Which changes in adolescents' knowledge, attitudes, and practices following a school-based intervention in France increase HPV vaccination uptake and intentions? A mediation analysis

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Publication Details

Journal
Vaccine
Published
2026-09-17
DOI
https://doi.org/10.1016/j.vaccine.2026.129150
Primary Topic
Cervical Cancer and HPV Research
Type
article
Field-Weighted Citation Impact
0.00

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article

Which changes in adolescents' knowledge, attitudes, and practices following a school-based intervention in France increase HPV vaccination uptake and intentions? A mediation analysis

Sébastien Bruel, Jocelyn Raude, Aurélie Gauchet, Morgane Michel et al.
Vaccine
Cervical Cancer and HPV Research
article

Which changes in adolescents' knowledge, attitudes, and practices following a school-based intervention in France increase HPV vaccination uptake and intentions? A mediation analysis

Sébastien Bruel, Jocelyn Raude, Aurélie Gauchet, Morgane Michel, Anne‐Sophie Barret, Judith E. Mueller, Nathalie Thilly, Amanda Munoz, Anne-Sophie Le Duc-Banaszuk, Damien Oudin Doglioni, Amandine Gagneux-Brunon
article en

Abstract

BACKGROUND: In France, human papillomavirus vaccine (HPVV) coverage among adolescents remains below the national objective. The PrevHPV randomised trial assessed three intervention components to improve HPVV coverage among adolescents: educational and motivational activities (EMM); vaccination campaigns (FA) in middle schools; and General Practitioner (GP) training. FA increased vaccine uptake, while EMM improved vaccine uptake or intention, as well as HPVV-related knowledge, attitudes, and practices (KAP). This secondary analysis aimed to assess whether the positive effect of EMM on HPVV uptake or intention was mediated by specific KAP improvements. METHODS: A total of 2758 adolescents aged 13 to 15 years from 39 schools completed online questionnaires at baseline and 5 months post-intervention. We created binary variables for the outcome "gain in vaccine uptake or intention during follow-up" and for favourable changes in individual KAP items. We used mediation analyses to evaluate indirect effects of individual KAP items on the association between EMM and uptake/intention, adjusting for FA and GP components and accounting for school-level clustering. RESULTS: :1.10). CONCLUSION: These results help understanding the specific positive effects of co-constructed in-class educational activities and underpin the importance of improving vaccine-related attitudes - not only knowledge.

VaccineVol. 92
Université Claude Bernard Lyon 1 (FR), Centre National de la Recherche Scientifique (FR), Inserm (FR), Institut Pasteur (FR), École des Hautes Études en Santé Publique (FR), Université Paris Cité (FR), Santé Publique France (FR), Assistance Publique – Hôpitaux de Paris (FR), Institut de Recherche en Santé, Environnement et Travail (FR), Hôpital Robert-Debré (FR), Centre International de Recherche en Infectiologie (FR), Interdisciplinarité en Santé Publique Interventions et Instruments de mesure complexes – Région Est (FR), Université de Rennes (FR), Université Savoie Mont Blanc (FR), Université Jean Monnet (FR), Université Grenoble Alpes (FR), Université de Lorraine (FR)
Alliance Nationale pour les Sciences de la Vie et de la Santé, Institut pour la Recherche en Santé Publique
Openalex Percentile: Top 11%
Cervical Cancer and HPV Research
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