Okunade Kehinde Sharafadeen, Fayinto Ayomide I, Adekanye Temitope V, Allsop Matthew J, Adelabu Hameed, Soibi-Harry Adaiah, Thomas-Ogodo Olufemi, Onyeka Tonia C, Lawanson Teniola, Adenekan Muisi A, Akaba Godwin O, Salako Omolola, Nwogu Chidinma Magnus, Anorlu Rose I, Berek Jonathan S
Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Surulere, Lagos, Nigeria.
Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Surulere, Lagos, Nigeria.
JCO Glob Oncol. 2025 May;11:e2500150. doi: 10.1200/GO-25-00150. Epub 2025 Sep 9.
Expanding high-risk human papillomavirus (HPV) vaccine coverage in resource-constrained settings is critical to bridging the cervical cancer gap and achieving the global action plan for elimination. Mobile health (mHealth) technology via short message services (SMS) has the potential to improve HPV vaccination uptake. The mHealth-HPVac study evaluated the effectiveness of mHealth interventions in increasing HPV vaccine uptake among mothers of unvaccinated girls aged 9-14 years in Lagos, Nigeria.
A randomized controlled trial was conducted at the Lagos University Teaching Hospital between June 2024 and March 2025. We randomly assigned n = 180 eligible mothers to either a text message (intervention) or a usual care (control) arm. The primary analysis was conducted using the intention-to-treat principle. Bivariable and multivariable logistic regression models were performed to compare HPV vaccination uptake between the two arms, adjusting for potential confounders using odds ratios (ORs) and 95% CIs.
mHealth intervention significantly increased HPV vaccination uptake among mothers of vaccine-eligible girls (adjusted odds ratio [adj OR], 3.05 [95% CI, 1.61 to 5.77]; = .001). Higher education level was also significantly associated with increased vaccine uptake (adj OR, 3.35 [95% CI, 1.77 to 6.33]; < .001). There were no significant interaction effects by baseline characteristics on the association between mHealth intervention and HPV vaccine uptake.
The study showed that mHealth interventions significantly improve HPV vaccine uptake. Integrating mHealth strategies into routine immunization programs could be a scalable and cost-effective approach to increasing HPV vaccination coverage. However, future multicenter studies should consider using cluster randomization at the facility level to better optimize mobile interventions for diverse populations, identify the key drivers of successful SMS-based mHealth interventions, and gain deeper insights into the complex barriers to HPV vaccination uptake.
在资源有限的环境中扩大高危型人乳头瘤病毒（HPV）疫苗接种覆盖率对于缩小宫颈癌差距和实现全球消除宫颈癌行动计划至关重要。通过短信服务（SMS）的移动健康（mHealth）技术有潜力提高HPV疫苗接种率。mHealth-HPVac研究评估了mHealth干预措施在尼日利亚拉各斯提高9至14岁未接种疫苗女孩母亲的HPV疫苗接种率方面的有效性。
2024年6月至2025年3月在拉各斯大学教学医院进行了一项随机对照试验。我们将n = 180名符合条件的母亲随机分为短信（干预）组或常规护理（对照）组。主要分析采用意向性分析原则。进行双变量和多变量逻辑回归模型以比较两组之间的HPV疫苗接种率，并使用优势比（OR）和95%置信区间（CIs）对潜在混杂因素进行调整。
mHealth干预显著提高了符合疫苗接种条件女孩母亲的HPV疫苗接种率（调整后的优势比[adj OR]，3.05 [95% CI，1.61至5.77]；P = 0.001）。较高的教育水平也与疫苗接种率的提高显著相关（adj OR，3.35 [95% CI，1.77至6.33]；P < 0.001）。基线特征对mHealth干预与HPV疫苗接种率之间的关联没有显著的交互作用。
该研究表明mHealth干预措施显著提高了HPV疫苗接种率。将mHealth策略纳入常规免疫计划可能是提高HPV疫苗接种覆盖率的一种可扩展且具有成本效益的方法。然而，未来的多中心研究应考虑在机构层面使用整群随机化，以更好地优化针对不同人群的移动干预措施，确定基于短信的mHealth干预成功的关键驱动因素，并更深入地了解HPV疫苗接种的复杂障碍。
