title: School-based intervention for the prevention of HPV among adolescents: a cluster randomised controlled study.
abstract: OBJECTIVE
  To improve primary prevention of human papillomavirus (HPV) infection by promoting vaccination and increased condom use among upper secondary school students.
  
  
  METHODS
  Cluster randomised controlled trial.
  
  
  METHODS
  18 upper secondary schools in Sweden.
  
  
  METHODS
  Schools were first randomised to the intervention or the control group, after which individual classes were randomised so as to be included or not. Of the 832 students aged 16 years invited to participate during the regular individual health interview with the school nurse, 751 (90.2%) agreed to participate and 741 (89.1%) students completed the study.
  
  
  METHODS
  The intervention was based on the Health Belief Model (HBM). According to HBM, a person's health behaviour can be explained by individual beliefs regarding health actions. School nurses delivered 30 min face-to-face structured information about HPV, including cancer risks and HPV prevention, by propagating condom use and HPV vaccination. Students in the intervention and the control groups completed questionnaires at baseline and after 3 months.
  
  
  METHODS
  Intention to use condom with a new partner and beliefs about primary prevention of HPV, and also specifically vaccination status and increased condom use.
  
  
  RESULTS
  All statistical analyses were performed at the individual level. The intervention had a significant effect on the intention to use condom (p=0.004). There was also a significant effect on HBM total score (p=0.003), with a 2.559 points higher score for the intervention group compared to the controls. The influence on the HBM parameters susceptibility and severity was also significant (p<0.001 for both variables). The intervention also influenced behaviour: girls in the intervention group chose to have themselves vaccinated to a significantly higher degree than the controls (p=0.02). No harms were reported.
  
  
  CONCLUSIONS
  The school-based intervention had favourable effects on the beliefs about primary prevention of HPV, and increased the HPV vaccination rates in a diverse population of adolescents.
  
  
  BACKGROUND
  NCT02280967; Results.
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Grandahl
authors.affiliation: Centre for Clinical Research Västerås, Uppsala University, Västerås, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Rosenblad
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Christina
authors.initials: C
authors.lastname: Stenhammar
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Tanja
authors.initials: T
authors.lastname: Tydén
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Ragnar
authors.initials: R
authors.lastname: Westerling
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Margareta
authors.initials: M
authors.lastname: Larsson
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Oscarsson
authors.affiliation: Centre for Research and Development, Uppsala University/Region of Gävleborg, Gävle, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Andrae
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Tina
authors.initials: T
authors.lastname: Dalianis
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Tryggve
authors.initials: T
authors.lastname: Nevéus
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D017280:Condoms / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D033182:Intention; D008297:Male; D017063:Outcome Assessment, Health Care; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines; D021841:Safe Sex; D012572:School Health Services; D012574:Schools; D011795:Surveys and Questionnaires; D013548:Sweden; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV; adolescents; prevention; randomised control trial; school-based
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