SEARCH: SMS Electronic Adolescent Reminders for Completion of HPV vaccination- Uganda

宫颈癌是乌干达女性的主要癌症。许多妇女被诊断为晚期 艾滋病毒/艾滋病是一种严重的疾病，80%的妇女在诊断后5年内死亡，因此初级预防至关重要。HPV是 这是导致宫颈癌的主要原因，使接种疫苗成为唯一最重要的初级预防措施。 乌干达的国家HPV疫苗接种计划始于2015年11月， 青春期前/青春期少女。多次剂量系列采用了两种策略：1）以学校为基础，2） 以社区为基础。然而，在坎帕拉，只有29%的女孩接受了两种所需剂量。不足的原因 疫苗接种包括在特殊疫苗接种日缺课， 学校计划，不记得来一个卫生设施为那些正在接种疫苗所需的剂量 在社区中，缺乏关于HPV和疫苗的知识，包括对疫苗的误解。 虽然在美国，关于使用短信疫苗提醒的研究很强，它们的使用并没有 但在撒哈拉以南非洲或其他中低收入国家的青春期前/青少年人群中得到证实， 低收入国家（LMIC）。根据世界银行的数据，目前乌干达89.9%的城市家庭 一部手机这项研究将在三个保健中心及其附属学校和社区进行 由坎帕拉首都城市管理局（KCCA）监督的免疫中心以及 Makerere/Mulago/哥伦比亚青少年健康诊所，也在坎帕拉。虽然短信可以用于 对于识字率低的人口，家庭可以选择接收自动电话提醒。 R21：目标1：确定所需的HPV疫苗短信提醒内容（和并行自动电话 我们将使用关键线人访谈进行形成性研究 与每个地点的利益相关者以及政策制定者进行沟通。目的2：开发和预测试HPV疫苗提醒 我们将与家庭分享设计好的信息原型， 清晰度、语气和说服力。目的3：初步评估疫苗提醒对HPV疫苗接种的影响 将在一个KCCA研究中心和青少年诊所随机分配青春期前/青少年的护理人员，按研究中心分层， 语言和所需的HPV疫苗剂量（开始与完成）。可行性里程碑将包括到达， 效应量的确定和实施措施。R33：目标4：进行全面随机对照 评估短信提醒对HPV疫苗接种影响的试验我们将进行一项全面的RCT 评估HPV疫苗短信提醒的影响。主要成果将是： 预防针我们还将收集过程/可行性措施。该项目如果成功，将提供 这不仅是乌干达使用HPV疫苗短信提醒的重要基础，也是其他国家使用HPV疫苗的重要基础。 在乌干达和其他中低收入国家的儿童和青少年接种疫苗。

Cervical cancer is the leading female cancer in Uganda. Many women are diagnosed with late-stage disease, and 80% of women die within 5 years of diagnosis, making primary prevention critical. HPV is the principal cause of cervical cancer, making vaccination the single most important primary preventive measure. The national HPV vaccination program in Uganda began in November 2015 and focuses solely on preteen/adolescent girls. Two strategies have been adopted for the multi-dose series: 1) school-based and 2) community-based. However, in Kampala, only 29% of girls receive both needed doses. Reasons for under vaccination include school absenteeism on special vaccination days for those receiving vaccination as part of a school program, failing to remember to come to a health facility for a needed dose for those being vaccinated in the community, and lack of knowledge regarding HPV and the vaccines including vaccine misperceptions. While research regarding the use of text message vaccine reminders is strong in the U.S., their use has not yet been demonstrated in a preteen/adolescent population in Sub-Saharan African or other low- and middle- income countries (LMICs). According to the World Bank, currently 89.9% of urban households in Uganda have a cell phone. This study will take place at three health centres and their affiliated schools and community immunization centers overseen by the Kampala Capital City Authority (KCCA) as well as at the Makerere/Mulago/Columbia Adolescent Health Clinic, also in Kampala. While text messages can be used in populations with low literacy, families can opt to receive automated phone call reminders instead. R21: Aim 1: Identify desired HPV vaccine text message reminder content (and parallel automated phone reminders) using key informant interviews We will conduct formative research using key informant interviews with stakeholders at each site as well as policy makers. Aim 2: Develop and pretest HPV vaccine reminders with target population We will share prototypes of the designed messages with families to identify issues with clarity, tone, and persuasiveness. Aim 3: Pilot assess the impact of vaccine reminders on HPV vaccination We will randomize caregivers of preteens/adolescents at one KCCA site and the adolescent clinic, stratified by site, language and HPV vaccine dose needed (initiation vs. completion). Feasibility milestones will include reach, effect size determination and implementation measures. R33: Aim 4: Conduct a full-scale randomized-control trial to assess the impact of text message reminders on HPV vaccination We will conduct a full-scale RCT assessing the impact of the HPV vaccine text message reminders. The main outcome will be timeliness of vaccination. We will also collect process/feasibility measures. This project, if successful, will provide an important foundation not only for the use of HPV vaccine text message reminders in Uganda but also for other childhood and adolescent vaccinations in Uganda and in other LMICs.