Pre-post school educational intervention assessment on HPV vaccination attitudes and willingness

Abstract

Abstract Background In Italy, vaccination coverage against human Papilloma Virus (HPV) showed a decreasing trend during last years. Different reasons could lead to a decrease in HPV vaccination confidence, such as not taking part to school seminars on HPV infection and vaccination. A pre-post intervention study was conducted in order to assess the improvement of knowledge, attitudes and behavior on HPV-related diseases and willingness on HPV vaccination among secondary school students. Methods Two anonymous pre-post intervention questionnaires made up of 25 and 8 items, respectively, were administered to a representative sample of students attending secondary schools of Palermo, Italy. Between the two questionnaire administration, an educational intervention on HPV-related diseases and HPV vaccination, conducted by Public Health medical residents at the University of Palermo, was carried out. Results During 2017/2018 and 2018/2019 school years, a sample of 1702 students, attending 18 first-grade secondary schools of the Province of Palermo, was enrolled. Evaluating a 10-scale likert question on the willingness of the children regarding vaccination against HPV, a significant increase of the average score from 8.50 (SD ± 1.79) to 9.01 (SD ± 1.50) (p value <0.001) was observed after intervention. At the multivariate analysis, male students (adjOR 1.76; 95% CI 1.28-2.42) and students attending schools in areas with a high deprivation index (adjOR 1.25; CI 95 % 1.01-1.55), showed a lower increase in HPV vaccination willingness after the educational intervention. In addition, 188 children from 5 schools of more deprived areas, not yet immunized, were vaccinated against HPV. Conclusions Standardized educational interventions in the school environment could increase confidence towards HPV and other vaccinations among students. Furthermore, vaccination offer at schools could represent a fundamental strategy to increase vaccination coverage, especially in more deprived areas. Key messages The research confirms the effectiveness of school educational interventions in increasing HPV vaccination confidence. Vaccination offer at schools could represent a fundamental strategy to increase vaccination coverage especially in more deprived areas.