Addressing HPV vaccine hesitancy by co-designing a digital health intervention with and for socioeconomically disadvantaged adolescents and parents/guardians in Sweden (HPV-END-IT)

The human papillomavirus (HPV) is responsible for most cervical and anogenital cancers.

The HPV vaccine can effectively reduce invasive cervical cancer; however, HPV vaccine uptake is low in certain groups due to hesitancy and refusal, which undermines the success of the vaccine.

In Sweden, HPV vaccine hesitancy has mainly been observed among parents and adolescents in socioeconomically disadvantaged communities with large immigrant populations.The purpose of this project is therefore to co-design and assess the feasibility and preliminary effects of digital health intervention tools to reduce HPV vaccine hesitancy and increase uptake of this vaccine in socioeconomically disadvantaged communities in Stockholm, Sweden.

Several research questions shall assess whether a co-designed digital health intervention has the potential to improve HPV uptake, awareness and confidence.The project involves three sub-studies implemented by an interdisciplinary team.

Study 1 will involve a formative stage whereby adolescents, parents/guardians and school nurses situated in socially disadvantaged areas in Stockholm will be interviewed to understand their perspectives and concerns related to the HPV vaccine.

Thereafter, study 2 will use knowledge gained from study 1 to inform the co-design phase where adolescent boys/girls and their parents/guardians are invited to develop and provide feedback on content and prototypes for digital health interventions.

Finally, study 3 will involve pilot-testing of the intervention for feasibility, acceptability and preliminary effect, using a cluster-randomized design.This project is highly feasible as it builds on the study team’s previous research, which show that immigrant communities in Sweden experience poorer health outcomes as well as vaccine hesitancy.

Because 1 in 5 Swedes have a migrant background this study is relevant to Swedish society.

An appropriate and accessible digital health intervention has the potential to prevent cervical cancer, saving lives and reducing future burdens on an overstretched Swedish healthcare system. The results from this project will be generalizable to similar contexts in Sweden and possibily beyond.