The effect of school-based interventions on HPV vaccine-related knowledge, attitudes, and practices among adolescents in France: Secondary results from the PrevHPV trial

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-06-05 DOI:10.1016/j.vaccine.2025.127344

Josée M. Dussault , Alexia F. Rivera Torres , Damien Oudin Doglioni , Amandine Gagneux-Brunon , Anne-Sophie Le Duc-Banaszuk , Sébastien Bruel , Morgane Michel , Aurélie Gauchet , Anne-Sophie Barret , Jonathan Sicsic , Jocelyn Raude , Nathalie Thilly , Judith E. Mueller , On behalf of the PrevHPV Consortium

{"title":"The effect of school-based interventions on HPV vaccine-related knowledge, attitudes, and practices among adolescents in France: Secondary results from the PrevHPV trial","authors":"Josée M. Dussault , Alexia F. Rivera Torres , Damien Oudin Doglioni , Amandine Gagneux-Brunon , Anne-Sophie Le Duc-Banaszuk , Sébastien Bruel , Morgane Michel , Aurélie Gauchet , Anne-Sophie Barret , Jonathan Sicsic , Jocelyn Raude , Nathalie Thilly , Judith E. Mueller , On behalf of the PrevHPV Consortium","doi":"10.1016/j.vaccine.2025.127344","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>In France, HPV vaccine uptake among adolescents remains a public health concern. Therefore, we examined changes in French adolescents' knowledge, attitudes, and practices (KAP) following exposure to HPV-vaccination-related interventions.</div></div><div><h3>Methods</h3><div>Our cluster-randomized trial applied an incomplete factorial design to allocate three intervention components (in-school education, free in-school vaccination, and general practitioner [GP] trainings) into six arms, randomly assigned to 91 French municipalities. Adolescents' (<em>N</em> = 2758; typically aged 13–14) self-reported HPV-vaccine-related KAP was assessed via online questionnaires at baseline and follow-up. Using logistic regression, we estimated the decomposed effects of each intervention component on favorable responses to individual KAP items. Each model adjusted for the baseline level of the outcome. We conducted subgroup analyses of the effect of the education component.</div></div><div><h3>Results</h3><div>Adolescents who received in-school education, compared to those who did not, provided improved responses on all knowledge items at follow-up. They also reported more favorable attitudes, which included the perceived benefit-risk balance (OR = 1.6 [95 %-CI, 1.2–2.0]) and judging reduced onward transmission as important (1.5 [1.1–2.1]). In-school education increased the likelihood of having HPV-vaccine-related discussions with friends (1.8 [1.2–2.6]). In-school vaccination increased adolescents' likelihood of knowing that friends are vaccinated (3.1 [2.2–4.2]), and perceived accessibility (2.2 [1.5–3.2]). Perceived difficulties in accessing clear vaccine information increased specifically among multilingual adolescents (0.5 [0.2–0.9]).</div></div><div><h3>Conclusion</h3><div>Free in-school HPV vaccination significantly increases perceived ease of access to HPV vaccination for students who are already motivated to get vaccinated, and in-school education and motivation improves students' HPV vaccine-related knowledge and attitudes and can encourage them to get vaccinated. Thus, when offered together over the course of multiple academic years, we would expect to see increased vaccine uptake as adolescents become both more amenable toward vaccination and perceive easier access. Educational material needs tailoring for families from different linguistic and cultural backgrounds.</div></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":"61 ","pages":"Article 127344"},"PeriodicalIF":4.5000,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Vaccine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0264410X25006413","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

In France, HPV vaccine uptake among adolescents remains a public health concern. Therefore, we examined changes in French adolescents' knowledge, attitudes, and practices (KAP) following exposure to HPV-vaccination-related interventions.

Methods

Our cluster-randomized trial applied an incomplete factorial design to allocate three intervention components (in-school education, free in-school vaccination, and general practitioner [GP] trainings) into six arms, randomly assigned to 91 French municipalities. Adolescents' (N = 2758; typically aged 13–14) self-reported HPV-vaccine-related KAP was assessed via online questionnaires at baseline and follow-up. Using logistic regression, we estimated the decomposed effects of each intervention component on favorable responses to individual KAP items. Each model adjusted for the baseline level of the outcome. We conducted subgroup analyses of the effect of the education component.

Results

Adolescents who received in-school education, compared to those who did not, provided improved responses on all knowledge items at follow-up. They also reported more favorable attitudes, which included the perceived benefit-risk balance (OR = 1.6 [95 %-CI, 1.2–2.0]) and judging reduced onward transmission as important (1.5 [1.1–2.1]). In-school education increased the likelihood of having HPV-vaccine-related discussions with friends (1.8 [1.2–2.6]). In-school vaccination increased adolescents' likelihood of knowing that friends are vaccinated (3.1 [2.2–4.2]), and perceived accessibility (2.2 [1.5–3.2]). Perceived difficulties in accessing clear vaccine information increased specifically among multilingual adolescents (0.5 [0.2–0.9]).

Conclusion

Free in-school HPV vaccination significantly increases perceived ease of access to HPV vaccination for students who are already motivated to get vaccinated, and in-school education and motivation improves students' HPV vaccine-related knowledge and attitudes and can encourage them to get vaccinated. Thus, when offered together over the course of multiple academic years, we would expect to see increased vaccine uptake as adolescents become both more amenable toward vaccination and perceive easier access. Educational material needs tailoring for families from different linguistic and cultural backgrounds.

查看原文本刊更多论文

学校干预对法国青少年HPV疫苗相关知识、态度和实践的影响：PrevHPV试验的次要结果

在法国，青少年接种HPV疫苗仍然是一个公共卫生问题。因此，我们研究了暴露于hpv疫苗相关干预措施后法国青少年的知识、态度和实践（KAP）的变化。方法一项聚类随机试验采用不完全析因设计，将三个干预成分（校内教育、免费校内疫苗接种和全科医生培训）分为六个组，随机分配到法国91个城市。青少年(N = 2758；通过基线和随访时的在线问卷评估自我报告的hpv疫苗相关KAP（通常为13-14岁）。使用逻辑回归，我们估计了每个干预成分对个别KAP项目的有利反应的分解效应。每个模型都根据结果的基线水平进行调整。我们对教育成分的影响进行了亚组分析。结果与未接受学校教育的青少年相比，接受过学校教育的青少年在随访时对所有知识项目的回答都有所改善。他们还报告了更有利的态度，其中包括感知到的利益-风险平衡（OR = 1.6 [95% -CI, 1.2-2.0]）和判断减少后续传播的重要性（1.5[1.1-2.1]）。学校教育增加了与朋友进行hpv疫苗相关讨论的可能性（1.8[1.2-2.6]）。在学校接种疫苗增加了青少年知道朋友接种疫苗的可能性（3.1[2.2 - 4.2]）和感知可及性（2.2[1.5-3.2]）。特别是在多语种青少年中，获得明确疫苗信息的感知困难增加（0.5[0.2-0.9]）。结论学校免费HPV疫苗接种显著提高了有接种动机的学生获得HPV疫苗的易感性，学校教育和激励提高了学生的HPV疫苗相关知识和态度，可以鼓励他们接种HPV疫苗。因此，当在多个学年的过程中同时提供疫苗时，我们预计随着青少年变得更容易接受疫苗接种并认为更容易获得疫苗接种，疫苗接种率会增加。教材需要为不同语言和文化背景的家庭量身定做。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

期刊介绍： Vaccine is unique in publishing the highest quality science across all disciplines relevant to the field of vaccinology - all original article submissions across basic and clinical research, vaccine manufacturing, history, public policy, behavioral science and ethics, social sciences, safety, and many other related areas are welcomed. The submission categories as given in the Guide for Authors indicate where we receive the most papers. Papers outside these major areas are also welcome and authors are encouraged to contact us with specific questions.