coverage in school-based programs: Findings from a pilot study in Quebec, Canada

Maude Dionne  1 , Chantal Sauvageau  1   2   3 , Doriane Etienne  4   3 , Holly O Witteman  2   4   3 , Ève Dubé  2   3
Affiliations

Feasibility of interventions to increase HPV vaccination acceptability and coverage in school-based programs: Findings from a pilot study in Quebec, Canada

Maude Dionne et al. Prev Med Rep. .

Abstract

Introduction: Human papillomavirus (HPV) vaccines have been offered in Quebec schools to 4th-grade (9-10 years old) girls since 2008 and boys since 2016. HPV vaccine coverage does not reach the 90 % target in many regions. This project evaluated the feasibility and the acceptability of interventions to improve HPV vaccine acceptability and coverage in school-based programs.

Methods: The evaluation was conducted in 32 Quebec schools in 2019-2020. We tested a strategy of three interventions implemented in sequence (face-to-face information session, email reminder with an online decision support tool, and telephone reminder using motivational interviewing (MI) techniques). Parents and school staff completed online surveys. School nurses participated in individual interviews. Key stakeholders participated in a workshop to identify enabling conditions and barriers to implementing interventions across Quebec.

Results: The strategy was generally well-received by school staff, nurses, and parents. Many parents found the 3 interventions helpful to support their vaccination decision. Most parents (92 %) suggested that the face-to-face information session and the decision support tool (82 %) be offered to all parents. Nevertheless, delivering classroom presentations was perceived by nurses as logistically challenging. Parents were generally satisfied with the telephone reminder, but only a limited number of nurses applied motivational interviewing techniques, as half (51 %) of unreturned consent forms were due to forgetfulness.

Conclusion: Our strategy was accepted and deemed feasible by a majority of parents, school staff, and nurses. Collaboration between health authorities and schools is essential for implementing interventions to enhance vaccine acceptance in school-based programs.

Keywords: Feasibility; HPV vaccine; Human papillomavirus; Immunization; Intervention; School-based immunization program; Vaccine acceptability; Vaccine coverage.

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Conflict of interest statement

Dre Chantal Sauvageau has research grants paid to the organization (Institut national de santé publique du Québec or CRCHU de Québec-Université Laval) for clinical trials and epidemiological studies funded by non-profit organizations: Ministère de la Santé et des Services sociaux du Québec, Bill & Melinda Gates Foundation and Michael Smith Foundation). Dre Sauvageau is an active member of the Comité sur l'immunization du Québec and the Groupe de travail sur la vaccination contre le VPH et le zona of the Comité consultatif national de l'immunization. Other authors have no conflicts of interest to disclose.

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