title: Barriers and facilitators to uptake of the school-based HPV vaccination programme in an ethnically diverse group of young women.
abstract: To identify the barriers and facilitators to uptake of the HPV vaccine in an ethnically diverse group of young women in the south west of England.
  
  
  
  Three school-based vaccination sessions were observed. Twenty-three young women aged 12 to 13 years, and six key informants, were interviewed between October 2012 and July 2013. Data were analysed using thematic analysis and the Framework method for data management.
  
  
  
  The priority given to preventing cervical cancer in this age group influenced whether young women received the HPV vaccine. Access could be affected by differing levels of commitment by school staff, school nurses, parents and young women to ensure parental consent forms were returned. Beliefs and values, particularly relevant to minority ethnic groups, in relation to adolescent sexual activity may affect uptake. Literacy and language difficulties undermine informed consent and may prevent vaccination.
  
  
  
  The school-based HPV vaccination programme successfully reaches the majority of young women. However, responsibility for key aspects remain unresolved which can affect delivery and prevent uptake for some groups. A multi-faceted approach, targeting appropriate levels of the socio-ecological model, is required to address procedures for consent and cultural and literacy barriers faced by minority ethnic groups, increase uptake and reduce inequalities.
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol BS8 2PS, UK.
authors.forename: Harriet
authors.initials: H
authors.lastname: Batista Ferrer
authors.affiliation: Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK.
authors.forename: Caroline L
authors.initials: CL
authors.lastname: Trotter
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol BS8 2PS, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Hickman
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol BS8 2PS, UK.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Audrey
mesh_terms: D000293:Adolescent; D044466:Asian People / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D002648:Child; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration / Q000706:statistics & numerical data*; D030361:Papillomavirus Infections / Q000208:ethnology / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D012572:School Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D002583:Uterine Cervical Neoplasms / Q000208:ethnology / Q000517:prevention & control; D044465:White People / Q000706:statistics & numerical data
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV vaccine; adolescents; decision-making; ethnicity; health inequalities