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

背景：HPV感染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，一些地区和人群的覆盖率较低。一些在疫苗接种覆盖率低的学校上学的年轻妇女对HPV疫苗接种的信息需求未得到满足，这可能使她们无法接种疫苗。目标：针对年轻人制定一套教育方案，可用于以学校为基础的青少年疫苗接种方案，以提高疫苗接种率较低的地区和人口的疫苗覆盖率。我们还将了解是否有可能进行更大规模的研究，以测试一揽子教育是否有助于增加年轻人对HPV疫苗的了解，他们参与决策过程，以及这是否会导致在覆盖率较低的学校中有多少年轻人接种疫苗。研究计划：参与者的招募将通过HPV疫苗接种覆盖率低的地区的卫生保健组织、青年团体和学校进行。研究分为三个阶段。在第一阶段，我们将审查现有的年轻人免疫材料。我们还将与12至15岁的年轻人和其他主要利益相关者（NHS专员、免疫护士、青年工作者/从业者和学校员工）进行交谈，以了解他们认为应该由谁来提供教育方案以及内容应该是什么。在第二阶段，来自八家媒体机构的创意设计师和来自创意青年网络的年轻人（n=6）将共同制作教育包的内容和材料（如视频、幻灯片）。将在一个青年组织举办一次讲习班，请6-8岁的年轻人就重要的疫苗信息和传递信息的最佳方式发表意见。联合制作团队将根据参与者的反馈制作材料。我们会在其他青年团体（18至24岁）举办另外三个工作坊，以取得进一步的反馈。合拍组将根据年轻人的意见对材料进行修改，直到它们符合目的为止。利用第一阶段和第二阶段的发现，我们将发展一个理论来解释我们认为教育一揽子计划应该如何运作。在第三阶段，我们将对教育方案进行一些初步测试；重点关注如何在学校实施，以及年轻人和主要利益相关者是否可以接受。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约一个小时，并将在接种疫苗前两周左右交付给八年级学生。该会议旨在为年轻人创造一个安全的空间，让他们提出有关HPV疫苗的问题，以及在接种过程中会发生什么。我们会观察整套教育方案的执行情况，并与年轻人和主要持份者进行更多访谈。这将帮助我们发现教育课程是否按照预期进行，哪些部分效果很好，哪些部分效果不好，以及原因。我们还将测试从年轻人那里获得反馈的方法，并找出是否有可能收集有关从免疫小组获得的同意类型的信息。研究发现：为了分享研究结果，我们将组织一个由年轻人和主要利益相关者（NHS专员、免疫护士、青年工作者/从业者和学校员工）参加的研讨会和一个网络研讨会。研究结果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发展的理论，并就未来是否与更多的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.