Educational interventions to increase HPV vaccination acceptance: a systematic review.

BACKGROUND The Human papillomavirus (HPV) vaccine has been available for protection against HPV-associated cervical cancer and genital warts since 2006. Nonetheless, uptake has varied among countries and populations within countries. Studies have found that individuals' knowledge and attitudes toward the vaccine are associated with immunization uptake. The purpose of the current review is to summarize and evaluate the evidence for educational interventions to increase HPV vaccination acceptance. METHODS We searched the databases of PubMed and Web of Science for English-language articles describing educational interventions designed to improve HPV vaccination uptake, intention or attitude. RESULTS We identified 33 studies of HPV vaccination educational interventions: 7 tested the effectiveness of interventions with parents, 8 with adolescents or young adults, and 18 compared the effectiveness of different message frames in an educational intervention among adolescents, young adults or their parents. Most studies involved populations with higher educational attainment and most interventions required participants to be literate. The minority of studies used the outcome of HPV vaccine uptake. Well-designed studies adequately powered to detect change in vaccine uptake were rare and generally did not demonstrate effectiveness of the tested intervention. CONCLUSIONS There is not strong evidence to recommend any specific educational intervention for wide-spread implementation. Future studies are required to determine the effectiveness of culturally-competent interventions reaching diverse populations.