Development of a multicomponent intervention to increase parental vaccine confidence and young people’s access to the universal HPV vaccination programme in England: protocol for a co-design study

Harri Fisher*, Tracey Chantler, Sarah Denford, Adam Finn, Matt Hickman, Sandra Mounier-Jack, Marion R Roderick, Leanne Tucker, Julie Yates, Suzanne Audrey

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Abstract

Introduction Persistent infection with HPV can result in cancers affecting men and, especially, women. Lower uptake exists by area and different population groups. Increasing parental confidence about, and adolescent access to, the universal HPV vaccination programme may help reduce inequalities in uptake. However, the evidence-base for interventions to address uptake for schools-based HPV vaccination programmes is currently lacking. This study protocol outlines how a multicomponent intervention to address this evidence gap will be codesigned with parents.

Methods and analysis The proposed research will be undertaken in localities covered by two immunisation teams in London and the south-west of England. The ‘person-based approach’ to intervention development will be followed. In the first phase, an exploratory qualitative study will be undertaken with key stakeholders (n=8) and parents (n=40) who did not provide consent for their adolescent child to be vaccinated. During the interviews, parents’ views on ways to improve parental confidence about, and adolescents’ access to, HPV vaccination will be sought. The findings will be used to inform the co-design of a preliminary plan for a targeted, multicomponent intervention. In the second phase, at least two parent working groups (n=8) will be convened and will work with creative designers to co-design communication materials aimed at increasing parents’ confidence in vaccination. At least two workshops with each parent group will be organised to obtain feedback on the intervention plan and communication materials to ensure they are fit for purpose. These findings will inform a protocol for a future study to test the effectiveness of the intervention at increasing HPV vaccination uptake.

Ethics and dissemination The National Health Services Research Ethics Service and London School of Hygiene & Tropical Medicine Observational / Interventions Research Ethics Committee provided approvals for the study (reference 22/SW/0003 & 26902, respectively). We will work with parent advisory groups to inform our dissemination strategy and co-present our findings (eg, at community events or through social media). We will disseminate our findings with academics and healthcare professionals through webinars and academic conferences, as well as peer-reviewed publications.
Original languageEnglish
Article numbere062050
JournalBMJ Open
Volume12
Issue number4
Early online date6 Apr 2022
DOIs
Publication statusE-pub ahead of print - 6 Apr 2022

Bibliographical note

Funding Information:
4Department of Paediatric Immunology and Infectious Diseases, University Hospitals of Bristol and Weston NHS Foundation Trust, Bristol, UK 5Bristol Parent Carers, Bristol, UK 6Screening and Immunisation, South West, NHS England South, Taunton, UK Acknowledgements HF, SA and SD acknowledge support from the NIHR Health Protection Research Unit in Behavioural Science and Evaluation at University of Bristol. The Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation at University of Bristol is part of the National Institute for Health Research (NIHR) and a partnership between University of Bristol and UK Health Security Agency (UKHSA), in collaboration with the MRC Biostatistics Unit at University of Cambridge and University of the West of England. This study is funded by the National Institute for Health Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation (NIHR200929), a partnership between UK Health Security Agency and the London School of Hygiene and Tropical Medicine. The views expressed are those of the author(s) and not necessarily those of the NIHR, UK Health Security Agency or the Department of Health and Social Care. The support of The Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), a UKCRC Public Health Research Centre of Excellence. Joint funding (MR/KO232331/1) from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the Welsh Government and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. Collaborators N/A. Contributors All authors were involved in the conception and design of the research. HF is joint principal investigator and contributes expertise in research on HPV vaccination programmes; SA is joint principal investigator and contributes expertise in qualitative research and process evaluation. AF provides experience in the field of vaccine and policy development. JY and MR will support the dissemination of findings and wider implementation of the educational package as appropriate. LT is a member of the public and will assist in arranging planned activities for PPI. MH provides expertise in infectious disease control. SD offers expertise in the ‘person-based approach’ to intervention development. SM-J has expertise in health systems and policy evaluations, notably vaccination programmes. TC provides implementation, mixed methods and anthropology research expertise in relation to UK vaccination programmes. HF wrote the first draft and all authors contributed to the final version of the manuscript. Funding This project is funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number NIHR202760). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

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