Public Health Evidence and Innovation Division, Provincial Population and Public Health, Alberta Health Services, Calgary, Alberta, Canada.
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
PLoS One. 2022 Dec 1;17(12):e0278472. doi: 10.1371/journal.pone.0278472. eCollection 2022.
More than 1,300 Canadians are diagnosed with cervical cancer annually, which is nearly preventable through human papillomavirus (HPV) immunization. Across Canada, coverage rates remain below the 90% target set out by the Action Plan for the Elimination of Cervical Cancer in Canada (2020-2030). To support this Plan, the Canadian Partnership Against Cancer has commissioned the Urban Public Health Network (UPHN) to coordinate a quality improvement project with Canada's school-based HPV immunization programs. In Alberta, the UPHN partnered with Alberta Health Services (AHS) for this work. This study has one overarching research question: what are parent/guardian and program stakeholder perceived barriers, enablers and opportunities to immunization for youth as part of the school-based HPV immunization program in Alberta? This study uses a mixed-methods sequential explanatory design. A survey will be emailed to a sample of Albertans with children aged 11-17 years. Questions will be based on a Conceptual Framework of Access to Health Care. Subsequent qualitative work will explore the survey's findings. Parents/guardians identifying as vaccine hesitant in the survey will be invited to participate in virtual, semi-structured, in-depth interviews. Stakeholders of the school-based immunization program will be purposively sampled from AHS' five health zones for virtual focus groups. Quantitative data will be analyzed using SAS Studio 3.6 to carry out descriptive statistics and, using logistic regression, investigate if Framework constructs are associated with parents'/guardians' decision to immunize their children. Qualitative data will be analyzed using NVivo 12 to conduct template thematic analysis guided by the Framework. Study results will provide insights for Alberta's public health practitioners to make evidence-informed decisions when tailoring the school-based HPV immunization program to increase uptake in vaccine hesitant populations. Findings will contribute to the national study, which will culminate in recommendations to increase HPV immunization uptake nationally and progress towards the 90% coverage target.
每年有超过 1300 名加拿大人被诊断出患有宫颈癌，而这种癌症几乎可以通过人乳头瘤病毒（HPV）疫苗接种来预防。在加拿大各地，疫苗接种覆盖率仍低于加拿大消除宫颈癌行动计划（2020-2030 年）设定的 90%目标。为了支持该计划，加拿大癌症伙伴关系委托城市公共卫生网络（UPHN）与加拿大学校 HPV 免疫接种计划合作开展一项质量改进项目。在艾伯塔省，UPHN 为此项工作与艾伯塔省卫生服务局（AHS）合作。本研究有一个总体研究问题：作为艾伯塔省学校 HPV 免疫接种计划的一部分，家长/监护人以及项目利益相关者对青少年接种疫苗的障碍、促进因素和机会有何看法？本研究采用混合方法顺序解释性设计。一项调查将通过电子邮件发送给有 11-17 岁子女的艾伯塔省居民样本。问题将基于医疗保健获取概念框架。随后的定性工作将探索调查结果。在调查中被确定为疫苗犹豫的家长/监护人将受邀参加虚拟的、半结构化的深入访谈。学校免疫接种计划的利益相关者将根据 AHS 的五个卫生区有目的地抽样参加虚拟焦点小组。将使用 SAS Studio 3.6 分析定量数据，以进行描述性统计，并使用逻辑回归调查框架结构是否与父母/监护人决定为子女接种疫苗有关。定性数据将使用 NVivo 12 进行分析，使用框架指导模板主题分析。研究结果将为艾伯塔省的公共卫生工作者提供见解，以便在为疫苗犹豫人群定制学校 HPV 免疫接种计划以增加疫苗接种率时做出基于证据的决策。研究结果将为全国性研究做出贡献，该研究将最终提出建议，以提高全国 HPV 疫苗接种率，实现 90%覆盖率目标。
