Complex intervention to promote human papillomavirus (HPV) vaccine uptake in school settings: A cluster-randomized trial.

Davies, C; Marshall, HS; Brotherton, JML; McCaffery, K; Kang, M; Macartney, K; Garland, SM; Kaldor, J; Zimet, G; Skinner, SR; HPV.edu Study Group,

Complex intervention to promote human papillomavirus (HPV) vaccine uptake in school settings: A cluster-randomized trial.

Davies, C Marshall, HS Brotherton, JML McCaffery, K Kang, M

Macartney, K Garland, SM Kaldor, J Zimet, G Skinner, SR HPV.edu Study Group,

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Publisher:: Elsevier
Publication Type:: Journal Article
Citation:: Prev Med, 2023, 172, pp. 107542
Issue Date:: 2023-07

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Field	Value	Language
dc.contributor.author	Davies, C
dc.contributor.author	Marshall, HS
dc.contributor.author	Brotherton, JML
dc.contributor.author	McCaffery, K
dc.contributor.author	Kang, M https://orcid.org/0000-0002-9438-2518
dc.contributor.author	Macartney, K
dc.contributor.author	Garland, SM
dc.contributor.author	Kaldor, J
dc.contributor.author	Zimet, G
dc.contributor.author	Skinner, SR
dc.contributor.author	HPV.edu Study Group,
dc.date.accessioned	2023-11-08T03:59:47Z
dc.date.available	2023-05-08
dc.date.available	2023-11-08T03:59:47Z
dc.date.issued	2023-07
dc.identifier.citation	Prev Med, 2023, 172, pp. 107542
dc.identifier.issn	0091-7435
dc.identifier.issn	1096-0260
dc.identifier.uri	http://hdl.handle.net/10453/173235
dc.description.abstract	Using a cluster-randomized trial design, we aimed to evaluate a complex intervention to increase uptake of human papillomavirus (HPV) vaccination in schools. The study was undertaken in high schools in Western Australia and South Australia between 2013 and 2015 with adolescents aged 12-13 years. Interventions included education, shared decision-making, and logistical strategies. The main outcome was school vaccine uptake. Secondary outcomes included consent forms returned and mean time to vaccinate 50 students. We hypothesised that a complex intervention would increase 3-dose HPV vaccine uptake. We recruited 40 schools (21 intervention, 19 control) with 6, 967 adolescents. There was no difference between intervention and control (3-dose mean 75.7% and 78.9%, respectively). Following adjustment for baseline covariates, absolute differences in coverage in favour of the intervention group were: dose 1, 0.8% (95% CI, -1.4,3.0); dose 2, 0.2% (95% CI, -2.7, 3.1); dose 3, 0.5% (95% CI, -2.6, 3.7). The percentage of returned consent forms in intervention schools (91.4%) was higher than in control schools (difference: 6%, 95% CI, 1.4, 10.7). There was a shorter mean time to vaccinate 50 students at dose 3. The difference for dose 3 was 110 min (95% CI, 42, 177); for dose 2, 90 min (95% CI, -15, 196); and dose 1, 28 min (95% CI, -71, 127). Logs revealed the inconsistent implementation of logistical strategies. The intervention had no impact on uptake. Inadequate resourcing for logistical strategies and advisory board reluctance toward strategies with potential financial implications impacted the implementation of logistical components. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry, ACTRN12614000404628, 14.04.2014. The study protocol was published in 2015 before data collection was finalised (Skinner et al., 2015). THE HPV.EDU STUDY GROUP: We would like to acknowledge the contributions to this study by members of the HPV.edu Study Group, including: Professor Annette Braunack-Mayer: Australian Centre for Health Engagement, Evidence and Values, School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, NSW, Australia; Dr. Joanne Collins: Women's and Children's Health Network and School of Medicine and Robinson Research Institute, University of Adelaide, SA, Australia; Associate Professor Spring Cooper: School of Public Health, City University of New York (CUNY), New York, NY, USA; Heidi Hutton: Telethon Kids Institute, University of Western Australia, WA, Australia; Jane Jones: Telethon Kids Institute, University of Western Australia, WA, Australia; Dr. Adriana Parrella: Women's and Children's Health Network and School of Medicine and Robinson Research Institute, University of Adelaide, SA, Australia; and South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia; Associate Professor David G. Regan: The Kirby Institute for Infection and Immunity in Society, Faculty of Medicine, UNSW Sydney, NSW, Australia; Professor Peter Richmond: Perth Children's Hospital, Child and Adolescent Health Service, Western Australia, Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, WA, Australia, and School of Medicine, University of Western Australia, Perth, WA, Australia; Dr. Tanya Stoney: Telethon Kids Institute, University of Western Australia, WA, Australia. Contact for the HPV.edu study group: Cristyn.Davies@sydney.edu.au or Rachel.Skinner@sydney.edu.au.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier
dc.relation.ispartof	Prev Med
dc.relation.isbasedon	10.1016/j.ypmed.2023.107542
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1106 Human Movement and Sports Sciences, 1117 Public Health and Health Services
dc.subject.classification	Public Health
dc.subject.classification	4202 Epidemiology
dc.subject.classification	4206 Public health
dc.subject.mesh	Child
dc.subject.mesh	Adolescent
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Human Papillomavirus Viruses
dc.subject.mesh	Australia
dc.subject.mesh	Papillomavirus Infections
dc.subject.mesh	Papillomavirus Vaccines
dc.subject.mesh	Child Health
dc.subject.mesh	Women's Health
dc.subject.mesh	Vaccination
dc.subject.mesh	Humans
dc.subject.mesh	Papillomavirus Infections
dc.subject.mesh	Vaccination
dc.subject.mesh	Adolescent
dc.subject.mesh	Child
dc.subject.mesh	Women's Health
dc.subject.mesh	Australia
dc.subject.mesh	Female
dc.subject.mesh	Papillomavirus Vaccines
dc.subject.mesh	Child Health
dc.subject.mesh	Human Papillomavirus Viruses
dc.subject.mesh	Child
dc.subject.mesh	Adolescent
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Human Papillomavirus Viruses
dc.subject.mesh	Australia
dc.subject.mesh	Papillomavirus Infections
dc.subject.mesh	Papillomavirus Vaccines
dc.subject.mesh	Child Health
dc.subject.mesh	Women's Health
dc.subject.mesh	Vaccination
dc.title	Complex intervention to promote human papillomavirus (HPV) vaccine uptake in school settings: A cluster-randomized trial.
dc.type	Journal Article
utslib.citation.volume	172
utslib.location.activity	United States
utslib.for	1106 Human Movement and Sports Sciences
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	open_access	*
dc.date.updated	2023-11-08T03:59:45Z
pubs.publication-status	Published
pubs.volume	172

Abstract:

Using a cluster-randomized trial design, we aimed to evaluate a complex intervention to increase uptake of human papillomavirus (HPV) vaccination in schools. The study was undertaken in high schools in Western Australia and South Australia between 2013 and 2015 with adolescents aged 12-13 years. Interventions included education, shared decision-making, and logistical strategies. The main outcome was school vaccine uptake. Secondary outcomes included consent forms returned and mean time to vaccinate 50 students. We hypothesised that a complex intervention would increase 3-dose HPV vaccine uptake. We recruited 40 schools (21 intervention, 19 control) with 6, 967 adolescents. There was no difference between intervention and control (3-dose mean 75.7% and 78.9%, respectively). Following adjustment for baseline covariates, absolute differences in coverage in favour of the intervention group were: dose 1, 0.8% (95% CI, -1.4,3.0); dose 2, 0.2% (95% CI, -2.7, 3.1); dose 3, 0.5% (95% CI, -2.6, 3.7). The percentage of returned consent forms in intervention schools (91.4%) was higher than in control schools (difference: 6%, 95% CI, 1.4, 10.7). There was a shorter mean time to vaccinate 50 students at dose 3. The difference for dose 3 was 110 min (95% CI, 42, 177); for dose 2, 90 min (95% CI, -15, 196); and dose 1, 28 min (95% CI, -71, 127). Logs revealed the inconsistent implementation of logistical strategies. The intervention had no impact on uptake. Inadequate resourcing for logistical strategies and advisory board reluctance toward strategies with potential financial implications impacted the implementation of logistical components. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry, ACTRN12614000404628, 14.04.2014. The study protocol was published in 2015 before data collection was finalised (Skinner et al., 2015). THE HPV.EDU STUDY GROUP: We would like to acknowledge the contributions to this study by members of the HPV.edu Study Group, including: Professor Annette Braunack-Mayer: Australian Centre for Health Engagement, Evidence and Values, School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, NSW, Australia; Dr. Joanne Collins: Women's and Children's Health Network and School of Medicine and Robinson Research Institute, University of Adelaide, SA, Australia; Associate Professor Spring Cooper: School of Public Health, City University of New York (CUNY), New York, NY, USA; Heidi Hutton: Telethon Kids Institute, University of Western Australia, WA, Australia; Jane Jones: Telethon Kids Institute, University of Western Australia, WA, Australia; Dr. Adriana Parrella: Women's and Children's Health Network and School of Medicine and Robinson Research Institute, University of Adelaide, SA, Australia; and South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia; Associate Professor David G. Regan: The Kirby Institute for Infection and Immunity in Society, Faculty of Medicine, UNSW Sydney, NSW, Australia; Professor Peter Richmond: Perth Children's Hospital, Child and Adolescent Health Service, Western Australia, Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, WA, Australia, and School of Medicine, University of Western Australia, Perth, WA, Australia; Dr. Tanya Stoney: Telethon Kids Institute, University of Western Australia, WA, Australia. Contact for the HPV.edu study group: Cristyn.Davies@sydney.edu.au or Rachel.Skinner@sydney.edu.au.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/173235