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

被引：9
|
作者：
Vujovich-Dunn, C. [1 ]
Wand, H. [1 ]
Brotherton, J. M. L. [2 ,3 ]
Gidding, H. [4 ,5 ,6 ,7 ]
Sisnowski, J. [1 ,8 ]
Lorch, R. [1 ]
Veitch, M. [9 ]
Sheppeard, V. [10 ,11 ]
Effler, P. [12 ]
Skinner, S. R. [13 ,14 ]
Venn, A. [15 ]
Davies, C. [13 ,14 ]
Hocking, J. [3 ]
Whop, L. [8 ,16 ]
Leask, J. [7 ,17 ]
Canfell, K. [18 ]
Sanci, L. [19 ]
Smith, M. [18 ,20 ]
Kang, M. [21 ]
Temple-Smith, M. [19 ]
Kidd, M. [22 ]
Burns, S. [23 ]
Selvey, L. [24 ]
Meijer, D. [25 ]
Ennis, S. [25 ]
Thomson, C. [12 ]
Lane, N. [9 ]
Kaldor, J. [1 ]
Guy, R. [1 ]
机构：
[1] Univ New South Wales, Kirby Inst, Kensington, NSW, Australia
[2] Australian Ctr Prevent Cerv Canc Populat Hlth, Melbourne, Vic, Australia
[3] Univ Melbourne, Melbourne Sch Populat & Global Hlth, Carlton, Vic, Australia
[4] Univ Sydney, Northern Clin Sch, Sydney, NSW, Australia
[5] Northern Sydney Local Hlth Dist, Kolling Inst, Women & Babies Res, Sydney, NSW, Australia
[6] Univ New South Wales, Sch Populat Hlth, Kensington, NSW, Australia
[7] Natl Ctr Immunisat Res & Surveillance, Sydney, NSW, Australia
[8] Australian Natl Univ, Natl Ctr Epidemiol & Populat Hlth, Canberra, ACT, Australia
[9] Tasmanian Govt, Dept Hlth & Human Serv, Hobart, Tas, Australia
[10] NSW Hlth, Communicable Dis Branch, St Leonards, NSW, Australia
[11] Univ Sydney, Sydney Sch Publ Hlth, Camperdown, NSW, Australia
[12] Communicable Dis Control Directorate, Dept Hlth, Perth, WA, Australia
[13] Univ Sydney, Fac Med & Hlth, Specialty Child & Adolescent Hlth, Sydney, NSW, Australia
[14] Childrens Hosp Westmead, Sydney Childrens Hosp Network, Westmead, NSW, Australia
[15] Univ Tasmania, Menzies Inst Med Res, Tasmanian, Australia
[16] Charles Darwin Univ, Menzies Sch Hlth Res, Cairns, Qld, Australia
[17] Univ Sydney, Fac Med & Hlth, Sydney Nursing Sch, Camperdown, NSW, Australia
[18] Univ Sydney, Daffodil Ctr, Joint Venture Canc Council, Sydney, NSW, Australia
[19] Univ Melbourne, Med Dent & Hlth Sci, Carlton, Vic, Australia
[20] Univ Sydney, Sch Publ Hlth, Sydney, NSW, Australia
[21] Univ Sydney, Westmead Clin Sch, Sydney, NSW, Australia
[22] Flinders Univ S Australia, Southgate Inst Hlth Soc & Equ, Bedford Pk, SA, Australia
[23] Curtin Univ, Sch Populat Hlth, Bentley, WA, Australia
[24] Univ Queensland, Sch Publ Hlth, St Lucia, Qld, Australia
[25] Hlth Protect NSW, Immunisat Unit, St Leonards, NSW, Australia
来源：
BMC PUBLIC HEALTH | 2022年 / 22卷 / 01期
基金：
澳大利亚国家健康与医学研究理事会;
关键词：
HPV vaccines; Primary prevention; Cervical cancer; Immunisation programs; School-based; Health equity; HUMAN-PAPILLOMAVIRUS VACCINATION; CERVICAL-CANCER; SOCIOECONOMIC-STATUS; GENITAL WARTS; COVERAGE; AUSTRALIA; ELIMINATION; MORTALITY; IMPACT; INCOME;
D O I：
10.1186/s12889-022-13088-x
中图分类号：
R1 [预防医学、卫生学];
学科分类号：
1004 ; 120402 ;
摘要：
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.
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页数：10
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