تأثیر مداخلات آموزشی بر دانش و نگرش نوجوانان در مورد واکسن پاپیلوما ویروس انسانی: یک مطالعه‌ی مروری نظام‌مند

نوع مقاله : مقاله مروری

نویسندگان

1 دانشجوی دکتری بهداشت باروری، کمیته‌ی تحقیقات دانشجویی، گروه مامایی و بهداشت باروری، دانشکده‌ی پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

2 استاد، مرکز تحقیقات مامایی و بهداشت باروری، گروه مامایی و بهداشت باروری، دانشکده‌ی پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

3 مربی، گروه پرستاری و مامایی، دانشکده‌ی پرستاری و مامایی، واحد لارستان، دانشگاه آزاد اسلامی،لار، ایران

4 گروه مامایی، دانشکده‌ی پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

چکیده

مقدمه: ویروس پاپیلومای انسانی (Human papillomavirus یا HPV) شایع‌ترین عفونت جنسی منتقل ‌شده به ‌ویژه در افراد زیر 25 سال می‌باشد که اغلب به دلیل عدم آگاهی و باور غلط انتقال می‌یابد. با توجه به نقش پیش سرطانی این ویروس و اهمیت پیش‌گیری از آن، تزریق واکسن HPV در تمام کشورها مورد توجه قرار گرفته است. از این ‌رو، بهبود آگاهی و نگرش در میان نوجوانان ضروری به نظر می‌رسد. بنابراین، مطالعه‌ی مرور نظام‌مند حاضر، با هدف بررسی تأثیر مداخلات آموزشی بر دانش و نگرش دختران نوجوان در مورد واکسن HPV انجام شد.روش‌ها: در این مطالعه‌ی مرور نظام‌مند، همه‌ی مطالعات کمی منتشر شده، بدون محدودیت زمانی بررسی شدند. جستجوی مطالعات در پایگاه‌های اطلاعاتی انگلیسی و فارسی انجام شد. واژگان کلیدی بر اساس Mesh و شامل «Knowledge»، «Attitudes»، «Papillomavirus vaccines»، «Gardasil» و «Intervention study» بودند که با عملگرهای Boolean «OR» و «AND» ترکیب شدند. در نهایت، دو پژوهشگر به ‌طور مستقل مقالات را جهت ارزیابی کیفیت و استخراج یافته‌ها مورد بررسی قرار دادند.یافته‌ها: 21 مقاله با حجم نمونه‌ی کلی 10086 نفر انتخاب شد. مقالات از نوع کارآزمایی بالینی تصادفی، غیر تصادفی و شبه تجربی بودند و سال انتشار آن‌ها بین 2019-2008 بود. یافته‌های پژوهش نشان داد که مداخلات آموزشی بر اساس مدل اعتقاد بهداشتی، مدل آموزش همسالان، مداخلات مبتنی بر مدرسه و به ‌صورت سایر مداخلات آموزشی بود. مدل اعتقاد بهداشتی و مداخلات مبتنی بر مدرسه، شایع‌ترین چارچوب‌ها در طراحی مداخلات آموزشی در مورد واکسن پاپیلوما ویروس انسانی در میان نوجوانان بود. در تمامی مطالعات، انواع مداخلات آموزشی تأثیر مثبتی بر افزایش دانش و بهبود نگرش نوجوانان نسبت به واکسن HPV داشتند.نتیجه‌گیری: انواع مداخلات آموزشی به ‌صورت مدل Health belief model (HBM)، مدل آموزش هم‌سالان، مداخلات مبتنی بر مدرسه و سایر مداخلات آموزشی، می‌تواند منجر به افزایش دانش و نگرش افراد نسبت به واکسن HPV شوند. با توجه به مؤثر بودن مداخلات آموزشی بر اساس مدل اعتقاد بهداشتی و مداخلات مبتنی بر مدرسه بر افزایش دانش و نگرش نوجوانان در مورد این واکسن، طراحی و اجرای مداخلات در مدارس پیشنهاد می‌شود.

کلیدواژه‌ها

عنوان مقاله [English]

The Effect of Educational Interventions on Adolescents' Knowledge and Attitude about the Human Papillomavirus Vaccine; A Systematic Review

نویسندگان [English]

  • Mojdeh Banaei 1
  • Masomeh Simbar 2
  • sanaz Safarzade 3
  • Hadis Shahrahmani 1
  • Azam Khiabani 4
1 PhD Student of Reproductive Health, Student Research Committee, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Professor, Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Instructor, Department of Midwifery, School of Nursing and Midwifery, Larestan Branch, Islamic Azad Uuiversity, Lar, Iran
4 Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
چکیده [English]

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide, especially in people with age of under 25 years. It is often caused due to lack of awareness and misconception. Given the precancerous role of this virus and the importance of its prevention, HPV vaccination has been considered in all countries; so it is necessary to improve the knowledge and attitude of adolescents. Therefore, awareness and attitudes among high-risk groups need to be improved, especially among the vulnerable teens. This systematic review was conducted to evaluate the effect of educational interventions on knowledge and attitude of adolescent girls about HPV vaccine.Methods: All quantitative studies, which were published without time limit, were entered in this systematic review article. The investigation was performed in the English and national databases such. Keywords were as Knowledge, Attitudes, Papillomavirus Vaccines, Gardasil, and Intervention study combined with the Boolean OR and AND operators. Finally, two researchers independently reviewed the articles for the quality appraisal and extracted their main findings.Findings: Finally, 21 articles with a total sample size of 10086 were entered the study. Articles were interventional types and were published from 2008 to 2019. Educational interventions were based on Health Belief Model, Peer Education Model, School-Based Interventions, and other Educational Interventions. The Health Belief Model and School-Based Interventions were the most common frameworks for designing educational interventions for the HPV vaccine among adolescents. In all studies, educational interventions had a positive effect on increasing adolescents' knowledge and attitude toward the HPV vaccine.Conclusion: Educational interventions can lead to increased knowledge and attitudes towards HPV vaccine. Considering the effectiveness of educational interventions based on the Health Belief Model and School-Based Interventions to increase adolescents' knowledge and attitude about this vaccine, designing and implementing such interventions in school are recommended.

کلیدواژه‌ها [English]

  • Papillomavirus vaccines
  • Gardasil
  • Attitudes
  • Knowledge
  • Education

مراجع

  1. Smith LM, Kaufman JS, Strumpf EC, Levesque LE. Effect of human papillomavirus (HPV) vaccination on clinical indicators of sexual behaviour among adolescent girls: the Ontario Grade 8 HPV Vaccine Cohort Study. CMAJ 2015; 187(2): E74-E81.
  2. Cherven B, Landier W, Castellino SM, Chen Y, Wong L, York J, et al. Predictors of human papillomavirus (HPV) vaccine intent and subsequent initiation among adolescent and young adult cancer survivors. Pediatrics 2019; 144(2): 248.
  3. Han JJ, Beltran TH, Song JW, Klaric J, Choi YS. Prevalence of genital human papillomavirus infection and human papillomavirus vaccination rates among us adult men: National Health and Nutrition Examination Survey (NHANES) 2013-2014. JAMA Oncol 2017; 3(6): 810-6.
  4. Dadashi M, Vaez Jalali M, Fallah F, Goudarzi H, Nasiri M, Owlia P, et al. Epidemiology of Human Papillomavirus (HPV) infection among Iranian women identified with cervical infections: A systematic review and meta-analysis of national data. Infection Epidemiology and Microbiology 2017; 3(2): 68-72.
  5. Bruni L, Diaz M, Castellsague X, Ferrer E, Bosch FX, de Sanjose S. Cervical human papillomavirus prevalence in 5 continents: Meta-analysis of 1 million women with normal cytological findings. J Infect Dis 2010; 202(12): 1789-99.
  6. Grover S, Garg N, Rupali R, Kaur B. Awareness about reproductive health, contraceptive methods, STDs including HIV/AIDS, and HPV vaccine, among adolescent girls in district Faridkot in Punjab. Int J Reprod Contracept Obstet Gynecol 2017; 6(5): 2003-9.
  7. Rashidi Fakari F, Simbar M, Ghasemi V, Saei Gharenaz M. Inhibitors and facilitators of unwanted adolescent pregnancy in iran and the world: A review. Evidence Based Care 2017; 7(2): 59-70.
  8. Baisley KJ, Andreasen A, Irani J, Nnko S, Changalucha J, Crucitti T, et al. HPV prevalence around the time of sexual debut in adolescent girls in Tanzania. Sex Transm Infect 2019. [Epub ahead of print].
  9. Mbulawa ZZA, van Schalkwyk C, Hu NC, Meiring TL, Barnabas S, Dabee S, et al. High human papillomavirus (HPV) prevalence in South African adolescents and young women encourages expanded HPV vaccination campaigns. PLoS One 2018; 13(1): e0190166.
  10. Rashid S, Labani S, Das BC. Knowledge, awareness and attitude on HPV, HPV vaccine and cervical cancer among the college students in India. PLoS One 2016; 11(11): e0166713.
  11. Naud PS, Roteli-Martins CM, De Carvalho NS, Teixeira JC, de Borba PC, Sanchez N, et al. Sustained efficacy, immunogenicity, and safety of the HPV-16/18 AS04-adjuvanted vaccine: Final analysis of a long-term follow-up study up to 9.4 years post-vaccination. Hum Vaccin Immunother 2014; 10(8): 2147-62.
  12. Patel H, Jeve YB, Sherman SM, Moss EL. Knowledge of human papillomavirus and the human papillomavirus vaccine in European adolescents: A systematic review. Sex Transm Infect 2016; 92(6): 474-9.
  13. Wang HH, Wu SY. HPV vaccine knowledge and perceived risk of cervical cancer among female college students in Taiwan. Asian Pac J Cancer Prev 2013; 14(12): 7371-4.
  14. Bahrami N, Simbar M, Soleimani M. Sexual health challenges of adolescents in Iran: A review article. J Sch Public Health Inst Public Health Res 2013; 10(4): 1-16. [In Persian].
  15. Nagpal J, Linares LO, Weiss J, Schlecht NF, Shankar V, Braun-Courville D, et al. Knowledge about human papillomavirus and time to complete vaccination among vulnerable female youth. J Pediatr 2016; 171: 122-7.
  16. Zouheir Y, Daouam S, Hamdi S, Alaoui A, Fechtali T. Knowledge of Human papillomavirus and acceptability to vaccinate in adolescents and young adults of the moroccan population. J Pediatr Adolesc Gynecol 2016; 29(3): 292-8.
  17. Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ 2011; 343: d5928.
  18. Gottvall M, Tyden T, Hoglund AT, Larsson M. Knowledge of human papillomavirus among high school students can be increased by an educational intervention. Int J STD AIDS 2010; 21(8): 558-62.
  19. Grandahl M, Rosenblad A, Stenhammar C, Tyden T, Westerling R, Larsson M, et al. School-based intervention for the prevention of HPV among adolescents: a cluster randomised controlled study. BMJ Open 2016; 6(1): e009875.
  20. Kim HW. Awareness of human papillomavirus and factors associated with intention to obtain HPV vaccination among Korean youth: Quasi experimental study. BMC Int Health Hum Rights 2015; 15: 4.
  21. Krawczyk A, Lau E, Perez S, Delisle V, Amsel R, Rosberger Z. How to inform: comparing written and video education interventions to increase human papillomavirus knowledge and vaccination intentions in young adults. J Am Coll Health 2012; 60(4): 316-22.
  22. Mehta P, Sharma M, Lee RC. Designing and evaluating a health belief model-based intervention to increase intent of HPV vaccination among college males. Int Q Community Health Educ 2013; 34(1): 101-17.
  23. Molokwu J, Dwivedi A, Mallawaarachchi I, Hernandez A, Shokar N. Tiempo de Vacunarte (time to get vaccinated): Outcomes of an intervention to improve HPV vaccination rates in a predominantly Hispanic community. Prev Med 2019; 121: 115-20.
  24. Al-Shaikh GK, Syed SB, Fayed AA, Al-Shaikh RA, Al-Mussaed EM, Khan FH, et al. Effectiveness of health education programme: Level of knowledge about prevention of cervical cancer among Saudi female healthcare students. J Pak Med Assoc 2017; 67(4): 513-20.
  25. Ferrara M, Langiano E, Vito E. A school based community randomized trial of the effect of peer health education on primary prevention knowledge, attitude and behaviours towards HPV among adolescents. Ital J Public Health 2012; 9(1): 20-32.
  26. Sadoh AE, Okonkwobo C, Nwaneri DU, Ogboghodo BC, Eregiea C, Oviawe O, et al. Effect of peer education on knowledge of human papilloma virus and cervical cancer among female adolescent students in Benin City, Nigeria. Ann Glob Health 2018; 84(1): 121-8.
  27. Castellanos M, Odaimi T, Demissie S, Lee A, Farberov M. A new peer-to-peer educational model to increase knowledge and acceptability of HPV vaccination. J Adolesc Health 2018; 62(2): S105-S106.
  28. Lai CY, Wu WW, Tsai SY, Cheng SF, Lin KC, Liang SY. The effectiveness of a facebook-assisted teaching method on knowledge and attitudes about cervical cancer prevention and hpv vaccination intention among female adolescent students in Taiwan. Health Educ Behav 2015; 42(3): 352-60.
  29. Liu CR, Liang H, Zhang X, Pu C, Li Q, Li QL, et al. Effect of an educational intervention on HPV knowledge and attitudes towards HPV and its vaccines among junior middle school students in Chengdu, China. BMC Public Health 2019; 19(1): 488.
  30. Kwan TT, Tam KF, Lee PW, Chan KK, Ngan HY. The effect of school-based cervical cancer education on perceptions towards human papillomavirus vaccination among Hong Kong Chinese adolescent girls. Patient Educ Couns 2011; 84(1): 118-22.
  31. Hofman R, Schiffers PA, Richardus JH, Raat H, de Kok IM, van Ballegooijen M, et al. Increasing girls' knowledge about human papillomavirus vaccination with a pre-test and a national leaflet: a quasi-experimental study. BMC Public Health 2013; 13: 611.
  32. Steckelberg A, Albrecht M, Kezle A, Kasper J, Muhlhauser I. Impact of numerical information on risk knowledge regarding human papillomavirus (HPV) vaccination among schoolgirls: a randomised controlled trial. Ger Med Sci 2013; 11: Doc15.
  33. Tu YC, Lin YJ, Fan LW, Tsai TI, Wang HH. Effects of multimedia framed messages on human papillomavirus prevention among adolescents. West J Nurs Res 2019; 41(1): 58-77.
  34. Brabin L, Stretch R, Roberts SA, Elton P, Baxter D, McCann R. Survey of girls' recall of a film providing information on human papillomavirus and cervical cancer 6 months after an offer of vaccination. Vaccine 2010; 28(25): 4210-4.
  35. Bennett AT, Patel DA, Carlos RC, Zochowski MK, Pennewell SM, Chi AM, et al. Human papillomavirus vaccine uptake after a tailored, online educational intervention for female university students: A randomized controlled trial. J Womens Health (Larchmt) 2015; 24(11): 950-7.
  36. Doherty K, Low KG. The effects of a web-based intervention on college students' knowledge of human papillomavirus and attitudes toward vaccination. Int J Sex Health 2008; 20(4): 223-32.
  37. DiClemente RJ, Murray CC, Graham T, Still J. Overcoming barriers to HPV vaccination: A randomized clinical trial of a culturally-tailored, media intervention among African American girls. Hum Vaccin Immunother 2015; 11(12): 2883-94.
  38. Juraskova I, O'Brien M, Mullan B, Bari R, Laidsaar-Powell R, McCaffery K. HPV vaccination and the effect of information framing on intentions and behaviour: an application of the theory of planned behaviour and moral norm. Int J Behav Med 2012; 19(4): 518-25.
  39. Simbar M, Ramezani Tehrani F, Hashemi Z. Sexual-Reproductive Health Belief Model of college students. Iran South Med J 2004; 7(1): 70-78. [In Persian].
  40. Shirzadi S, Asghari JM, Nadrian H, Mahmoodi H. Determinants of puberty health among female adolescents residing in boarding welfare centers in Tehran: An application of health belief model. Med J Islam Repub Iran 2016; 30: 432.
  41. Zhao FH, Tiggelaar SM, Hu SY, Xu LN, Hong Y, Niyazi M, et al. A multi-center survey of age of sexual debut and sexual behavior in Chinese women: Suggestions for optimal age of human papillomavirus vaccination in China. Cancer Epidemiol 2012; 36(4): 384-90.
  42. Kim HW, Park S, Ahn HY, Park EJ. The effects of an HPV education program by gender among Korean university students. Nurse Educ Today 2015; 35(4): 562-7.
  43. Calderon Y, Cowan E, Nickerson J, Mathew S, Fettig J, Rosenberg M, et al. Educational effectiveness of an HIV pretest video for adolescents: A randomized controlled trial. Pediatrics 2011; 127(5): 911-6.
  44. Ghasemi V, Simbar M, Rashidi Fakari F, Saei Ghare Naz M, Kiani Z. The effect of peer education on health promotion of Iranian adolescents: A systematic review. Int J Pediatr 2019; 7(3): 9139-57.
  45. Abbaspour Z, Saidian M, Abedi P. Peer education vs. health provider education in knowledge and attitude about prevention and transmission of AIDS in high school students. Pak J Med Sci 2007; 23(1): 108-10.
  46. Hatami M, Kazemi A, Mehrabi T. Effect of peer education in school on sexual health knowledge and attitude in girl adolescents. J Educ Health Promot 2015; 4: 78.
  47. Betsch C, Brewer NT, Brocard P, Davies P, Gaissmaier W, Haase N, et al. Opportunities and challenges of Web 2.0 for vaccination decisions. Vaccine 2012; 30(25): 3727-33.
  48. Pourmohsen M, Simbar M, Nahidi F, Fakor F, Alavi Majd H. HPV risk factors and prevention behaviours: A review. J Clin Diagn Res 2018; 12(12): LE01-LE05.
  49. Kahn JA, Rosenthal SL, Jin Y, Huang B, Namakydoust A, Zimet GD. Rates of human papillomavirus vaccination, attitudes about vaccination, and human papillomavirus prevalence in young women. Obstet Gynecol 2008; 111(5): 1103-10.
  50. Allen JD, Mohllajee AP, Shelton RC, Othus MK, Fontenot HB, Hanna R. Stage of adoption of the human papillomavirus vaccine among college women. Prev Med 2009; 48(5): 420-5.
مجله دانشکده پزشکی اصفهان
دوره 37، شماره 553 - شماره پیاپی 553
بهمن و اسفند 1398
صفحه 1298-1312

فایل ها

سابقه مقاله

  • تاریخ دریافت: 22 مهر 1398
  • تاریخ بازنگری: 12 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

هم رسانی

ارجاع به این مقاله

آمار