Tailored intervention to increase HPV vaccination in marginalised Roma communities in Slovakia

Abstract Background Marginalized Roma communities (MRCs) in Slovakia face systemic barriers to vaccination, including financial obstacles, lack of culturally sensitive information, and restricted healthcare capacities. Within the RIVER-EU project, two interventions were identified as promising: the use of community health promoters and a multilevel approach combining education, navigation, and improved vaccine access. Methods Following a participatory adaptation process, the intervention was implemented in 16 marginalized Roma communities. Roma health mediators, in close cooperation with researchers, conducted educational sessions for parents and adolescents aged 12-14 years. The intervention included videos, informational materials, and follow-up navigation to vaccination, aiming to bring vaccination coverage in marginalized communities closer to that of the general population. Results In total, 348 parents and 275 children participated. Post-intervention, intention to vaccinate increased significantly among both parents and children (p < 0.001), and knowledge about HPV and vaccination improved markedly. Vaccination rates in the intervention communities were presumed to be near zero. The intervention helped to initiate HPV vaccinations among eligible children, representing an important step toward reducing disparities in vaccine uptake. Roma health mediators played a vital role in building trust and supporting families through the vaccination process. Conclusions Using Roma health mediators, supported by researchers, to deliver culturally adapted health information proved effective in addressing informational and navigation barriers to HPV vaccination. Key lessons learned highlight the importance of building local partnerships, simplifying consent procedures, providing flexible session formats, and ensuring ongoing education to counter misinformation. For sustainability, collaboration with organizations like Healthy regions and continued community engagement are essential.