Table 4. Summary of equity considerations in the included studies.

Social factors according to PROGRESS-Plus	Findings
Education, place of residence and socioeconomic status	· Knowledge, attitudes, intentions and behaviours related to HPV immunization and cervical cancer screening were improved by creating an enabling environment in low-income countries facing poor access to health services, long hospital wait times, lower education levels, lack of basic amenities (e.g., latrines and safe running water) and higher prevalence of risky sexual behaviours (Khani Jeihooni et al., 2021; Olubodun et al., 2022). · The majority of population groups studied received a high school education or less, which had implications on how the educational components of the intervention were designed (e.g., delivered verbally through lay health advisors, promoters, mixed marketing approach, PowerPoint) (Chu et al., 2021; Khani Jeihooni et al., 2021; Larkey et al., 2012; Lee et al., 2018; Ma et al., 2022; McDonough et al., 2016; Olubodun et al., 2022). · Given the majority of the population groups were from low-income households or lived in poverty (Chu et al., 2021; Khani Jeihooni et al., 2021; Larkey et al., 2012; Ma et al., 2022; McDonough et al., 2016; Olubodun et al., 2022), provision of free Pap tests or referrals reduced cost barriers (especially for those who were uninsured) to receiving cervical cancer screening (McDonough et al., 2016; Olubodun et al., 2022).
Language	· Given language negatively affected knowledge and confidence in HPV-related decision-making, interventions provided multiple translated versions of their materials for their target population (Chu et al., 2021; Larkey et al., 2012; Lee et al., 2018; Ma et al., 2022; McDonough et al., 2016; Olubodun et al., 2022). · Participants preferred community classes delivered in the community’s native language, which facilitated community dialogue and reduced mistrust of immunization and healthcare (Chu et al., 2021).
Race, ethnicity, religion and culture	· Racial and ethnic minority groups in the United States have lower uptake of HPV immunization and cervical cancer screening due to limited awareness and lack of knowledge; language barriers; physical barriers (e.g., transportation and time to get to clinics); misperceptions about efficacy and safety regarding HPV immunization; mistrust of healthcare or immunization; lack of strong healthcare provider recommendations; healthcare costs (e.g., lack of insurance); and cultural beliefs, norms (e.g., restrictions around pork products) and stigma (e.g., association between getting the HPV vaccine and increasing sexual behaviours) (Chu et al., 2021; Larkey et al., 2012; Ma et al., 2022). · Culturally appropriate interventions resulted in significant improvement in mothers’ confidence, knowledge, beliefs and intentions to immunize their own children (Chu et al., 2021). · Several studies utilized focus groups, stakeholder feedback and consultations with community leaders to inform their research design to create culturally relevant, community-based and audience-sensitive and specific content (Chu et al., 2021; Larkey et al., 2012; Lee et al., 2018; Ma et al., 2022; McDonough et al., 2016). · Inviting community members and organizations to support HPV immunization initiatives (e.g., sharing the HPV immunization program with their communities) had a positive effect on participant recruitment among racial and ethnic groups (Chu et al., 2021; Ma et al., 2022). · Storytelling narratives effectively increased HPV immunization intentions (Lee et al., 2018). · Delivery of an immunization information by co-ethnic research assistants was found to be successful in promoting behaviour changes in target populations (Chu et al., 2021). · Trusted community members (e.g., lay health advisors, patient navigators) were found to have the ability to broker the relationships between healthcare providers and target population groups and act on their established social networks to diffuse information into the communities (Larkey et al., 2012; McDonough et al., 2016).
Gender and/or sex	· HPV immunization target populations were predominantly specified as girls and women (Chu et al., 2021; Khani Jeihooni et al., 2021; Larkey et al., 2012; Lee et al., 2018; Ma et al., 2022; McDonough et al., 2016; Olubodun et al., 2022). · Barriers for women to seek a Pap test included the painful nature of the test; shame attributed to getting tested; inadequate knowledge; cultural and religious beliefs; and psychosocial causes (e.g., subjective norms, social pressures, embarrassment) (Khani Jeihooni et al., 2021). · Women who had adequate knowledge of cervical cancer were more likely to recognize the risks, severity, susceptibility and benefits of cervical cancer screening (Khani Jeihooni et al., 2021). · Subjective norms, such as support of family members and healthcare staff cooperation, impacted the intention and behaviour of women to seek cervical cancer screening (Khani Jeihooni et al., 2021). · Findings were mixed regarding the influence of fathers and husbands on women receiving cervical cancer screening and children’s decisions to receive HPV Immunization. One study indicated that Somali fathers had less influence than mothers on their decisions to immunize their children (Chu et al., 2021). In some countries, husbands may need to consent before women are able to undergo cervical cancer screening. Thus, providing education sessions for husbands was recommended to reduce disapproval of screening (Olubodun et al., 2022). · Overall, the reported preference to have a female sample collector for cervical cancer screening may indicate an opportunity to engage female physicians and nurses while reducing patients’ shyness and shame (Olubodun et al., 2022).