Stakeholder perspectives on HPV vaccination uptake among Aboriginal and Torres Strait Islander adolescents via the school immunisation programmes in Queensland: a qualitative study

Introduction Aboriginal and Torres Strait Islander women experience inequitable cervical cancer outcomes including higher incidence and mortality rates than other Australian women. Cervical cancer can be prevented through human papillomavirus (HPV) vaccination, which is primarily delivered through s...

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Main Authors: Julia Brotherton, Gail Garvey, Vanessa Clements, Joan Cunningham, Lisa J Whop, Kate Anderson, Allison Jauré, Ami Morseu-Diop, Tamara Butler, Evan AhWing, Sonya Egert, Frances Lomas, Casey Ross
Format: Article
Language:English
Published: BMJ Publishing Group 2025-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/6/e097518.full
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author Julia Brotherton
Gail Garvey
Vanessa Clements
Joan Cunningham
Lisa J Whop
Kate Anderson
Allison Jauré
Ami Morseu-Diop
Tamara Butler
Evan AhWing
Sonya Egert
Frances Lomas
Casey Ross
author_facet Julia Brotherton
Gail Garvey
Vanessa Clements
Joan Cunningham
Lisa J Whop
Kate Anderson
Allison Jauré
Ami Morseu-Diop
Tamara Butler
Evan AhWing
Sonya Egert
Frances Lomas
Casey Ross
author_sort Julia Brotherton
collection DOAJ
description Introduction Aboriginal and Torres Strait Islander women experience inequitable cervical cancer outcomes including higher incidence and mortality rates than other Australian women. Cervical cancer can be prevented through human papillomavirus (HPV) vaccination, which is primarily delivered through school immunisation programmes and found to be very effective. However, Aboriginal and Torres Strait Islander adolescents have lower rates of HPV vaccination uptake compared with non-Indigenous adolescents.Objectives This study explored the perspectives and experiences of HPV vaccination programme providers and school staff involved in the delivery of school-based HPV vaccination programmes for Aboriginal and Torres Strait Islander adolescents in Queensland.Design This qualitative project recruited 10 maximally diverse schools to participate. We purposively invited immunisation programme providers and school staff associated with delivering or supporting and used a snowballing approach to recruitment. We used an Indigenist Research approach and an ecological model for health to centre Aboriginal and Torres Strait Islander experiences and priorities.Participants We interviewed 18 immunisation programme providers and school staff involved in delivery between 2020 and 2022. Interview topics included programme delivery and processes, engagement with Aboriginal and Torres Strait Islander adolescents and caregivers, factors impacting uptake and completion, and suggestions for improvement.Results Stakeholders highlighted multilayered challenges navigating a school-based immunisation programme across health and education sectors, especially within the context of the COVID-19 pandemic. This included logistical barriers around programme coordination and scheduling, roles and responsibilities, and communication issues between schools, programme providers, caregivers and adolescents. Four themes were identified: (1) co-ordination of the clinic between schools and programme providers, (2) supporting Aboriginal and Torres Strait Islander families through the vaccination pathway, (3) HPV vaccination resources and (4) COVID-19 disruptions to HPV vaccination programme.Conclusions The findings suggest a need for better communication and coordination of the school-based clinic, including consideration of staff capacity and school resources; enhanced linkages with and support for Aboriginal and Torres Strait Islander student support staff and community organisations who play a critical role in supporting adolescents’ vaccination, and flexible methods of consent supported by culturally appropriate resources. These findings informed recommendations for improved practice and will contribute towards reaching Australia’s cervical cancer elimination targets.
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spelling doaj-art-14fcdc6fb2a94bd8892f5fec307367fd2025-08-20T02:03:19ZengBMJ Publishing GroupBMJ Open2044-60552025-06-0115610.1136/bmjopen-2024-097518Stakeholder perspectives on HPV vaccination uptake among Aboriginal and Torres Strait Islander adolescents via the school immunisation programmes in Queensland: a qualitative studyJulia Brotherton0Gail Garvey1Vanessa Clements2Joan Cunningham3Lisa J Whop4Kate Anderson5Allison Jauré6Ami Morseu-Diop7Tamara Butler8Evan AhWing9Sonya Egert10Frances Lomas11Casey Ross12Melbourne School of Population and Global Health, University of Melbourne VCCC, Melbourne, Victoria, AustraliaThe School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, AustraliaQueensland Health, Brisbane, Queensland, AustraliaMenzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, AustraliaYardhura Walani, National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, Australian Capital Territory, AustraliaYardhura Walani, National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, Australian Capital Territory, AustraliaSydney School of Public Health, The University of Sydney, Sydney, New South Wales, AustraliaYardhura Walani, National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, Australian Capital Territory, AustraliaYardhura Walani, National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, Australian Capital Territory, AustraliaNorthwest Indigenous Catholic Social Services AU, Mt Isa, Queensland, AustraliaSouthern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health, Brisbane, Queensland, AustraliaInala Wangarra, Brisbane, Queensland, AustraliaEducation Queensland, Brisbane, Queensland, AustraliaIntroduction Aboriginal and Torres Strait Islander women experience inequitable cervical cancer outcomes including higher incidence and mortality rates than other Australian women. Cervical cancer can be prevented through human papillomavirus (HPV) vaccination, which is primarily delivered through school immunisation programmes and found to be very effective. However, Aboriginal and Torres Strait Islander adolescents have lower rates of HPV vaccination uptake compared with non-Indigenous adolescents.Objectives This study explored the perspectives and experiences of HPV vaccination programme providers and school staff involved in the delivery of school-based HPV vaccination programmes for Aboriginal and Torres Strait Islander adolescents in Queensland.Design This qualitative project recruited 10 maximally diverse schools to participate. We purposively invited immunisation programme providers and school staff associated with delivering or supporting and used a snowballing approach to recruitment. We used an Indigenist Research approach and an ecological model for health to centre Aboriginal and Torres Strait Islander experiences and priorities.Participants We interviewed 18 immunisation programme providers and school staff involved in delivery between 2020 and 2022. Interview topics included programme delivery and processes, engagement with Aboriginal and Torres Strait Islander adolescents and caregivers, factors impacting uptake and completion, and suggestions for improvement.Results Stakeholders highlighted multilayered challenges navigating a school-based immunisation programme across health and education sectors, especially within the context of the COVID-19 pandemic. This included logistical barriers around programme coordination and scheduling, roles and responsibilities, and communication issues between schools, programme providers, caregivers and adolescents. Four themes were identified: (1) co-ordination of the clinic between schools and programme providers, (2) supporting Aboriginal and Torres Strait Islander families through the vaccination pathway, (3) HPV vaccination resources and (4) COVID-19 disruptions to HPV vaccination programme.Conclusions The findings suggest a need for better communication and coordination of the school-based clinic, including consideration of staff capacity and school resources; enhanced linkages with and support for Aboriginal and Torres Strait Islander student support staff and community organisations who play a critical role in supporting adolescents’ vaccination, and flexible methods of consent supported by culturally appropriate resources. These findings informed recommendations for improved practice and will contribute towards reaching Australia’s cervical cancer elimination targets.https://bmjopen.bmj.com/content/15/6/e097518.full
spellingShingle Julia Brotherton
Gail Garvey
Vanessa Clements
Joan Cunningham
Lisa J Whop
Kate Anderson
Allison Jauré
Ami Morseu-Diop
Tamara Butler
Evan AhWing
Sonya Egert
Frances Lomas
Casey Ross
Stakeholder perspectives on HPV vaccination uptake among Aboriginal and Torres Strait Islander adolescents via the school immunisation programmes in Queensland: a qualitative study
BMJ Open
title Stakeholder perspectives on HPV vaccination uptake among Aboriginal and Torres Strait Islander adolescents via the school immunisation programmes in Queensland: a qualitative study
title_full Stakeholder perspectives on HPV vaccination uptake among Aboriginal and Torres Strait Islander adolescents via the school immunisation programmes in Queensland: a qualitative study
title_fullStr Stakeholder perspectives on HPV vaccination uptake among Aboriginal and Torres Strait Islander adolescents via the school immunisation programmes in Queensland: a qualitative study
title_full_unstemmed Stakeholder perspectives on HPV vaccination uptake among Aboriginal and Torres Strait Islander adolescents via the school immunisation programmes in Queensland: a qualitative study
title_short Stakeholder perspectives on HPV vaccination uptake among Aboriginal and Torres Strait Islander adolescents via the school immunisation programmes in Queensland: a qualitative study
title_sort stakeholder perspectives on hpv vaccination uptake among aboriginal and torres strait islander adolescents via the school immunisation programmes in queensland a qualitative study
url https://bmjopen.bmj.com/content/15/6/e097518.full
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