The practicality, acceptability and impact of self-consent procedures for the schools-based HPV vaccination programme
Chief Investigator
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Institution
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Dates
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Funding Stream
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Grant Ref
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Amount
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Dr Suzanne Audrey
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University of Bristol
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01/09/2017 - 31/08/2019
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NIHR Research for Patient Benefit
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RfPB PB-PG-0416-20013
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£167,298
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Summary
AIM: To examine whether it is practical and acceptable for young
people to consent for themselves to have the HPV vaccination,
rather than their parents giving written consent. We will also look
at the impact of selfconsent on the number of young people
receiving the vaccine .
BACKGROUND: HPV vaccination can reduce cervical cancer in women.
However, girls from lower socio-economic groups, some ethnic
groups, and those not attending 'mainstream' schools are less
likely to receive the vaccine. It is recommended that HPV
vaccination takes place aged 12/13 years. Because this seems quite
young, written parental consent is asked for but it can be
difficult for some girls to provide. The law allows girls to
consent for themselves if they understand what the vaccine is for
and what the side effects might be.
DESIGN AND METHODS: We will summarise all the available evidence
about adolescents self-consenting for vaccination. We will observe
new self-consent procedures in Bristol and South Gloucestershire,
and conduct interviews and focus groups with girls, parents, school
nurses and school staff. We will also look at the uptake rates of
HPV vaccination before and after the new self-consent procedures to
see if uptake increases overall and in relation to socio-economic
status, ethnicity and type of school.
PATIENT AND PUBLIC INVOLVEMENT: We have discussed self-consent
with a group of young people at the Bristol Royal Hospital for Sick
Children. We will consult them again about the design of the study
and the forms and paperwork we use with people who take part.
DISSEMINATION: We will make recommendations about self-consent
and present our findings at events for healthcare practitioners and
academic conferences. Two papers will be written for peer-reviewed
journals. We will summarise the results to share with school
nurses, school staff, young people and their parents who request
it.
Patient and public involvement
The research topic arose from doctoral research undertaken by
Harriet Batista in relation to inequalities in the uptake of HPV
vaccination. During that research interviews were conducted with
young women, parents, school staff and school nurses, and
observations were conducted of the HPV vaccination sessions. This
research identified the requirment for written parental consent as
a important factor contributing to low uptake in some groups of
young women. The research also identified misunderstandings and
reluctance in relation to self consent, amongst practitioners and
school staff, for vaccinations in young women aged 12/13 years. In
drafting the outline application for this study, we consulted the
Bristol Young People's Advisory Group (YPAG) at the Bristol Royal
Hospital for Children. The group comprises young people aged
between 10 and 17 who are interested in healthcare and research.
They meet regularly to help researchers with their projects.
Bristol YPAG have taken part in preliminary discussions about
self-consent procedures, at which a group of 11 young people
discussed self-consent for vaccination of young people who are of
secondary school age. Following this discussion, all 'voted' in
favour of self-consent preferably with parents being informed.
We will continue our relationship with Bristol YPAG who will be
consulted during the course of the research about the design of the
study and participant materials. The group is coordinated by
Michael Bell who is a coapplicant on this research application. If
it is shown that self-consent helps to increase the uptake of HPV
vaccination in groups that are currently less likely to receive it,
we will ask Bristol YPAG, and other young people identified through
the study, to consider the self-consent materials and whether they
can be further improved for wider implementation. We will also
consult a purposive sample of stakeholders about the materials. We
will hold a dissemination event at the end of the study to consider
findings and recommendations with the young people, parents and
school staff involved in the study.
Links to further information
http://bmjopen.bmj.com/content/8/3/e021321
https://research-information.bristol.ac.uk/en/publications/impact-and-acceptability-of-selfconsent-procedures-for-the-schoolbased-human-papillomavirus-vaccine(6a93caa9-5c16-4547-8272-b73351549c80).html
