Parent-Centered Versus Parent-Adolescent Dyad Interventions to enhance HPV Vaccination Uptake in Children and Adolescents: A Systematic Review and Meta- analysis

Abstract

<title>Abstract</title> Introduction: The human papillomavirus (HPV) vaccine is pivotal in preventing HPV-related cancers, yet vaccine uptake rates vary significantly. This study assesses the efficacy of parent-adolescent dyad and parent-centered interventions on enhancing HPV vaccine uptake across different doses and over time. Methods The study systematically searched Cochrane, PubMed, Web of Science, and Scopus databases from inception until the day of the search, synthesizing data to compare intervention effectiveness across HPV vaccination stages and time intervals. It assessed HPV vaccine uptake among children and adolescents aged 9–18 years after parent or parent-adolescent dyad interventions, alongside completion rates. Meta-analyses, utilizing random-effects models, were conducted for each outcome. Results For the first dose, parent-adolescent dyad interventions indicated a potential, though uncertain, increase in uptake (odds ratio [OR] 1.43, 95% confidence interval [CI]: 0.84, 2.42), while parent-centered interventions showed a significant, consistent improvement (OR 1.14, 95% CI: 1.08, 1.19). The second dose benefited markedly from dyad interventions (OR 3.75, 95% CI: 1.04, 13.52), with parent-centered interventions also demonstrating effectiveness (OR 1.27, 95% CI: 1.08, 1.48). For doses three and above, dyad interventions suggested a strong impact (OR 1.77, 95% CI: 1.13, 2.77), albeit with variability for parent-centered strategies (OR 1.13, 95% CI: 0.41, 3.11). Over time, interventions consistently improved uptake, particularly notable at 6 and 12 months for initial doses and showing long-term improvements in completing the series. Conclusion The study underscores the differential yet significant impact of parent-adolescent dyad and parent-centered interventions on HPV vaccine uptake across various doses and over time. These findings highlight the importance of tailored, dynamic public health strategies that engage both parents and adolescents to enhance HPV vaccination rates, supporting broader efforts to mitigate HPV-related health outcomes.