A Systematic Review of Interventions to promote HPV Vaccination Globally

Background: Despite the human papillomavirus (HPV) vaccine being a safe, effective cancer prevention method, its uptake is subomptimal in the United States (U.S.). Previous research have found a variety of intervention strategies (environmental and behavioral) in increasing its uptake. The purpose of the study is to systematically review the literature for interventions to promote HPV vaccination from 2015 to 2020. Methods We updated a systemative review of interventions to promote HPV vaccine uptake globally. We ran key word searches in six bibliographic databases. Audiences, design, level of intervention, components and outcomes were abstracted from the full-text articles in Excel databases. Results Of the 79 articles, most were conducted in the U.S. (72.2%) and in clinical (40.5%) or school settings (32.9%), and were directed a single level (76.3%). Related to the intervention type, most were informational (n = 25, 31.6%) or patient-targeted decision support (n = 23, 29.1%). About 24% were multi-level interventions, with 16 (88.9%) combining two levels. Twenty-seven (33.8%) reported the use of theory in intervention development. Of those reporting HPV vaccine outcomes, post-intervention vaccine initiation ranged from 5–99.2%, while series completion ranged from 6.8–93.0%. Facilitators to implementation were use of patient navigators and user-friendly resources, while barriers included costs, time to implement and difficulties of integrating interventions into organizational workflow. Conclusions There is a strong need to expand implementation of HPV-vaccine promotion interventions beyond education alone and at a single level of intervention. Development and evaluation of effective strategies and multi-level interventions may increase the uptake of the HPV vaccine among adolescents and young adults.