Investing in surveillance and community engagement to improve HPV immunization provision: An innovation in enabling evidence-based public health practice

SETTING: Canadian public health organizations across multiple provinces. INTERVENTION: The intervention is a funding initiative by the Canadian Partnership Against Cancer and the Urban Public Health Network to improve Human papillomavirus immunization by enabling exploration activities by local organizations to leverage data-driven surveillance and community engagement. These activities included quantitative analysis of immunization data linked to sociodemographic indicators and qualitative engagement involving interviews, focus groups, and participatory surveillance with providers and community members. The objective of this multi-site intervention is to demonstrate the value of utilizing mixed forms of surveillance data to improve public health practice using principles of "learning systems." OUTCOMES: Mixed-methods surveillance identified geographic and demographic gaps, barriers with regard to HPV immunization coverage including language, trust, and systemic inequities. Exploration activities revealed significant disparities in HPV immunization coverage across regions and populations. Barriers included language and literacy challenges, mistrust of health systems, systemic racism, and logistical issues such as consent processes. Case examples from Vancouver Coastal Health, Saskatchewan Health Authority, Métis Nation BC, and others demonstrated how tailored strategies emerged from these insights. Quantitative findings highlighted sociodemographic predictors of under-immunization, while qualitative data underscored cultural and contextual factors influencing vaccine uptake. IMPLICATIONS: This multi-site, multi-method approach provided actionable intelligence for local public health organizations to adapt HPV immunization programs. Lessons learned include the need for flexible funding models and capacity-building for epidemiological analysis. The COVID-19 pandemic significantly influenced implementation timelines and resource allocation, underscoring the importance of resilience in public health systems. Limitations include variability in data infrastructure and challenges in harmonizing approaches across jurisdictions.