PROJECT SUMMARY/ABSTRACT:
Human papilloma virus (HPV) infection causes over 30,000 cancers each year, even though multi-valent
vaccinations for HPV have been available since 2006. Uptake of the vaccine is well below national targets
(80% by 2030) and vaccination rates are not being administered by the recommended age of 13. School
based health centers (SBHCs) are an important setting where medically underserved adolescents can
access preventive health care services. While SBHCs provide access to health care, only 10% of students
on campuses with SBHCs are using their services. Collaborative multilevel interventions are needed to
increase use of SBHCs and improve vaccination uptake among medically underserved adolescents in these
settings. Peer-to-Peer education offers promise in creating collaborative environments between SBHCs and
schools, to increase healthcare access and improve healthy behaviors. Our proposed innovation, PEER, will
tailor messaging to adolescents and parents through a validated engagement approach, Boot Camp
Translation (Aim 1). Then PEER will conduct a multilevel interventional study that uses a stepped-wedge
design to test the effectiveness and implementation of student-, patient-, provider- and school-based
interventions focused on improving use of SBHCs and uptake of HPV vaccination in age-eligible adolescents
(Aim 2). Analysis of mediator and moderators will elucidate the mechanisms of action and identify subgroups
for whom the intervention was more and less effective. PEER will be led by an experienced team of
scientists, clinicians, and community organizations with expertise in implementation science, HPV
vaccination research, and community engagement. PEER will also be overseen by an advisory board made
up of stakeholders including school administration and youth. If successful, PEER could significantly
increase the use of SBHCs, and decrease HPV-associated cancers and, thus, reduce the burden of cancer
in the United States.
