Measuring school level attributable risk to support school-based HPV vaccination programs
Abstract 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 charact...
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-022-13088-x |
| _version_ | 1818012401171169280 |
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| author | C. Vujovich-Dunn H. Wand J. M. L. Brotherton H. Gidding J. Sisnowski R. Lorch M. Veitch V. Sheppeard P. Effler S. R. Skinner A. Venn C. Davies J. Hocking L. Whop J. Leask K. Canfell L. Sanci M. Smith M. Kang M. Temple-Smith M. Kidd S. Burns L. Selvey D. Meijer S. Ennis C. Thomson N. Lane J. Kaldor R. Guy |
| author_facet | C. Vujovich-Dunn H. Wand J. M. L. Brotherton H. Gidding J. Sisnowski R. Lorch M. Veitch V. Sheppeard P. Effler S. R. Skinner A. Venn C. Davies J. Hocking L. Whop J. Leask K. Canfell L. Sanci M. Smith M. Kang M. Temple-Smith M. Kidd S. Burns L. Selvey D. Meijer S. Ennis C. Thomson N. Lane J. Kaldor R. Guy |
| author_sort | C. Vujovich-Dunn |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-14T06:19:37Z |
| format | Article |
| id | doaj.art-4dd6aa30f9ea4b5bb1ddd727fe3e26e9 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-04-14T06:19:37Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-4dd6aa30f9ea4b5bb1ddd727fe3e26e92022-12-22T02:08:05ZengBMCBMC Public Health1471-24582022-04-0122111010.1186/s12889-022-13088-xMeasuring school level attributable risk to support school-based HPV vaccination programsC. Vujovich-Dunn0H. Wand1J. M. L. Brotherton2H. Gidding3J. Sisnowski4R. Lorch5M. Veitch6V. Sheppeard7P. Effler8S. R. Skinner9A. Venn10C. Davies11J. Hocking12L. Whop13J. Leask14K. Canfell15L. Sanci16M. Smith17M. Kang18M. Temple-Smith19M. Kidd20S. Burns21L. Selvey22D. Meijer23S. Ennis24C. Thomson25N. Lane26J. Kaldor27R. Guy28University of New South Wales, Kirby InstituteUniversity of New South Wales, Kirby InstituteAustralian Centre for the Prevention of Cervical Cancer, Population HealthUniversity of Sydney, Northern Clinical SchoolUniversity of New South Wales, Kirby InstituteUniversity of New South Wales, Kirby InstituteDepartment of Health and Human Services, Tasmanian GovernmentCommunicable Diseases Branch, NSW HealthCommunicable Disease Control Directorate, Department of HealthUniversity of Sydney, Specialty of Child and Adolescent Health, Faculty of Medicine and HealthMenzies Institute for Medical Research, University of TasmaniaUniversity of Sydney, Specialty of Child and Adolescent Health, Faculty of Medicine and HealthUniversity of Melbourne, Melbourne School of Population and Global HealthAustralian National University, National Centre for Epidemiology & Population HealthNational Centre for Immunisation Research and SurveillanceThe Daffodil Centre, University of Sydney, A Joint Venture With Cancer Council NSWUniversity of Melbourne, Medicine, Dentistry and Health SciencesThe Daffodil Centre, University of Sydney, A Joint Venture With Cancer Council NSWUniversity of Sydney, Westmead Clinical SchoolUniversity of Melbourne, Medicine, Dentistry and Health SciencesFlinders University, Southgate Institute for Health, Society and EquityCurtin University, School of Population HealthUniversity of Queensland, School of Public HealthImmunisation Unit, Health Protection NSW, St Leonard’sImmunisation Unit, Health Protection NSW, St Leonard’sCommunicable Disease Control Directorate, Department of HealthDepartment of Health and Human Services, Tasmanian GovernmentUniversity of New South Wales, Kirby InstituteUniversity of New South Wales, Kirby InstituteAbstract 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.https://doi.org/10.1186/s12889-022-13088-xHPV vaccinesPrimary preventionCervical cancerImmunisation programsSchool-basedHealth equity |
| spellingShingle | C. Vujovich-Dunn H. Wand J. M. L. Brotherton H. Gidding J. Sisnowski R. Lorch M. Veitch V. Sheppeard P. Effler S. R. Skinner A. Venn C. Davies J. Hocking L. Whop J. Leask K. Canfell L. Sanci M. Smith M. Kang M. Temple-Smith M. Kidd S. Burns L. Selvey D. Meijer S. Ennis C. Thomson N. Lane J. Kaldor R. Guy Measuring school level attributable risk to support school-based HPV vaccination programs BMC Public Health HPV vaccines Primary prevention Cervical cancer Immunisation programs School-based Health equity |
| title | Measuring school level attributable risk to support school-based HPV vaccination programs |
| title_full | Measuring school level attributable risk to support school-based HPV vaccination programs |
| title_fullStr | Measuring school level attributable risk to support school-based HPV vaccination programs |
| title_full_unstemmed | Measuring school level attributable risk to support school-based HPV vaccination programs |
| title_short | Measuring school level attributable risk to support school-based HPV vaccination programs |
| title_sort | measuring school level attributable risk to support school based hpv vaccination programs |
| topic | HPV vaccines Primary prevention Cervical cancer Immunisation programs School-based Health equity |
| url | https://doi.org/10.1186/s12889-022-13088-x |
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