Measuring school level attributable risk to support school-based HPV vaccination programs.

Adolescent Australia / epidemiology Female Humans Male Papillomavirus Infections / prevention & control Papillomavirus Vaccines Schools Vaccination
Cervical cancer HPV vaccines Health equity Immunisation programs Primary prevention School-based

Journal

BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562

Informations de publication

Date de publication:
25 04 2022
Historique:
received: 11 10 2021
accepted: 24 03 2022
entrez: 26 4 2022
pubmed: 27 4 2022
medline: 28 4 2022
Statut: epublish

Résumé

In Australia in 2017, 89% of 15-year-old females and 86% of 15-year-old males had received at least one dose of the HPV vaccine. However, considerable variation in HPV vaccination initiation (dose one) across schools remains. It is important to understand the school-level characteristics most strongly associated with low initiation and their contribution to the overall between-school variation. A population-based ecological analysis was conducted using school-level data for 2016 on all adolescent students eligible for HPV vaccination in three Australian jurisdictions. We conducted logistic regression to determine school-level factors associated with lower HPV vaccination initiation (< 75% dose 1 uptake) and estimated the population attributable risk (PAR) and the proportion of schools with the factor (school-level prevalence). The factors most strongly associated with lower initiation, and their prevalence were; small schools (OR = 9.3, 95%CI = 6.1-14.1; 33% of schools), special education schools (OR = 5.6,95%CI = 3.7-8.5; 8% of schools), higher Indigenous enrolments (OR = 2.7,95% CI:1.9-3.7; 31% of schools), lower attendance rates (OR = 2.6,95%CI = 1.7-3.7; 35% of schools), remote location (OR = 2.6,95%CI = 1.6-4.3; 6% of schools,) and lower socioeconomic area (OR = 1.8,95% CI = 1.3-2.5; 33% of schools). The highest PARs were small schools (PAR = 79%, 95%CI:76-82), higher Indigenous enrolments (PAR = 38%, 95%CI: 31-44) and lower attendance rate (PAR = 37%, 95%CI: 29-46). This analysis suggests that initiatives to support schools that are smaller, with a higher proportion of Indigenous adolescents and lower attendance rates may contribute most to reducing the variation of HPV vaccination uptake observed at a school-level in these jurisdictions. Estimating population-level coverage at the school-level is useful to guide policy and prioritise resourcing to support school-based vaccination programs.

Sections du résumé

BACKGROUND
In Australia in 2017, 89% of 15-year-old females and 86% of 15-year-old males had received at least one dose of the HPV vaccine. However, considerable variation in HPV vaccination initiation (dose one) across schools remains. It is important to understand the school-level characteristics most strongly associated with low initiation and their contribution to the overall between-school variation.
METHODS
A population-based ecological analysis was conducted using school-level data for 2016 on all adolescent students eligible for HPV vaccination in three Australian jurisdictions. We conducted logistic regression to determine school-level factors associated with lower HPV vaccination initiation (< 75% dose 1 uptake) and estimated the population attributable risk (PAR) and the proportion of schools with the factor (school-level prevalence).
RESULTS
The factors most strongly associated with lower initiation, and their prevalence were; small schools (OR = 9.3, 95%CI = 6.1-14.1; 33% of schools), special education schools (OR = 5.6,95%CI = 3.7-8.5; 8% of schools), higher Indigenous enrolments (OR = 2.7,95% CI:1.9-3.7; 31% of schools), lower attendance rates (OR = 2.6,95%CI = 1.7-3.7; 35% of schools), remote location (OR = 2.6,95%CI = 1.6-4.3; 6% of schools,) and lower socioeconomic area (OR = 1.8,95% CI = 1.3-2.5; 33% of schools). The highest PARs were small schools (PAR = 79%, 95%CI:76-82), higher Indigenous enrolments (PAR = 38%, 95%CI: 31-44) and lower attendance rate (PAR = 37%, 95%CI: 29-46).
CONCLUSION
This analysis suggests that initiatives to support schools that are smaller, with a higher proportion of Indigenous adolescents and lower attendance rates may contribute most to reducing the variation of HPV vaccination uptake observed at a school-level in these jurisdictions. Estimating population-level coverage at the school-level is useful to guide policy and prioritise resourcing to support school-based vaccination programs.

Identifiants

DOI: 10.1186/s12889-022-13088-x PMID: 35468743 PMC: PMC9036743
pubmed: 35468743
doi: 10.1186/s12889-022-13088-x
pii: 10.1186/s12889-022-13088-x
pmc: PMC9036743
doi:

Substances chimiques

Papillomavirus Vaccines 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

822

Informations de copyright

© 2022. The Author(s).

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Auteurs

C Vujovich-Dunn (C)

University of New South Wales, Kirby Institute, Kensington, Australia. cvujovich-dunn@kirby.unsw.edu.au.

H Wand (H)

University of New South Wales, Kirby Institute, Kensington, Australia.

J M L Brotherton (JML)

Australian Centre for the Prevention of Cervical Cancer, Population Health, East Melbourne, Victoria, Australia.
University of Melbourne, Melbourne School of Population and Global Health, Carlton, VIC, Australia.

H Gidding (H)

University of Sydney, Northern Clinical School, Sydney, Australia.
Women and Babies Research, Kolling Institute, Northern Sydney Local Health District, Sydney, Australia.
School of Population Health, University of New South Wales, Kensington, Australia.
National Centre for Immunisation Research and Surveillance, Sydney, Australia.

J Sisnowski (J)

University of New South Wales, Kirby Institute, Kensington, Australia.
Australian National University, National Centre for Epidemiology & Population Health, Canberra, Australia.

R Lorch (R)

University of New South Wales, Kirby Institute, Kensington, Australia.

M Veitch (M)

Department of Health and Human Services, Tasmanian Government, Hobart, Australia.

V Sheppeard (V)

Communicable Diseases Branch, NSW Health, St Leonards, New South Wales, Australia.
University of Sydney, Sydney School of Public Health, Camperdown, NSW, Australia.

P Effler (P)

Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia.

S R Skinner (SR)

University of Sydney, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney, Australia.
Children's Hospital Westmead, Sydney Children's Hospitals Network, Westmead, Australia.

A Venn (A)

Menzies Institute for Medical Research, University of Tasmania, Tasmanian, Australia.

C Davies (C)

University of Sydney, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney, Australia.
Children's Hospital Westmead, Sydney Children's Hospitals Network, Westmead, Australia.

J Hocking (J)

University of Melbourne, Melbourne School of Population and Global Health, Carlton, VIC, Australia.

L Whop (L)

Australian National University, National Centre for Epidemiology & Population Health, Canberra, Australia.
Menzies School of Health Research, Charles Darwin University, Cairns, QLD, Australia.

J Leask (J)

National Centre for Immunisation Research and Surveillance, Sydney, Australia.
University of Sydney, Sydney Nursing School, Faculty of Medicine and Health, Camperdown, NSW, Australia.

K Canfell (K)

The Daffodil Centre, University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, Australia.

L Sanci (L)

University of Melbourne, Medicine, Dentistry and Health Sciences, Carlton, VIC, Australia.

M Smith (M)

The Daffodil Centre, University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, Australia.
School of Public Health, University of Sydney, Sydney, New South Wales, Australia.

M Kang (M)

University of Sydney, Westmead Clinical School, Sydney, New South Wales, Australia.

M Temple-Smith (M)

University of Melbourne, Medicine, Dentistry and Health Sciences, Carlton, VIC, Australia.

M Kidd (M)

Flinders University, Southgate Institute for Health, Society and Equity, Bedford Park, South Australia, Australia.

S Burns (S)

Curtin University, School of Population Health, Bentley, WA, Australia.

L Selvey (L)

University of Queensland, School of Public Health, St Lucia, QLD, Australia.

D Meijer (D)

Immunisation Unit, Health Protection NSW, St Leonard's, New South Wales, Australia.

S Ennis (S)

Immunisation Unit, Health Protection NSW, St Leonard's, New South Wales, Australia.

C Thomson (C)

Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia.

N Lane (N)

Department of Health and Human Services, Tasmanian Government, Hobart, Australia.

J Kaldor (J)

University of New South Wales, Kirby Institute, Kensington, Australia.

R Guy (R)

University of New South Wales, Kirby Institute, Kensington, Australia.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adolescent › Measuring school level attributable risk to...
questionsmedicales.fr › Régions géographiques › Océanie › Australasie › Australie › Measuring school level attributable risk to...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Measuring school level attributable risk to...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Maladies transmissibles › Maladies sexuellement transmissibles › Maladies sexuellement transmissibles virales › Infections à papillomavirus › Measuring school level attributable risk to...
questionsmedicales.fr › Mélanges complexes › Produits biologiques › Vaccins › Vaccins antiviraux › Vaccins contre les papillomavirus › Measuring school level attributable risk to...
questionsmedicales.fr › Établissements non médicaux publics ou privés › Établissements scolaires › Measuring school level attributable risk to...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Pratiques en santé publique › Prévention primaire › Immunisation › Vaccination › Measuring school level attributable risk to...