Development of a multicomponent intervention to increase parental vaccine confidence and young people's access to the universal HPV vaccination programme in England: protocol for a co-design study.

INTRODUCTION: Persistent infection with HPV can result in cancers affecting men and, especially, women. Lower uptake exists by area and different population groups. Increasing parental confidence about, and adolescent access to, the universal HPV vaccination programme may help reduce inequalities in uptake. However, the evidence-base for interventions to address uptake for schools-based HPV vaccination programmes is currently lacking. This study protocol outlines how a multicomponent intervention to address this evidence gap will be codesigned with parents. METHODS AND ANALYSIS: The proposed research will be undertaken in localities covered by two immunisation teams in London and the south-west of England. The 'person-based approach' to intervention development will be followed. In the first phase, an exploratory qualitative study will be undertaken with key stakeholders (n=8) and parents (n=40) who did not provide consent for their adolescent child to be vaccinated. During the interviews, parents' views on ways to improve parental confidence about, and adolescents' access to, HPV vaccination will be sought. The findings will be used to inform the co-design of a preliminary plan for a targeted, multicomponent intervention. In the second phase, at least two parent working groups (n=8) will be convened and will work with creative designers to co-design communication materials aimed at increasing parents' confidence in vaccination. At least two workshops with each parent group will be organised to obtain feedback on the intervention plan and communication materials to ensure they are fit for purpose. These findings will inform a protocol for a future study to test the effectiveness of the intervention at increasing HPV vaccination uptake. ETHICS AND DISSEMINATION: The National Health Services Research Ethics Service and London School of Hygiene & Tropical Medicine Observational / Interventions Research Ethics Committee provided approvals for the study (reference 22/SW/0003 & 26902, respectively). We will work with parent advisory groups to inform our dissemination strategy and co-present our findings (eg, at community events or through social media). We will disseminate our findings with academics and healthcare professionals through webinars and academic conferences, as well as peer-reviewed publications.

Experiences of the coronavirus disease-19 (COVID-19) pandemic from the perspectives of young people: Rapid qualitative study.

OBJECTIVES: Young people are considered at lower risk from coronavirus disease-19 (COVID-19). However, measures to limit the population health impact of the current COVID-19 pandemic have caused significant disruptions to their lives. The objective of this study was to explore the experiences of young people predominantly living in the south-west of England during the COVID-19 pandemic. STUDY DESIGN: Rapid qualitative study. METHODS: Following advertisement on social media, a purposive sample of young people by age and gender who had expressed an interest were invited to participate. In June 2020, 21 young people (12-17 years) took part in 18 semi-structured interviews, either through a digital platform or by telephone. Interviews were recorded digitally and transcribed verbatim. Thematic analysis was undertaken, assisted by NVvivo Software. RESULTS: Young people felt the greatest impacts of the pandemic have been disruption to how they learned because of school closures and limited face-to-face interaction with their social networks. There was variation in terms of how satisfied young people were with self-directed learning at home, and some anxieties in relation to its effectiveness outside the school environment. Most young people reported maintaining social relationships remotely, but some young people appeared to have little social interaction outside their household. High levels of adherence to social distancing and handwashing were reported, which could lead to a sense of injustice resulting from visibility of other people breaching social distancing guidance. Young people were willing to be vaccinated against COVID-19 if a vaccine became available, with the greatest motivator being to protect others above themselves. CONCLUSIONS: Young people have experienced significant disruption to their education and social networks during the COVID-19 pandemic. During lockdown, high levels of compliance to government public health guidelines to reduce transmission of COVID-19 were reported by young people. If an effective vaccine is developed, a schools-based vaccination programme could be an efficient method to interrupt transmission to more at-risk populations and prevent further disruptions to young people's education.