A Comparative Analysis of Parent-Centered versus Parent-Adolescent Dyad Interventions to Enhance HPV vaccination Uptake in Children and Adolescents: Protocol for Systematic Review and meta-analysis

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However, HPV vaccination uptake remains suboptimal in this population. This protocol outlines a comprehensive review that aims to evaluate the effectiveness of interventions targeting parents and parent-adolescent dyads in improving HPV vaccination uptake among children and adolescents aged 9-18 years. Objective The objective of this study is to assess the impact of parent-directed and parent-adolescent dyad interventions on HPV vaccination uptake in children and adolescents aged 9-18 years. Specific objectives include reviewing existing literature on parent-oriented and parent-adolescent dyad interventions, assessing vaccination uptake, identifying influencing factors, and providing evidence-based recommendations for intervention development and implementation. Methods A systematic review will be conducted, encompassing literature published up to the present day. Various databases will be searched for relevant studies on parent-focused and parent-adolescent dyad interventions aimed at improving HPV vaccination uptake. Data extraction and analysis will be performed to assess the proportion of children and adolescents receiving HPV vaccination following interventions, factors influencing vaccination uptake, and completion rates of the recommended vaccine series. Results The review findings will be analyzed using appropriate statistical methods, including meta-analysis to estimate the overall effect size of interventions. Subgroup and sensitivity analyses will be conducted to explore heterogeneity and assess the robustness of the results. Conclusion This protocol outlines a comprehensive review that will contribute to the current understanding of the effectiveness of parent-oriented and parent-adolescent dyad interventions in improving HPV vaccination uptake among children and adolescents. The findings will inform the development and implementation of targeted interventions to address barriers and improve vaccination coverage, ultimately reducing the burden of HPV-related diseases. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/14-56", "name": "A Comparative Analysis of Parent-Centered versus Parent-Adolescent..." } } ] } Home Browse A Comparative Analysis of Parent-Centered versus Parent-Adolescent... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Bhengu P, Ndwandwe D, Kuodi P et al. A Comparative Analysis of Parent-Centered versus Parent-Adolescent Dyad Interventions to Enhance HPV vaccination Uptake in Children and Adolescents: Protocol for Systematic Review and meta-analysis [version 1; peer review: 1 not approved] . F1000Research 2025, 14 :56 ( https://doi.org/10.12688/f1000research.146725.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Study Protocol A Comparative Analysis of Parent-Centered versus Parent-Adolescent Dyad Interventions to Enhance HPV vaccination Uptake in Children and Adolescents: Protocol for Systematic Review and meta-analysis [version 1; peer review: 1 not approved] P Bhengu 1 , D Ndwandwe 2 , P Kuodi https://orcid.org/0000-0003-2483-3499 3 , [...] JL Tamuzi 4 , CS Wiysonge 5 , AV Mazingisa 2 , EJ Mavundza 2 , S Cooper 2 , PDMC Katoto 4,6 , M Shey 1,7 P Bhengu 1 , D Ndwandwe 2 , [...] P Kuodi https://orcid.org/0000-0003-2483-3499 3 , JL Tamuzi 4 , CS Wiysonge 5 , AV Mazingisa 2 , EJ Mavundza 2 , S Cooper 2 , PDMC Katoto 4,6 , M Shey 1,7 PUBLISHED 09 Jan 2025 Author details Author details 1 Medicine, University of Cape Town, Rondebosch, Western Cape, 7700, South Africa 2 Cochrane, South African Medical Research Council, Cape Town, 7505, South Africa 3 Azriel Faculty of Medicine, Bar-llan University, Safed, Israel 4 Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Stellenbosch University, Stellenbosch, Western Cape, 7600, South Africa 5 Regional Office for Africa, World Health Organization Regional Office for Africa, Brazzaville, Congo 6 School of Public Health and Family Medicine, University of Cape Town, Rondebosch, Western Cape, 7700, South Africa 7 Health Sciences, CIDRI-Africa & Institute of Infectious Disease and Molecular Medicine (IDM), Faculty of Health Sciences, Cape Town, 7700, South Africa P Bhengu Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing D Ndwandwe Roles: Supervision, Writing – Review & Editing P Kuodi Roles: Data Curation, Formal Analysis, Methodology, Software, Validation, Writing – Review & Editing JL Tamuzi Roles: Formal Analysis, Software, Writing – Review & Editing CS Wiysonge Roles: Conceptualization, Funding Acquisition, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing AV Mazingisa Roles: Investigation EJ Mavundza Roles: Writing – Review & Editing S Cooper Roles: Supervision, Writing – Review & Editing PDMC Katoto Roles: Conceptualization, Formal Analysis, Methodology, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing M Shey Roles: Conceptualization, Funding Acquisition, Project Administration, Resources, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background Human papillomavirus (HPV) vaccination among children and adolescents is crucial for the prevention of HPV-related diseases later in life. However, HPV vaccination uptake remains suboptimal in this population. This protocol outlines a comprehensive review that aims to evaluate the effectiveness of interventions targeting parents and parent-adolescent dyads in improving HPV vaccination uptake among children and adolescents aged 9-18 years. Objective The objective of this study is to assess the impact of parent-directed and parent-adolescent dyad interventions on HPV vaccination uptake in children and adolescents aged 9-18 years. Specific objectives include reviewing existing literature on parent-oriented and parent-adolescent dyad interventions, assessing vaccination uptake, identifying influencing factors, and providing evidence-based recommendations for intervention development and implementation. Methods A systematic review will be conducted, encompassing literature published up to the present day. Various databases will be searched for relevant studies on parent-focused and parent-adolescent dyad interventions aimed at improving HPV vaccination uptake. Data extraction and analysis will be performed to assess the proportion of children and adolescents receiving HPV vaccination following interventions, factors influencing vaccination uptake, and completion rates of the recommended vaccine series. Results The review findings will be analyzed using appropriate statistical methods, including meta-analysis to estimate the overall effect size of interventions. Subgroup and sensitivity analyses will be conducted to explore heterogeneity and assess the robustness of the results. Conclusion This protocol outlines a comprehensive review that will contribute to the current understanding of the effectiveness of parent-oriented and parent-adolescent dyad interventions in improving HPV vaccination uptake among children and adolescents. The findings will inform the development and implementation of targeted interventions to address barriers and improve vaccination coverage, ultimately reducing the burden of HPV-related diseases. READ ALL READ LESS Keywords HPV vaccination, parent-cantered interventions, parent-adolescent dyad interventions, children, adolescents, systematic review Corresponding Author(s) P Bhengu ( [email protected] ) Close Corresponding author: P Bhengu Competing interests: No competing interests were disclosed. Grant information: The work reported herein was made possible through funding by the South African Medical Research Council through its Division of Research Capacity Development under the Bongani Mayosi National Health Scholars Programme from funding received from the Public Health Enhancement Fund / South African National Department of Health. The content hereof is the sole responsibility of the authors and does not necessarily represent the official views of the SAMRC. This research is also supported by the South African Medical Research Council (SAMRC), through Cochrane South Africa. Project code 43500 The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Copyright: © 2025 Bhengu P et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Bhengu P, Ndwandwe D, Kuodi P et al. A Comparative Analysis of Parent-Centered versus Parent-Adolescent Dyad Interventions to Enhance HPV vaccination Uptake in Children and Adolescents: Protocol for Systematic Review and meta-analysis [version 1; peer review: 1 not approved] . F1000Research 2025, 14 :56 ( https://doi.org/10.12688/f1000research.146725.1 ) First published: 09 Jan 2025, 14 :56 ( https://doi.org/10.12688/f1000research.146725.1 ) Latest published: 09 Jan 2025, 14 :56 ( https://doi.org/10.12688/f1000research.146725.1 ) Introduction Human papillomavirus (HPV) is a cancer-causing virus that is transmitted through sexual contact ( Bruni et al., 2021 ; Wang & Palefsky, 2015 ). HPV vaccination is an effective virus-prevention strategy. However, uptake of the HPV vaccine among children and adolescents remains low. Parents play a significant role in their children’s HPV vaccination decisions. As techniques to enhance HPV vaccination uptake in children and adolescents, parent-directed interventions as well as parent-adolescent dyad interventions have been recommended ( Choi et al., 2023 ). A comparison of these strategies will give healthcare practitioners and policymakers valuable information about the most effective interventions for improving HPV vaccination uptake in children and adolescents. The goal of this protocol is to undertake a comprehensive review of the effectiveness of interventions aimed at parents and parent-adolescent dyads in improving HPV vaccination uptake in order to influence policy and practice ( Bhengu, 2024 ). Research question What is the impact of parent-directed and parent-adolescent dyad interventions on HPV vaccination uptake among children and adolescents between 9-18 years? Objectives General objective To evaluate the effectiveness of interventions targeting parents and parent-adolescent dyads in improving HPV vaccination uptake among children and adolescents between 9-18 years. Specific objectives a) To systematically review and synthesize existing literature on parent-directed and parent-adolescent dyad interventions aimed at increasing HPV vaccination uptake. b) To assess the proportion of children and adolescents between 9 and 18 years who receive at least one dose of HPV vaccine after parent-directed or parent-adolescent dyad interventions compared to the standard HPV vaccination program. c) To determine the proportion of children and adolescents between 9 and 18 years who complete the recommended HPV vaccine series after parent-directed or parent-adolescent dyad interventions compared to the standard HPV vaccination program. d) To identify factors influencing HPV vaccination uptake, including parental knowledge, attitudes, and barriers, within the context of parent-directed and parent-adolescent dyad interventions. e) To provide evidence-based recommendations for the development and implementation of effective interventions to improve HPV vaccination uptake among children and adolescents between 9-18 years. Methods Criteria for considering studies for this review We will evaluate randomized trials, non-randomized trials, interrupted time-series studies, and controlled before-and-after studies that fulfil the study design criteria for Cochrane Effective Practice and Organization of Care ( EPOC, 2017 ). Only cluster-randomized control studies with at least two intervention and two comparison clusters will be considered. Interrupted time series investigations will be considered only if the data are collected during at least three time points before and three time points after the intervention. Only controlled before-and-after studies with at least two intervention groups and at least two comparison groups will be considered Type of participants: Participants are girls aged 9 to 18 years eligible for WHO recommended HPV vaccines and their parents. Types of interventions: The intervention will involve educational programs, counselling sessions, reminders, and other strategies targeting parents and parent-adolescent dyads to increase awareness and knowledge about HPV vaccination, address concerns, and promote vaccination uptake. These might include: * interventions to communicate with adolescents or their parents (or both) about adolescent HPV vaccination; * financial and non-financial incentives for adolescents or their parents (or both); and * mandatory vaccination i.e. vaccination requirement for school attendance Exclusions: We will exclude systematic reviews and studies that are not centered on parents or parent-adolescent dyads such as interventions focusing on providers or health systems improvement etc. We will also exclude studies not reporting separated data for girls between 9 and 18 years. Comparisons: The comparison group will include individuals who receive standard HPV vaccination services without any additional parent-directed or parent-adolescent dyad interventions. Additionally, alternative interventions and similar interventions implemented with different degrees of intensity might also be compared. Types of outcome measures Primary outcome: - Proportion of children and adolescents aged 9-18 years who receive at least one dose of HPV vaccine. Secondary outcomes: - Proportion of children and adolescents aged 9-18 years who complete the recommended HPV vaccine series. - Parental knowledge, attitudes, and barriers to HPV vaccination. Search methods for identification of studies We will collaboratework with an information specialist librarian to createdevelop a comprehensive search strategy for. We will do searches in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Web of Science, and Scopus. We shall then implement the strategy, searching for records indexed in these databases from their inception to beginning until the day of the search The following search terms will be used: “HPV vaccination,” “parent-centered interventions,” “parent-adolescent dyad interventions,” “children,” “adolescents,” “uptake,” “barriers,” and “facilitators.” We will also assess the proceedings of recent HPV-related conferences for potentially eligible articles not available from other sources. Selection of studies Two authors will independently evaluate the summaries of identified records to determine their potential eligibility. Full texts of studies deemed potentially relevant will then be retrieved and reviewed by both authors, resolving any discrepancy on the relevance of any article through discussion and mutual agreemenassess the titles and abstracts of records for potential eligibility. Following this, the full text of potentially relevant studies will be obtained and assessed in duplicate. Disagreements between the two review authors will be resolved by discussion and consensut Data extraction and management Two review authors will gather data from each included study independently using a systematic and consistent data extraction form. Extracted data will comprise study setting, study type, participant type, intervention type, comparator type, and outcomes monitored. Disagreements between the review authors will be settled through consensus and arbitration by third author. Bias risk assessment in included studies We will evaluate the risk of systematic errors in included studies, in duplicate, using the checklist developed by Cochrane ( Higgins et al., 2022 ). The two review authors will independently describe what the research authors reported doing for each domain for each included study and then make a decision regarding the risk of systematic errors in the study through discussion and consensus. Data synthesis Data from selected studies will be extracted and analysed using appropriate statistical methods. Meta-analysis will be performed to estimate the overall effect size of parent-drected and parent-adolescent dyad interventions on HPV vaccination uptake. Subgroup analyses and sensitivity analyses will be conducted to explore heterogeneity and assess the robustness of the findings. Limitations and strengths Limitations: - Potential variations in study design, interventions, and outcome measures across included studies. - Limited availability of studies specifically focusing on parent-adolescent dyad interventions. - Potential publication bias. Strengths: - Comprehensive search strategy to identify relevant studies. - Utilization of meta-analysis to generate pooled effect estimates. - Inclusion of both parent-directed and parent-adolescent dyad interventions, allowing for a comparative analysis. Public health significance This study’s findings will provide valuable insights into the effectiveness of parent-directed and parent-adolescent dyad interventions in improving HPV vaccination uptake among children and adolescents. The results will inform the development of evidence-based strategies and interventions to enhance HPV vaccination coverage, aligning with the objectives of the World Health Organization’sImmunization Agenda 2030. By promoting higher vaccination rates, this research has the potential to reduce HPV-related diseases, including cervical cancer, and contribute to improved public health outcomes. Reporting guidelines Harvard Dataverse : Checklist for article “A Comparative Analysis of Parent-Centered versus Parent-Adolescent Dyad Interventions to Enhance HPV vaccination Uptake in Children and Adolescents: Protocol for Systematic Review and meta-analysis” DOI: https://doi.org/10.7910/DVN/YOT2JG ( Bhengu, 2024 ). Data are available under the terms of the Creative Commons Zero “No rights reserved” data waiver (CC0 1.0 Public domain dedication). Data availability statement No data are associated with this article. References Bhengu P: Harvard Dataverse. 2024; Ms , V1 . Publisher Full Text Bruni L, Saura-Lázaro A, Montoliu A, et al. : HPV vaccination introduction worldwide and WHO and UNICEF estimates of national HPV immunization coverage 2010-2019. Prev. Med. 2021 Mar; 144 : 106399. Epub 2020 Dec 31. Erratum in: Prev Med. 2022 Feb; 155:106925. PubMed Abstract | Publisher Full Text Choi J, Tamí-Maury I, Cuccaro P, et al. : Digital Health Interventions to Improve Adolescent HPV Vaccination: A Systematic Review. Vaccines (Basel). 2023 Jan 22; 11 (2): 249. PubMed Abstract | Publisher Full Text | Free Full Text EPOC: Implications for practice. In EPOC Resources for Review Authors. Cochrane Effective Practice and Organisation of Care (EPOC); 2017. (accessed on 10 June 2023). Reference Source Higgins JPT, Thomas J, Chandler J, et al. : Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022). Cochrane; 2022. Reference Source Wang CCJ, Palefsky JM: Human papillomavirus (HPV) infections and the importance of HPV vaccination. Curr. Epidemiol. Rep. 2015; 2 : 101–109. PubMed Abstract | Publisher Full Text | Free Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 09 Jan 2025 ADD YOUR COMMENT Comment Author details Author details 1 Medicine, University of Cape Town, Rondebosch, Western Cape, 7700, South Africa 2 Cochrane, South African Medical Research Council, Cape Town, 7505, South Africa 3 Azriel Faculty of Medicine, Bar-llan University, Safed, Israel 4 Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Stellenbosch University, Stellenbosch, Western Cape, 7600, South Africa 5 Regional Office for Africa, World Health Organization Regional Office for Africa, Brazzaville, Congo 6 School of Public Health and Family Medicine, University of Cape Town, Rondebosch, Western Cape, 7700, South Africa 7 Health Sciences, CIDRI-Africa & Institute of Infectious Disease and Molecular Medicine (IDM), Faculty of Health Sciences, Cape Town, 7700, South Africa P Bhengu Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing D Ndwandwe Roles: Supervision, Writing – Review & Editing P Kuodi Roles: Data Curation, Formal Analysis, Methodology, Software, Validation, Writing – Review & Editing JL Tamuzi Roles: Formal Analysis, Software, Writing – Review & Editing CS Wiysonge Roles: Conceptualization, Funding Acquisition, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing AV Mazingisa Roles: Investigation EJ Mavundza Roles: Writing – Review & Editing S Cooper Roles: Supervision, Writing – Review & Editing PDMC Katoto Roles: Conceptualization, Formal Analysis, Methodology, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing M Shey Roles: Conceptualization, Funding Acquisition, Project Administration, Resources, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The work reported herein was made possible through funding by the South African Medical Research Council through its Division of Research Capacity Development under the Bongani Mayosi National Health Scholars Programme from funding received from the Public Health Enhancement Fund / South African National Department of Health. The content hereof is the sole responsibility of the authors and does not necessarily represent the official views of the SAMRC. This research is also supported by the South African Medical Research Council (SAMRC), through Cochrane South Africa. Project code 43500 The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Article Versions (1) version 1 Published: 09 Jan 2025, 14:56 https://doi.org/10.12688/f1000research.146725.1 Copyright © 2025 Bhengu P et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Bhengu P, Ndwandwe D, Kuodi P et al. A Comparative Analysis of Parent-Centered versus Parent-Adolescent Dyad Interventions to Enhance HPV vaccination Uptake in Children and Adolescents: Protocol for Systematic Review and meta-analysis [version 1; peer review: 1 not approved] . F1000Research 2025, 14 :56 ( https://doi.org/10.12688/f1000research.146725.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 09 Jan 2025 Views 0 Cite How to cite this report: Xiong S. Reviewer Report For: A Comparative Analysis of Parent-Centered versus Parent-Adolescent Dyad Interventions to Enhance HPV vaccination Uptake in Children and Adolescents: Protocol for Systematic Review and meta-analysis [version 1; peer review: 1 not approved] . F1000Research 2025, 14 :56 ( https://doi.org/10.5256/f1000research.160840.r393982 ) The direct URL for this report is: https://f1000research.com/articles/14-56/v1#referee-response-393982 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 11 Aug 2025 Serena Xiong , University of Minnesota Medical School, Minnesota, USA Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.160840.r393982 COMMENTS FOR AUTHORS This manuscript outlines a protocol for a systematic review and meta-analysis of parent-centered and parent–adolescent dyad interventions and their effects on HPV vaccination uptake among children and adolescents aged 9–18. Below, I provide major ... Continue reading READ ALL COMMENTS FOR AUTHORS This manuscript outlines a protocol for a systematic review and meta-analysis of parent-centered and parent–adolescent dyad interventions and their effects on HPV vaccination uptake among children and adolescents aged 9–18. Below, I provide major and minor suggestions for strengthening the manuscript. GENERAL COMMENTS: Major suggestion: To improve overall readability and clarity, I strongly recommend seeking the assistance of a professional copy editor. The manuscript contains multiple grammatical issues and lacks adherence to standard academic writing conventions. Additionally, the use of bullet points in place of structured prose significantly weakens the clarity and coherence of the protocol. ABSTRACT: Major suggestion: The Methods section of the abstract lacks specificity. The databases that will be searched should be explicitly named. As currently written, the abstract is overly general, making it difficult to understand the precise objectives of the review and meta-analysis. Major suggestion: The authors do not clearly identify the types of studies that will be included or excluded. Additionally, it is not stated whether the review will adhere to PRISMA guidelines. Both points should be addressed explicitly in the abstract. INTRODUCTION: Major suggestion: The background section does not provide sufficient evidence or rationale for conducting this review. The authors should better articulate the current state of the literature on HPV vaccination interventions targeting parents and parent-adolescent dyads, and explain why a systematic review and meta-analysis is needed at this time. METHODS: Major suggestion: The protocol limits inclusion to studies with female participants. While this may align with WHO recommendations, it excludes male children and adolescents, who are also secondary targets for HPV vaccination. A clear and justified rationale for this exclusion is necessary. Major suggestion: There is no mention of protocol registration in a public registry (e.g., PROSPERO). Systematic review protocols should be registered to ensure transparency and avoid duplication of efforts. The authors should include registration information or state plans for registration. Major suggestion: The methods section is underdeveloped. At this stage, the authors should have already consulted a librarian to define or at least conceptualize the search strategy. This is a critical component of any systematic review protocol. Major suggestion: The manuscript does not specify any inclusion or exclusion criteria related to geographic or language limitations. It is also unclear whether the authors will conduct additional hand-searching of references. These details should be clearly outlined. Major suggestion: While the authors mention assessing risk of bias using a Cochrane checklist, this is insufficient. The manuscript must specify the exact tool to be used (e.g., Cochrane Risk of Bias Tool) and describe how bias will be evaluated. Major suggestion: The statistical analysis plan is severely lacking in detail. The authors do not specify which pooling methods (e.g., fixed-effect vs. random-effects models) will be used, nor how statistical heterogeneity will be assessed (e.g., I², Q-test, tau²). While they mention subgroup and sensitivity analyses, they do not provide information on the variables or methods that will be used to conduct these analyses. A comprehensive and rigorous statistical plan is essential for a meta-analysis protocol. Is the rationale for, and objectives of, the study clearly described? No Is the study design appropriate for the research question? No Are sufficient details of the methods provided to allow replication by others? No Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests: No competing interests were disclosed. Reviewer Expertise: Cancer prevention, behavioral epidemiology I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Xiong S. Reviewer Report For: A Comparative Analysis of Parent-Centered versus Parent-Adolescent Dyad Interventions to Enhance HPV vaccination Uptake in Children and Adolescents: Protocol for Systematic Review and meta-analysis [version 1; peer review: 1 not approved] . F1000Research 2025, 14 :56 ( https://doi.org/10.5256/f1000research.160840.r393982 ) The direct URL for this report is: https://f1000research.com/articles/14-56/v1#referee-response-393982 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 09 Jan 2025 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 Version 1 09 Jan 25 read Serena Xiong , University of Minnesota Medical School, Minnesota, USA Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Xiong S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 11 Aug 2025 | for Version 1 Serena Xiong , University of Minnesota Medical School, Minnesota, USA 0 Views copyright © 2025 Xiong S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions COMMENTS FOR AUTHORS This manuscript outlines a protocol for a systematic review and meta-analysis of parent-centered and parent–adolescent dyad interventions and their effects on HPV vaccination uptake among children and adolescents aged 9–18. Below, I provide major and minor suggestions for strengthening the manuscript. GENERAL COMMENTS: Major suggestion: To improve overall readability and clarity, I strongly recommend seeking the assistance of a professional copy editor. The manuscript contains multiple grammatical issues and lacks adherence to standard academic writing conventions. Additionally, the use of bullet points in place of structured prose significantly weakens the clarity and coherence of the protocol. ABSTRACT: Major suggestion: The Methods section of the abstract lacks specificity. The databases that will be searched should be explicitly named. As currently written, the abstract is overly general, making it difficult to understand the precise objectives of the review and meta-analysis. Major suggestion: The authors do not clearly identify the types of studies that will be included or excluded. Additionally, it is not stated whether the review will adhere to PRISMA guidelines. Both points should be addressed explicitly in the abstract. INTRODUCTION: Major suggestion: The background section does not provide sufficient evidence or rationale for conducting this review. The authors should better articulate the current state of the literature on HPV vaccination interventions targeting parents and parent-adolescent dyads, and explain why a systematic review and meta-analysis is needed at this time. METHODS: Major suggestion: The protocol limits inclusion to studies with female participants. While this may align with WHO recommendations, it excludes male children and adolescents, who are also secondary targets for HPV vaccination. A clear and justified rationale for this exclusion is necessary. Major suggestion: There is no mention of protocol registration in a public registry (e.g., PROSPERO). Systematic review protocols should be registered to ensure transparency and avoid duplication of efforts. The authors should include registration information or state plans for registration. Major suggestion: The methods section is underdeveloped. At this stage, the authors should have already consulted a librarian to define or at least conceptualize the search strategy. This is a critical component of any systematic review protocol. Major suggestion: The manuscript does not specify any inclusion or exclusion criteria related to geographic or language limitations. It is also unclear whether the authors will conduct additional hand-searching of references. These details should be clearly outlined. Major suggestion: While the authors mention assessing risk of bias using a Cochrane checklist, this is insufficient. The manuscript must specify the exact tool to be used (e.g., Cochrane Risk of Bias Tool) and describe how bias will be evaluated. Major suggestion: The statistical analysis plan is severely lacking in detail. The authors do not specify which pooling methods (e.g., fixed-effect vs. random-effects models) will be used, nor how statistical heterogeneity will be assessed (e.g., I², Q-test, tau²). While they mention subgroup and sensitivity analyses, they do not provide information on the variables or methods that will be used to conduct these analyses. A comprehensive and rigorous statistical plan is essential for a meta-analysis protocol. Is the rationale for, and objectives of, the study clearly described? No Is the study design appropriate for the research question? No Are sufficient details of the methods provided to allow replication by others? No Are the datasets clearly presented in a useable and accessible format? Not applicable Competing Interests No competing interests were disclosed. Reviewer Expertise Cancer prevention, behavioral epidemiology I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (0) Xiong S. Peer Review Report For: A Comparative Analysis of Parent-Centered versus Parent-Adolescent Dyad Interventions to Enhance HPV vaccination Uptake in Children and Adolescents: Protocol for Systematic Review and meta-analysis [version 1; peer review: 1 not approved] . F1000Research 2025, 14 :56 ( https://doi.org/10.5256/f1000research.160840.r393982) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-56/v1#referee-response-393982 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions Adjust parameters to alter display View on desktop for interactive features Includes Interactive Elements View on desktop for interactive features Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. 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