A qualitative evaluation of a STEAM (Science, technology, engineering, arts, and mathematics) peer education intervention on teenagers’ knowledge, confidence, and advocacy for HPV vaccine communication

Vaccine hesitancy is a rising global phenomenon. Ireland experienced a crisis in confidence and vaccine decline for the Human Papillomavirus (HPV) vaccine in 2015, with rapid national efforts to address concerns and improve uptake rates. We developed a unique STEAM (Science, Technology, Engineering, Arts and Mathematics) peer education intervention through an interdisciplinary team (immunologist, educationalist, designer, filmmaker, and psychologist) to address vaccine hesitancy and utilize peer education, which is promising but underused in the literature. We aimed to evaluate the effect of our STEAM intervention on Irish teenagers' knowledge and confidence in advocacy for the HPV vaccine to their younger peers facing their HPV vaccine offer. We used qualitative methods consisting of 12 focus group discussions with teens (n = 53), one qualitative in-class evaluation among younger peers (n = 35), and knowledge exit slips (n = 300) to evaluate teenagers' knowledge, confidence, advocacy, and younger peers' knowledge. Data were analyzed inductively using reflexive thematic analysis. Our overall egalitarian theme indicated democratic participation by teenagers with three related themes that were compatible with behavior as a vaccine advocate. Teenagers reported positive changes overall in HPV knowledge, confidence, and advocacy beliefs following the intervention. Younger peers could recall HPV facts and knowledge during in-class evaluations and exit slips. We conclude that scaffolding through our STEAM intervention enabled Irish teenagers to feel empowered to act as vaccine advocates. Peer education within our intervention shows promise in raising HPV awareness and knowledge and could be explored in wider contexts.