Multilevel Peer-to-Peer HPV Vaccination and Wellness Educational Program in School Based Health Centers (PEER)

PROJECT SUMMARY/ABSTRACT: Human papilloma virus (HPV) infection causes over 30,000 cancers each year, even though multi-valent vaccinations for HPV have been available since 2006. Uptake of the vaccine is well below national targets (80% by 2030) and vaccination rates are not being administered by the recommended age of 13. School based health centers (SBHCs) are an important setting where medically underserved adolescents can access preventive health care services. While SBHCs provide access to health care, only 10% of students on campuses with SBHCs are using their services. Collaborative multilevel interventions are needed to increase use of SBHCs and improve vaccination uptake among medically underserved adolescents in these settings. Peer-to-Peer education offers promise in creating collaborative environments between SBHCs and schools, to increase healthcare access and improve healthy behaviors. Our proposed innovation, PEER, will tailor messaging to adolescents and parents through a validated engagement approach, Boot Camp Translation (Aim 1). Then PEER will conduct a multilevel interventional study that uses a stepped-wedge design to test the effectiveness and implementation of student-, patient-, provider- and school-based interventions focused on improving use of SBHCs and uptake of HPV vaccination in age-eligible adolescents (Aim 2). Analysis of mediator and moderators will elucidate the mechanisms of action and identify subgroups for whom the intervention was more and less effective. PEER will be led by an experienced team of scientists, clinicians, and community organizations with expertise in implementation science, HPV vaccination research, and community engagement. PEER will also be overseen by an advisory board made up of stakeholders including school administration and youth. If successful, PEER could significantly increase the use of SBHCs, and decrease HPV-associated cancers and, thus, reduce the burden of cancer in the United States.