Co-production of an educational package for the universal HPV vaccination programme tailored for schools with low uptake: A participatory study

背景：感染HPV可导致影响男性和女性的癌症。从2019年9月起，已经向年轻女性提供的以学校为基础的HPV疫苗接种计划将包括12至13岁的年轻男性。我们的研究表明，一些地区和人口群体的覆盖率较低。一些在接种覆盖率低的学校上学的年轻女性对HPV疫苗接种的信息需求没有得到满足，这可能会使她们无法接受疫苗接种。AIMS：制定一套针对年轻人的教育包，可用于青少年学校疫苗接种计划，以增加接种率较低的地区和人口的疫苗覆盖率。我们亦会研究是否有可能进行更大规模的研究，以测试教育方案是否有助提高青少年对HPV疫苗的认识、他们对决策过程的参与，以及这是否会导致在覆盖率较低的学校接种疫苗的年轻人增加。研究计划：在HPV疫苗覆盖率较低的地区，将通过医疗机构、青年团体和学校招募参与者。这项研究分为三个阶段。在第一阶段，我们会检讨现有的青少年防疫注射材料。我们亦会与12至15岁的年青人及其他主要持份者(国民健康服务专员、防疫注射护士、青年工作者/从业员及学校教职员)交谈，以了解他们认为应由谁发放教育套餐，以及内容应为甚麽。在第二阶段，来自八间传媒机构的创意设计师及创意青年网络的年青人(n=6)将共同制作教育套装的内容及素材(例如录影带、幻灯片等)。将在一个青年组织中组织一次研讨会，邀请6-8岁的年轻人就重要的疫苗信息和传递这些信息的最佳方式发表意见。联合制作团队将利用参与者的反馈制作材料。此外，该署亦会在其他青年团体(18至24岁)举办另外三个工作坊，以收集更多意见。联合制作团队会根据年轻人的说法对材料进行修改，直到它们适合用途。我们将利用第一阶段和第二阶段的研究结果，建立一个理论来解释我们认为教育方案应该如何运作。在第三阶段，我们将对教育方案进行一些初步测试；重点是如何在学校提供教育方案，以及它是否为年轻人和主要利益相关者所接受。我们将邀请英格兰西南部和伦敦南部HPV疫苗接种计划覆盖率较低的学校(n=4)参加。在这个阶段，我们认为教育包将持续大约一个小时，并将在接种课程前大约两周分发给八年级学生。该课程的目的是为年轻人创造一个安全的空间，让他们询问他们对HPV疫苗的问题，以及在接种疫苗过程中会发生什么。我们将观察教育包的交付情况，并对年轻人和关键利益攸关方进行更多访谈。这将帮助我们找出教育会议是否按预期进行，哪些部分运行良好，哪些部分运行不好，以及原因。我们还将测试从年轻人那里获得反馈的方法，并了解是否有可能收集有关从疫苗接种小组获得的同意类型的信息。研究结果：为了分享研究结果，我们将与年轻人和主要利益相关者(NHS专员、免疫护士、青年工作者/从业者和学校教职员工)组织一次研讨会和一次网络研讨会。这一发现将发表在学术期刊上，并在会议上发表。我们将最终确定我们开发的理论，并就是否在未来与更多学校进行研究提出建议。

BACKGROUND: Infection with HPV can lead to cancers affecting men and women. From September 2019, the schools-based HPV vaccination programme, already delivered to young women, will include young men aged 12 to 13 years. Our research shows some areas and population groups have lower coverage. Some young women attending schools where vaccination coverage is low had unmet information needs about HPV vaccination which may stop them receiving the vaccine.AIMS: To develop an educational package with young people, that can be used within the adolescent schools-based vaccination programme, tailored to increase vaccine coverage in areas and populations with lower uptake. We will also find out whether it would be possible to undertake a larger scale study to test whether the education package helps increase young people's understanding about the HPV vaccine, their involvement in the decision-making process, and whether this leads to an increase in how many young people receive the vaccine in schools with lower coverage.RESEARCH PLAN: Recruitment of participants will take place through healthcare organisations, youth groups and schools in areas where HPV vaccination coverage is low. The research has three stages. In Stage One, we will review existing immunisation materials for young people. We will also talk to young people aged 12 to 15 years and other key stakeholders (NHS commissioners, immunisation nurses, youth workers/practitioners, & school staff) to find out who they think should deliver the educational package and what the content should be.In Stage Two, creative designers from Eight media agency and young people (n=6) from Creative Youth Network will co-produce the content and materials (e.g. videos, power points) for the educational package. A workshop will be organised in a youth organisation where young people (6-8) are asked to comment on important vaccine messages and the best way to deliver the messages. The co-production team will produce materials using the feedback from participants. Three more workshops in additional youth organisations (18-24) will be organised to obtain further feedback. The co-production team will make changes to the materials according to what the young people say until they are fit for purpose. Using the findings from Stages One and Two, we will develop a theory to explain how we think the educational package is supposed to work.In Stage Three, we will undertake some preliminary testing of the educational package; focussing on how it can be delivered in schools and whether it is acceptable to young people and key stakeholders. We will invite schools (n=4) with lower coverage of the HPV vaccination programme in the South West of England and South London to take part. At this stage, we think the educational package will last about an hour and will be delivered to Year 8 students about two weeks before the vaccination session. The session will aim to create a safe space for young people to ask questions they have about the HPV vaccine and what to expect during the vaccination process. We will observe the delivery of the education package and carry out more interviews with young people and key stakeholders. This will help us find out whether the educational session is delivered as intended, which parts work well, and which parts do not work well, and why. We will also test ways of getting feedback from young people and find out whether it is possible to collect information about types of consent obtained from the immunisation team. STUDY FINDINGS: To share the results of the study we will organise a workshop with young people and key stakeholders (NHS commissioners, immunisation nurses, youth workers/practitioners, & school staff) and a webinar. The findings will be published in academic journals and presented at conferences. We will finalise the theory we developed and make recommendations about whether to carry out a future study with a larger number of schools.