Peer-reviewed article
Aboriginal and Torres Strait Islander adolescent and parent perspectives on human papillomavirus vaccination through the School Immunisation Program in Queensland, Australia: a qualitative study
Tamara Butler, Kate Anderson, Ami Morseu-Diop, Julia ML Brotherton, Joan Cunningham et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This qualitative study explored what helps and what gets in the way of Aboriginal and Torres Strait Islander adolescents receiving the HPV vaccine through the School Immunisation Program in Queensland. Researchers held Yarns (a culturally appropriate conversation method) with 65 adolescents and 20 parents from 10 schools in 2020-2021. Most participants supported vaccination, but knowledge of HPV varied, and families found the consent form hard to complete and return. On the day of vaccination, adolescents wanted privacy, ways to manage strong emotions, and trusted support people present. The authors recommend flexible consent processes, culturally safe information, and Aboriginal and Torres Strait Islander support staff at clinics.
Key points
- Despite varying knowledge of HPV and its vaccine, most adolescents and parents supported vaccination to prevent disease.
- Adolescents and parents had difficulty completing and returning the consent form.
- They wanted more accessible information and better communication about the vaccine, delivered in culturally appropriate ways.
- Adolescents reported a need for privacy, ways to manage heightened emotions, and trusted support people at the vaccination clinic.
- The COVID-19 pandemic disrupted the school program, and the HPV vaccine was seen as more trustworthy than the then-new COVID-19 vaccines.
Limitations
This is a qualitative study of views from 65 adolescents and 20 parents in 10 Queensland schools, so it cannot show how common these views are or whether the recommended changes would actually raise vaccination rates. Findings were also shaped by the COVID-19 context of 2020-2021.
Abstract
BACKGROUND: Aboriginal and Torres Strait Islander peoples experience a greater burden of cervical cancer than other Australians. Vaccination can prevent diseases caused by human papillomavirus (HPV), but uptake remains inequitable. We aimed to understand barriers and enablers influencing the participation of Queensland Aboriginalmed and Torres Strait Islander adolescents in the school-based HPV vaccination program. METHODS: Using an Indigenist research approach and guided by a socio-ecological model for health promotion, Aboriginal and Torres Strait Islander voices were centred in this project. In 2020-2021 we conducted Yarns (a culturally appropriate qualitative method) with 65 Aboriginal and Torres Strait Islander adolescents and 20 parents from 10 diverse Queensland schools. Yarns addressed understandings of HPV and HPV vaccination, information and resources, vaccine consent, experience of vaccination, and suggestions for improvement. Thematic analysis using a codebook approach was conducted. RESULTS: The first major theme related to factors leading up to the vaccination clinic. Despite varying levels of knowledge and understanding of HPV and HPV vaccination, most adolescents and parents supported the idea of vaccinations to prevent diseases and benefit their health. Adolescents and parents reported difficulties completing and returning the consent form and wanted more accessible information and improved communication about the vaccine, delivered in culturally appropriate ways. The second major theme related to factors on the day of the vaccination clinic. Adolescents reported a need for privacy during vaccination, ways to manage heightened emotions triggered by the vaccination clinic, and the presence of trusted support people. Findings were contextualised within the COVID-19 pandemic and vaccination rollout, with the pandemic causing disruptions to the school program and the HPV vaccine perceived as more trustworthy than the then-new COVID-19 vaccines. CONCLUSIONS: We provide several recommendations to support Aboriginal and Torres Strait Islander adolescents to be vaccinated against HPV, such as flexible consent processes with assistance from Aboriginal and Torres Strait Islander support staff; availability of culturally safe educational materials for adolescents, parents and school staff; the presence of Aboriginal and Torres Strait Islander support staff at clinics, and adherence to optimal clinic set up and scheduling to improve adolescents' experience of vaccination. These recommendations can guide programmatic changes and interventions to increase HPV vaccination rates among Aboriginal and Torres Strait Islander adolescents, thereby advancing equity in cervical cancer outcomes.