Barriers and supports for uptake of human papillomavirus vaccination in Indigenous people globally: A systematic review.

• Type of Material: Article
• Authors: Shannon E MacDonald, University of Alberta; Lisa Kenzie, University of Alberta; Angeline Letendre, Cancer Prevention and Screening Innovation, Alberta Health Services, Edmonton, Canada.; Lea Bill, Alberta Health Services, Edmonton, Canada; Melissa Shea-Budgell, University of Calgary; Rita Henderson, University of Calgary; Cheryl Barnabe, University of Calgary; Juliet R Guichon, University of Calgary; Amy Colquhoun, Alberta Health, Edmonton, Canada; Heather Ganshorn, University of Calgary; Nancy Bedingfield, University of Calgary; Paul D Vandenboogaard, University of Alberta; Robert Bednarczyk, Emory University; Sarah Glaze, University of Calgary; Gregg Nelson, University of Calgary
• Language: English
• Date: 2023
• Publisher: Emory University Libraries
• Publication Version: Final Published Version
• Copyright Statement: © 2023 MacDonald et al
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pgph.0001406
• Title of Journal or Parent Work: PLOS Glob Public Health
• Volume: 3
• Issue: 1
• Start Page: e0001406
• End Page: e0001406
• Grant/Funding Information: This work was supported by Alberta Innovates through the Cancer Prevention Research Opportunity [2015 Collaborative Research and Innovation Opportunity (CRIO)] Grant #201500852. The research operating funds were received by GN, and supported the time commitment of LK, LB, and PDV. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
• Keywords: human papillomavirus vaccination(HPV)
• Research Categories: Health Sciences, Nursing; Health Sciences, Medicine and Surgery

Abstract

Despite the availability of effective and safe human papillomavirus (HPV) vaccines that reduce the incidence and impact of cervical cancer and other cancers, HPV vaccine coverage rates remain persistently low and the cervical cancer burden disproportionately high among Indigenous people globally. This study aimed to systematically identify, appraise, and summarize the literature on documented barriers and supports to HPV vaccination in Indigenous populations internationally. Forty-three studies were included and an inductive, qualitative, thematic synthesis was applied. We report on 10 barrier themes and 7 support themes to vaccine uptake, and provide a quantitative summary of metrics. Focusing on Indigenous perspectives reported in the literature, we propose recommendations on community-research collaboration, culturally safe intergenerational and gender-equitable community HPV vaccine education, as well as multi-level transparency to ensure informed consent is secured in the context of reciprocal relationships. Although the voices of key informant groups (e.g., HPV-vaccine eligible youth and community Elders) are underrepresented in the literature, the identification of barriers and supports to HPV vaccination in a global Indigenous context might help inform researchers and health policy makers who aim to improve HPV vaccine uptake in Indigenous populations.