Maness Sarah B, Carpenter Lois Coleman, Akpan Idara, St James Nubwa, Romero-Cely Daniela, Harmon G J Corey, Cano Miranda, Thompson Erika L
Department of Health Education and Promotion, East Carolina University, Greenville, NC 27858, USA.
Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
Vaccines (Basel). 2025 Apr 30;13(5):485. doi: 10.3390/vaccines13050485.
BACKGROUND/OBJECTIVES: Human papillomavirus (HPV) causes multiple types of cancer, and demographic-based inequities in HPV-related cancers persist. Behavioral interventions have increased HPV vaccination uptake, yet it is unclear how intervention effects vary by demographics. The purpose of this study was to examine whether existing HPV vaccine interventions for adolescents have unequal effects on HPV vaccine uptake.
We searched MEDLINE via PubMed, PsycINFO, CINAHL, Scopus, and Cochrane CENTRAL in October 2023. The search strategy combined keywords and subject terms for HPV vaccine, interventions/health promotion, and adolescents. Studies were included in final analyses if they were peer-reviewed, published in the US between 2006 and 2023, included outcome measures from an evidence-based HPV vaccination intervention, included adolescents aged 9-17, and demographic variables for age, race/ethnicity, income/SES, or geographic region. Studies were excluded if they were review articles, abstract-only, dissertations or theses, non-English language, non-US-based, or outside the age range of 9-17. Studies were also excluded if they did not include an intervention, outcome evaluation measures, or demographic measures. The screening and extraction processes were independently performed by multiple reviewers using Covidence software.
Ultimately, 74 articles were included for full extraction. Sex was the most common demographic variable analyzed by the HPV vaccine (n = 38), followed by race/ethnicity (n = 15), income/SES (n = 6), and geographic region (n = 6).
Few interventions assess whether intervention results differ by demographics, making it unclear whether these interventions reduce health inequities. This review included a wide variation in study designs, limiting our ability to uniformly assess study conclusions.
背景/目的：人乳头瘤病毒（HPV）会引发多种癌症，HPV相关癌症在基于人口统计学的方面存在不平等现象且持续存在。行为干预措施提高了HPV疫苗的接种率，但尚不清楚干预效果如何因人口统计学特征而异。本研究的目的是检验现有的针对青少年的HPV疫苗干预措施对HPV疫苗接种率的影响是否存在差异。
我们于2023年10月通过PubMed、PsycINFO、CINAHL、Scopus和Cochrane CENTRAL检索了MEDLINE。检索策略结合了HPV疫苗、干预措施/健康促进和青少年的关键词及主题词。如果研究经过同行评审、于2006年至2023年在美国发表、包含基于循证的HPV疫苗接种干预措施的结果指标、纳入了9至17岁的青少年以及年龄、种族/族裔、收入/社会经济地位或地理区域的人口统计学变量，则纳入最终分析。如果研究为综述文章、仅摘要、学位论文或毕业论文、非英语语言、非美国地区或不在9至17岁年龄范围内，则排除。如果研究未包括干预措施、结果评估指标或人口统计学指标，也予以排除。筛选和提取过程由多名评审员使用Covidence软件独立进行。
最终，74篇文章被纳入全面提取。性别是HPV疫苗研究中分析最常见的人口统计学变量（n = 38），其次是种族/族裔（n = 15）、收入/社会经济地位（n = 6）和地理区域（n = 6）。
很少有干预措施评估干预结果是否因人口统计学特征而异，因此不清楚这些干预措施是否能减少健康不平等现象。本综述纳入的研究设计差异很大，限制了我们统一评估研究结论的能力。
