How community engaged practices are applied in interventions promoting human papillomavirus (HPV) vaccination for culturally and linguistically diverse (CALD) children and adolescents: a systematic review.

Abstract

Background: Effective vaccines for human papillomavirus (HPV) are readily available but culturally and linguistically diverse (CALD) communities experience vaccination disparities. Whilst community engaged (CE) practices are recommended, we know little about this practice in local settings.

Aim: We aim to compare CE practices within HPV vaccination interventions targeting CALD children aged 9-17 years and identify how CE elements are linked to outcomes.

Method: Included interventions targeted vaccine eligible CALD children, their parents/caregivers, or health professionals servicing CALD populations. We searched six databases for studies published between 2006 and April 2024. We critically appraised included studies, and data was synthesised based on a CE health framework.

Results: We screened 3798 articles to identify 22 studies. Interventions were based in the United States (USA) and targeted nine different CALD communities. CE practice varied across interventions. All CE practices improved vaccine knowledge, but only multi-component, peer-led/delivered CE practice improved series completion. We note several confounders and analysis limitations.

Discussion: Most CE approaches were initiated by health services rather than the local community. All interventions were limited by study bias and reporting details. We experienced difficulties linking CE practice to intervention outcomes, highlighting tensions between health service driven CE and community empowered CE practices.