A community-based intervention in middle schools to improve HPV vaccination and cervical cancer screening in Japan

Abstract

Aim: Japan has low rates of cervical cancer screening and Human papilloma virus (HPV) vaccination. This researc examines the effectiveness of a family medicine resident-led, intervention in increasing knowledge about HPV an cervical cancer in middle school-girls and increasing knowledge and intention to have cervical cancer screening i their mothers Methods: We utilized a pre-Test/post-Test intervention design in three rural middle schools with 7th grade middl school-girls and their mothers. A school-based activity educated girls about HPV and cervical cancer. A home-base activity utilized a homework assignment for girls and their mothers. Pre/post intervention surveys were complete by the girls and their mothers. Major outcomes included changes in knowledge among girls and mothers an barriers to be screened for cervical cancer among mothers Results: Sixty-five students and sixty-Three mothers completed the study. Two out five mothers were not i compliance with current screening recommendations. Identified barriers included: embarrassment (79%), poo access (56%), fear of having cancer (52%), and cervical cancer screening being an unknown procedure (46%) Forty-four percent of mothers deemed their daughters to be at risk for cervical cancer. Trusted sources o information included: doctors (97%), newspapers/television (89%), government (79%), the Internet (78%), and friend (62%). Student knowledge scores (7-point scale) improved significantly from pre-to post-intervention (4.8 vs. 5.9 p 0.001). Knowledge scores (14-point scale) among mothers also significantly improved (11.7 vs. 12.0, p = 0.024) Conclusions: These data suggest a community-based intervention on a sensitive topic by family medicine resident can be implemented in middle schools, can improve school-girls' knowledge about HPV and cervical cancer, an can reach their mothers. Additional research could examine whether those intending to be screened receiv screening and how to reach women who still resist screening.