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

子宫颈癌是乌干达最主要的女性癌症。许多妇女被诊断为晚期 80%的妇女在确诊后5年内死亡，这使得初级预防至关重要。人乳头瘤病毒是 宫颈癌的主要原因，使接种疫苗成为最重要的单一初级预防措施。 乌干达的全国HPV疫苗接种计划于2015年11月开始，仅专注于 青春期前/青春期女孩对于多剂量系列，采取了两种策略：1)以学校为基础；2) 以社区为基础。然而，在坎帕拉，只有29%的女孩同时获得了所需的剂量。不足的原因 疫苗接种包括在特殊的疫苗接种日缺课。 学校计划，忘记到卫生机构为那些接种疫苗的人提供所需的剂量 缺乏对HPV和疫苗的知识，包括对疫苗的误解。 虽然在美国，关于使用短信提醒疫苗的研究很多，但它们的使用还没有 但在撒哈拉以南非洲或其他中低等地区的青春期前/青少年人群中得到了证实 收入国家(LMIC)。根据世界银行的数据，目前乌干达89.9%的城市家庭拥有 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 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。虽然文本消息可以在 对于识字率较低的人群，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(和平行自动电话 提醒)使用关键线人访谈我们将使用关键线人访谈进行形成性研究 每个站点的利益相关者以及政策制定者。目标2：开发和预先测试HPV疫苗提醒 与目标人群一起，我们将与家庭分享设计的信息原型，以确定问题所在 清晰度、语气和说服力。目标3：试点评估疫苗提醒对HPV疫苗接种的影响 将随机选择一个KCCA地点和青少年诊所的青少年照顾者，按地点分层， 所需的语言和HPV疫苗剂量(启动与完成)。可行性里程碑将包括REACH、 影响规模的确定和实施措施。R33：目标4：进行全面随机对照 试验评估短信提醒对HPV疫苗接种的影响我们将进行全面的随机对照试验 评估HPV疫苗短信提醒的影响。主要结果将是及时性 接种疫苗。我们还将收集流程/可行性措施。这个项目，如果成功，将提供一个 重要的基础不仅是在乌干达使用HPV疫苗短信提醒，而且还为其他 乌干达和其他小岛屿发展中国家的儿童和青少年疫苗接种。

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.