Interventions to increase HPV vaccination coverage: A systematic review

Elizabeth A Smulian, Krista R Mitchell, Shannon Stokley, Elizabeth A Smulian, Krista R Mitchell, Shannon Stokley

Abstract

We reviewed intervention studies designed to increase human papillomavirus (HPV) vaccination coverage to further understand the impact interventions can have on HPV vaccination coverage. We searched 5 databases for intervention studies published from June 2006 to May 2015. Studies were included if they quantitatively measured HPV vaccination coverage as an outcome and were conducted in the United States. We abstracted outcomes, methods, and results from each study and classified by type of intervention conducted. Findings from 34 studies suggest many types of intervention strategies can increase HPV vaccination coverage in different settings, and with modest cost. Interventions were effective especially when implemented in combination at both provider and community levels. However, not all interventions showed significant effects on coverage. More research is needed to identify the best methods for widespread implementation of effective strategies.

Keywords: HPV; coverage; human papillomavirus; interventions; vaccination.

Figures

Figure 1.
Figure 1.
Flow chart of review process and study selection.
Figure 2.
Figure 2.
Forest plot of selected HPV vaccination intervention results: series initiation. ▪ : Effect estimates from original source. ▴ : Effect estimates calculated by review authors based on given data in source. *Results presented if study included a measure of series initiation (one or more doses of HPV vaccine). Results were excluded if study did not include a measure of series initiation or if results were not presented in the original paper such that an effect size could be calculated. If studies measured series initiation in more than one population or using different methods, the specifics are indicated in parentheses following the study author's name. F denotes studies that focused on females and M denotes studies that focused on males. Full study characteristics and results can be found in Table 3. **Results were determined to be significant by the original paper. †Effect estimate's confidence intervals could not fit in the plot scale. Cassidy et al. found an OR of 9.43 (2.69–33.10) for series initiation. ‡Effect estimate's confidence intervals could not fit in the plot scale. Perkins et al. found an OR of 11 (6.9–17) for series initiation among males.

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Source: PubMed

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