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Abstract
Background Human papillomavirus (HPV) vaccination offers protection against the virus responsible for cervical, oropharyngeal, anal, vulval and penile cancers. However, there is considerable variation across, and even within, countries as to how HPV vaccination is offered and accepted. This review aimed to identify what interventions exist to promote uptake and how effective they are.
Methods We conducted an umbrella review using the JBI (Joanna Briggs Institute) methodology to evaluate routine or catch-up interventions to increase HPV vaccination uptake and/or intention for children aged 9 years and older, adolescents and young adults up to 26. Comprehensive searches for English language quantitative systematic reviews, published between January 2011 and July 2021, were conducted across five databases. After reviewing titles and abstract, relevant papers were independently assessed in detail.
Main results From 1046 records identified, 10 articles were included in the review. They reported on 95 randomised controlled trials, 28 quasi-experimental studies, 14 cohort studies, 6 non-randomised pretest/post-test studies with control groups, 5 single-group pretest/post-test studies, 1 single-group post-test study and 1 randomised longitudinal study. Some interventions promoted change at the individual, community or organisational level, while others used a multicomponent approach. Face-to-face presentations, printed information and supplementing both strategies with additional components appear effective at increasing vaccination intention, while reminders and multicomponent strategies, especially ones that include some intervention aimed at provider level, appear effective at increasing vaccination uptake. Interventions that did not lead to an improvement in HPV vaccination intention or uptake varied in design and impacts were inconsistent across children/adolescents, young adults or parents.
Conclusion The evidence suggests that there is no single solution to increasing vaccination uptake and that different approaches may be better suited to certain populations. However, generalisations are limited by poor reporting and a paucity of studies beyond the USA. Further high-quality studies, therefore, are needed to understand how best to increase HPV vaccination uptake in different target populations.
- VACCINATION
- SEXUAL HEALTH
- SYSTEMATIC REVIEW
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Footnotes
Handling editor Laith J Abu-Raddad
Twitter @ClareBennettCU, @husnasarica
Contributors DK was responsible for the conceptualisation of this project. The conduct of the umbrella review was led by DE and CB, with DE, CB, SMS, D-e-NW, AV, HSÇ, EK and GP conducting the screening, quality assessment, data extraction and narrative that underpinned this paper. All members of the team contributed to the reporting of the review. All authors edited and approved the final manuscript.
Funding This research was co-ordinated by the European Cancer Organisation, who received some financial contributions towards its cost from Community 365 charity and healthcare industry partners: NOMAN, BD, MSD and Roche.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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