Effectiveness of an educational intervention in enhancing parents’ knowledge, perception, and acceptability of human papillomavirus vaccine

Abstract

Background

Cervical cancer is the fourth most common cancer among women worldwide, largely caused by the human papillomavirus (HPV). The HPV vaccine has been proven to effectively reduce HPV infection rates and cervical cancer risk, making vaccination a crucial preventive measure.

Objectives

This study aims to evaluate the effectiveness of an educational intervention in improving parents’ knowledge, perception, and acceptability of the HPV vaccine.

Methods

A pre-post research study was conducted in 2024 involving 140 parents in a specialized hospital in Makkah, Saudi Arabia. The intervention consisted of structured educational lectures, PowerPoint presentations, workshops, and parents’ group discussions. Pre- and postintervention self-administered surveys were used to assess changes in knowledge, perception, and vaccine acceptability.

Results

The intervention resulted in a significant improvement in parents’ knowledge regarding HPV and its associated risks. Parental understanding of HPV transmission and vaccine benefits improved greatly following the intervention, rising from 17% to 87%. The mean knowledge score significantly increased from 5.2 ± 2.1 to 9.9 ± 1.8 (P < 0.001), indicating a large effect size (Cohen’s d = 0.58). Interestingly, parents with lower educational levels demonstrated the greatest improvement in knowledge scores compared with higher-educated parents (P = 0.039), suggesting that the intervention was particularly effective among this group. Additionally, the intervention positively influenced parental perception and acceptability of the HPV vaccine.

Conclusions

The research provides valuable insights into the effectiveness of educational interventions in enhancing parental understanding and HPV vaccine acceptance. The findings contribute to the development of targeted interventions, explicitly challenge prevalent misconceptions about HPV infection, and suggest strategies to improve parental awareness and facilitate informed decision-making regarding HPV prevention and testing in collaboration with stakeholders and community leaders.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-026-26772-z.

Background

Human papillomavirus (HPV) is a pervasive and significant public health concern globally. It is a sexually transmitted infection with over 100 different strains, some associated with various cancers, including cervical, genital, and oropharyngeal cancers [1]. The virus is primarily transmitted through sexual activity. Despite the high prevalence of HPV and its potential to cause serious health issues, awareness and understanding of the virus and the importance of vaccination remain limited among the general population, particularly in regions with cultural sensitivities around sexual health topics [2].

In the Kingdom of Saudi Arabia, cervical cancer ranks as the ninth most common cancer among women aged 15–44 [3]. The Age-Standardized Incidence Rate of cervical cancer in the Kingdom is projected to increase by 100% to 120% by the end of 2025 [3]. Cervical cancer is a preventable gynecological malignancy, with HPV infection being a significant risk factor. It is treatable if the disease caused by high-risk HPV types is identified and managed early. Therefore, this study aims to provide valuable insights into educational interventions’ impact on parental knowledge, perception, and acceptance regarding HPV and vaccination in Saudi Arabia. By empowering parents with accurate information and addressing their concerns, we can enhance the HPV vaccine’s acceptability and uptake, protecting future generations from HPV-related cancers.

In Saudi Arabia, the prevalence of high-risk HPV infection remains lower than global averages. Nevertheless, it is a growing public health concern [4, 5]. Despite the HPV vaccine’s availability in the national immunization program, vaccine uptake remains suboptimal [6]. Local studies conducted in various regions of the Kingdom, including Makkah, have reported limited parental awareness, low vaccination rates among adolescents, and persistent misconceptions regarding vaccine safety and effectiveness [7, 8]. Cultural sensitivities surrounding discussions of sexually transmitted infections, concerns about the vaccine’s side effects, lack of knowledge of HPV-related cancers, and limited communication between health-care providers and parents have been identified as major barriers to HPV vaccine acceptance [9, 10]. These factors highlight the need for culturally tailored educational interventions addressing misconceptions and supporting informed decision-making among parents.

Vaccination has been proven to be an effective primary prevention strategy against HPV infection and its associated precancerous lesions. The vaccine is most effective when administered before exposure to the virus, ideally before first sexual contact [11]. However, despite the HPV vaccine’s availability and proven efficacy, its rates remain suboptimal in many regions, including Saudi Arabia [12]. This is partly due to a lack of knowledge, misconceptions, and concerns about the vaccine among parents, who play a crucial role in the decision-making process for vaccinating their children.

The HPV vaccine has been incorporated into widespread immunization programs worldwide. It is particularly crucial to enhance vaccination rates and intention to vaccinate among sexually active individuals [13].

In Saudi Arabia, cultural and social factors significantly influence health behaviors and attitudes toward vaccination. Parents’ knowledge, perceptions, acceptability, and cultural and religious beliefs regarding the HPV vaccine are critical factors influencing vaccination uptake [14]. A study conducted in the Makkah region of Saudi Arabia indicated low levels of HPV vaccination coverage and negative attitudes toward vaccination among parents and adolescents [15] .Therefore, educational interventions aimed at improving parents’ understanding of HPV and the benefits of vaccination are essential. These interventions can address misconceptions, provide accurate information, and ultimately increase vaccination rates, thereby reducing incidences of HPV-related cancer [16].

Parents globally exhibit a low level of knowledge regarding HPV-related diseases, underscoring the significant lack of awareness of HPV infection [17]. “Perception barriers” play an important negative role in young female students’ willingness to receive HPV vaccination [18, 19, 20, 21]. The major barriers to vaccination are safety and effectiveness; the vaccination process, such as the potential for needles to cause injury and side effects; and the inability to make one’s own decisions or to pay a relatively high price for vaccination [22, 23]. Parents develop positive attitudes toward HPV vaccination when they believe in its effectiveness [17].

Given the rising burden of cervical cancer in Saudi Arabia, the persistently low uptake of HPV vaccination, and the presence of cultural and informational barriers, there is a clear need for targeted educational interventions to increase vaccination uptake and coverage. Strengthening parental knowledge and addressing misconceptions may play a key role in improving vaccine acceptability and supporting national prevention efforts. Therefore, this study aimed to evaluate the effectiveness of a structured educational intervention in improving parents’ knowledge, perceptions, and acceptance of the HPV vaccine in Makkah, Saudi Arabia. The study had the following objectives: (a) to assess parents’ knowledge of HPV; (b) to explore parents’ perceptions of HP; and (c) to assess the impact of an educational intervention on parents’ knowledge, perception, and acceptability regarding HPV.

Methods

A pre-post research design was utilized to evaluate the effect of an educational intervention about HPV on parents in Makkah, Saudi Arabia. The same group of parents completed a baseline (pretest) assessment before receiving the intervention and a follow-up (posttest) assessment after receiving the intervention, allowing comparison of their knowledge, perceptions, and acceptability regarding HPV and its vaccination over time. The study was conducted in July 2024.

Sampling and recruitment procedure

Convenience sampling was used to select a representative sample of parents of school-aged daughters in the waiting area of a maternity hospital [16].Participants were recruited from the hospital’s outpatient department. Two registered nurses who had been trained to conduct educational sessions and were experts in maternity nursing approached parents waiting for their appointments. The nurses provided a brief explanation of the study’s purpose and procedures and distributed participant information statements and consent forms. Parents who agreed to participate were directed to a private area to complete the preintervention survey online using their phones or the researcher’s tablet. In total, 150 parents were approached and 140 consented to participate, resulting in a participation rate of 93%. Ten parents (7%) declined to participate, citing a lack of time or interest. A total of 140 eligible parents completed both the pre- and postintervention surveys. This sample size was sufficient to provide at least 80% power to detect small-to-moderate changes in HPV knowledge scores at a 5% significance level.

No financial or material incentives were offered. This approach ensured voluntary participation and minimized potential coercion.

Preintervention assessment

• Knowledge assessment: Develop a self-administered survey to evaluate parents’ baseline knowledge of HPV, its transmission, associated risks, prevention methods, available testing options, and vaccination

• Perception assessment: Include questions to evaluate parents’ perceptions, beliefs, attitudes, and concerns about HPV and its impact on their children’s health

• Acceptability assessment: Include items to measure parents’ willingness to discuss HPV, seek testing, and consider vaccination for their children

The online survey was developed based on Yu, Y., Xu, M., Sun, J., Li, R., Li, M., et al. (2016) [17] and adapted to the study context. The survey was originally validated by a pilot study [17]. The survey was conducted primarily in English and then translated into Arabic. The questions were translated using forward and backward translation techniques. Native Arabic speakers who were experts in creating and validating survey instruments verified the survey. The information was revised in response to the experts’ suggestions. The final version of the survey instrument consisted of three parts: (1) demographic characteristics such as age, education level, occupation, and monthly family income; (2) awareness and knowledge of HPV and the HPV vaccine; and (3) reasons for accepting or not accepting vaccination. The survey was conducted online though Google Forms pre- and postintervention.

Intervention

The educational intervention was designed based on the literature review and highlighted the most important information that parents need to understand about HPV infection and vaccination. The intervention included educational lectures, PowerPoint presentations, workshops, and discussions. Parents who were willing to participate and had completed the survey were invited to attend the educational session conducted by the two registered nurses.

The educational sessions covered the following topics: introduction to HPV and its causes, risks, signs and symptoms, diagnosis, prevention, and treatment; common questions about HPV; and myths about HPV and vaccination. The educational sessions lasted approximately 30 min: 15 min of structured lectures and interactive discussions, followed by 15 min for questions and reflection. The educational sessions were designed to be interactive and enable parents to ask questions, discuss the topics, and reflect on their understanding of the topics. The group sizes were limited to 5–7 participants to promote engagement, with a total of 20 sessions conducted in July 2024. The Supplementary File provides a detailed outline of the educational program and materials used in the intervention (Arabic version).

Postintervention assessment

The self-administered survey used in the preintervention assessment was administered to the same group of parents after the completion of the educational intervention. The aim was to assess changes in knowledge, perception, and acceptability by comparing pre- and posttest responses. The items of the survey were classified as follows: (1) demographic characteristics such as age, education level, occupation, and monthly family income (5 items); (2) awareness and knowledge of HPV and HPV vaccine (13 items); (3) reasons for accepting or not accepting vaccination (8 items).

Data analysis

Data were collected electronically before and after intervention. Researchers used the Statistical Package for Social Sciences version 24 to analyze the data. To investigate the correlation among study variables, the statistical tests used included both descriptive statistics, such as frequencies, bar charts, means, and standard deviations (SD); and inferential statistics, such as t-test for independent samples, one-way ANOVA. For the second and third sections, scores were given when the answer was correct. No scores were given if the answer was incorrect. A table was created to show the scores for the pretest survey using the means of the scores. Another table was created to illustrate the results of the postsurvey scores. The “overall good knowledge” category was defined based on the mean and SD of the knowledge scores. Participants scoring above the mean plus one SD were classified as having “good knowledge.”

Results

A total of 140 eligible parents of school-aged daughters (9–17 years old) completed the study survey pre- and postintervention. Half of the participants were aged between 31 and 40 years. A total of 55 (39.3%) had university-level education or above and 52 (37.1%) had below secondary-level education. Regarding employment status, 55 (37.9%) worked in the private sector or had self-employed48 (34.3%) worked in the public sector, and 39 (27.9%) were unemployed (Table 1).

Table 1.

Sociodemographic characteristics of study participants, Makkah, Saudi Arabia (n = 140)

Demographic data	N	%
Age in years
< 30	32	22.9%
31–40	72	51.4%
41–50	30	21.4%
> 50	6	4.3%
Educational level
Below secondary	52	37.1%
Secondary	33	23.6%
University/above	55	39.3%
Employment
Unemployed	39	27.9%
Government work	48	34.3%
Private work	19	13.5%
Self-employed	34	24.3%
Monthly income
< 5000 SR	18	12.9%
5000–10,000 SR	37	26.4%
10,000–15,000 SR	45	32.1%
15,000–20,000 SR	27	19.3%
> 20,000 SR	13	9.3%

Table 2 presents parents’ knowledge and perception of HPV before and after intervention. A total of 48.6% of study participants were aware that HPV is a sexually transmitted virus. This percentage significantly increased to 91.4% postintervention (P < 0.001). Furthermore, 43.6% of the study participants answered that HPV causes cervical cancer. This percentage significantly increased to 94.2% postintervention (P < 0.1). A total of 57.9% of participants understood that the main hazard of HPV infection for men is genital warts. This percentage significantly increased to 82.9% postintervention (P < 0.001). Regarding knowledge and perception items that significantly improved after the educational program, 37.1% of participants displayed knowledge of methods for assessment of HPV infection (PAP smear) preintervention. This percentage increased to 94.2% postintervention (P < 0.001).

Table 2.

Parents’ knowledge and perception of human papillomavirus (HPV) vaccine before and after intervention

Knowledge and perception items		Phase
		Before		After			P-value
		No	%	No	%
The transmission route of HPV	Sexual transmission	68	48.6%	128		91.4%	< 0.001*
	Direct contact	65	46.4%	11		7.9%
	Air transmission	7	5.0%	1		0.7%
The main hazard of HPV infection for women	Causes cervical cancer	61	43.6%	131		94.2%	< 0.001*
	Causes a delay in menstruation	20	14.3%	4		2.9%
	Causes breast cancer	59	42.1%	4		2.9%
The main hazard of HPV infection for men	Causes genital warts	81	57.9%	116		82.9%	< 0.001*
	Causes prostate cancer	40	28.6%	21		15.0%
	Causes pulmonary infections	19	13.6%	3		2.1%
The main risk factor for cervical cancer	HPV infection	100	71.4%	136		97.1%	< 0.001*
	Cancer colon	23	16.4%	3		2.1%
	Lung cancer	17	12.1%	1		0.7%
Persistent HPV infection is the cause of cervical cancer	Yes	41	29.3%	126		90.0%	< 0.001*
	No	66	47.1%	7		5.0%
	I don’t know	33	23.6%	7		5.0%
The HPV vaccine effectively prevents most cervical cancers	Yes	34	24.3%	118		84.3%	< 0.001*
	No	63	45.0%	12		8.6%
	I don’t know	43	30.7%	10		7.1%
The HPV vaccine effectively prevents genital warts in men	Yes	28	20.0%	116		82.9%	< 0.001*
	No	67	47.9%	12		8.6%
	I don’t know	45	32.1%	12		8.6%
The injection times of the HPV vaccine	3 times	31	22.1%	108		77.7%	< 0.001*
	2 times	39	27.9%	10		7.2%
	1 time	70	50.0%	21		15.1%
The best time for vaccination	Before first sexual practice	66	47.1%	113		80.7%	0.005*
	After first sexual practice	33	23.6%	9		6.4%
	I don’t know	41	29.3%	18		12.9%
The HPV vaccine’s effectiveness among HPV infected people	Yes	47	33.6%	21		15.0%	< 0.001*
	No	52	37.1%	99		70.7%
	I don’t know	41	29.3%	20		14.3%
Test used to assess HPV infection	PAP smear	52	37.1%	131		94.2%	< 0.001*
	MRI	31	22.1%	3		2.2%
	CT scan	57	40.7%	5		3.6%
Main risk factor for HPV infection	Multiple partners	88	62.9%	128		91.4%	< 0.001*
	Late marriage	30	21.4%	5		3.6%
	Single partner	22	15.7%	7		5.0%
All people with genital HPV infections have obvious signs or symptoms	Yes	37	26.4%	15		10.8%	< 0.001*
	No	64	45.7%	109		78.4%
	I don’t know	39	27.9%	15		10.8%

P: McNemar’s test for related samples

* P < 0.05 * (significant).

Study participants had limited knowledge of vaccine knowledge (20%). This significantly improved to 82.9% postintervention (P < 0.001). A total of 37.1% of study participants believed that that HPV vaccines are not effective among HPV-infected people. This significantly changed to 70.7% postintervention.

Figure 1 illustrates the knowledge-level change among participants before and after attending the educational program about the HPV infection and vaccine. A total of 17.1% of the participants had overall good knowledge and perception of these topics before the educational program. This percentage significantly increased to 87.1% after the program (P < 0.001). The overall mean knowledge score before the program was 5.2 ± 2.1 out of 13. This increased to 9.9 ± 1.8 out of 13 after the intervention program (P < 0.001) with an assessed effect size of 0.58 (large effect size).

Fig. 1.

Overall knowledge-level change among parents pre- and postintervention of the educational program about the HPV infection and vaccine

Table 3 presents factors associated with participants’ knowledge and perception scores after attending the educational program. Among all factors, only participants with low education showed the highest improvement (mean change) in their knowledge score. They obtained 9.1 ± 1.6 points versus 6.9 ± 1.9 points for highly educated parents (P = 0.039).

Table 3.

Factors associated with the participants’ knowledge and perception score change after attending the educational program about the HPV infection and vaccine

Factors	Knowledge score			95% CI	P-value
	Before	After	Score change
	Mean ± SD	Mean ± SD	Mean ± SD
Age in years					0.682
20–30	1.2 ± 1.7	9.9 ± 1.7	8.7 ± 1.7	1.1–11.6
31–40	1.1 ± 1.8	9.9 ± 1.8	8.8 ± 1.8	1.2–12.1
41–50	1.2 ± 2.3	9.9 ± 2.3	8.7 ± 2.3	1.1–12.8
Educational level					0.039*
Below secondary	0.8 ± 1.6	9.9 ± 1.6	9.1 ± 1.6	6.1–13.6
Secondary	1.6 ± 2.3	9.9 ± 2.3	8.3 ± 2.3	6.6–14.7
University/above	3.0 ± 1.9	9.9 ± 1.9	6.9 ± 1.9	1.3–6.4
Employment					0.554
Unemployed	1.1 ± 2.0	9.9 ± 2.0	8.8 ± 2.0	3.2–14.9
Government work	0.9 ± 1.8	9.9 ± 1.8	9.0 ± 1.8	3.6–16.8
Private work	1.6 ± 1.9	9.9 ± 1.9	8.3 ± 1.9	3.4–15.2
Self-employed	1.3 ± 2.0	9.9 ± 2.0	8.6 ± 2.0	3.2–14.8
Monthly income					0.506
< 5000 SR	2.5 ± 2.5	9.9 ± 2.5	7.4 ± 2.5	2.6–11.8
5000–10,000 SR	1.1 ± 1.7	9.9 ± 1.7	8.8 ± 1.7	0.0-14.9
10,000–15,000 SR	0.7 ± 1.6	9.9 ± 1.6	9.2 ± 1.6	2.9–15.2
15,000–20,000 SR	0.6 ± 1.7	9.9 ± 1.7	9.3 ± 1.7	3.0-14.8
> 20,000 SR	2.1 ± 2.2	9.9 ± 2.2	7.8 ± 2.2	2.2–10.9

Score change = Participants’ scores after intervention - Participants’ scores before intervention.

CI Confidence interval of score change

P: One-way ANOVA.

*P < 0.05 (significant)

Table 4 depicts participants’ reasons to not take the HPV vaccine. The most reported reasons preintervention were “I don’t think HPV infection is widespread in my country (44.3%),” “Worry about the source of the vaccine (42.1%),” “Worry about the safety of the vaccine (41.7%),” and “Worry about the effectiveness of the vaccine (41.4%).” The least reported reasons preintervention program were “The vaccine is too expensive (28.8%) and “My daughter is too young to be at risk for cervical cancer (30.7%).” Postintervention, the frequency of the reasons significantly decreased, with the most reported ones being “Worry about the effectiveness of the vaccine (29.7%),” “Worry about the source of the vaccine (29.3%),” and “The vaccine has not been widely used; the decision will be made after it is widely used (27.9%).” “The vaccine is too expensive (21%)” and “Worry about the safety of the vaccine (21.4%)” were the least reported reasons postintervention.

Table 4.

Participants’ reasons for not taking the HPV vaccine

Reasons		Phase
		Before		After			P-value
		No	%	No	%
My daughter is too young to be at risk for cervical cancer	Disagree	44	31.4%	94		67.6%	0.001*
	Neutral	53	37.9%	14		10.1%
	Agree	43	30.7%	31		22.3%
The vaccine has not been widely used; the decision will be made after it is widely used	Disagree	40	28.6%	86		61.4%	0.001*
	Neutral	43	30.7%	15		10.7%
	Agree	57	40.7%	39		27.9%
Worry about the safety of the vaccine	Disagree	42	30.2%	86		61.4%	0.001*
	Neutral	39	28.1%	24		17.1%
	Agree	58	41.7%	30		21.4%
The children themselves make the decision	Disagree	50	35.7%	87		62.6%	0.001*
	Neutral	33	23.6%	18		12.9%
	Agree	57	40.7%	34		24.5%
Worry about the effectiveness of the vaccine	Disagree	42	30.0%	77		55.8%	0.001*
	Neutral	40	28.6%	20		14.5%
	Agree	58	41.4%	41		29.7%
The vaccine is too expensive	Disagree	43	30.9%	84		60.9%	0.001*
	Neutral	56	40.3%	25		18.1%
	Agree	40	28.8%	29		21.0%
Worry about the source of the vaccine	Disagree	42	30.0%	81		57.9%	0.001*
	Neutral	39	27.9%	18		12.9%
	Agree	59	42.1%	41		29.3%
I am not worried about HPV infection	Disagree	42	30.0%	91		65.5%	0.001*
	Neutral	45	32.1%	16		11.5%
	Agree	53	37.9%	32		23.0%
I don’t think HPV infection is widespread in my country	Disagree	35	25.0%	89		63.6%	0.001*
	Neutral	43	30.7%	19		13.6%
	Agree	62	44.3%	32		22.9%

P: Marginal homogeneity test

* P < 0.05 (significant)

Discussion

The current study aimed to evaluate the effectiveness of an educational intervention in improving parents’ knowledge, perception, and acceptability regarding the HPV infection and vaccine. At both the national and international levels, cervical cancer is connected to the highly contagious HPV, making it a primary public health concern [18]. In Saudi Arabia, cervical cancer is now the third most frequent type of gynecological cancer and one of the most common cancers in women [19, 20]. Vaccines against HPV types 16 and 18 are now available and can reduce incidences of such cancers [12].

In the current study, most parents were middle-aged and had a variety of education levels. The majority were employed in the government and private sectors. With regard to their basic knowledge and perception of the HPV infection and vaccine, the current study showed that the vast majority of them had low-to-moderate levels of knowledge of HPV and its vaccine. Less than one-third knew that persistent HPV infection is the cause of cervical cancer, and less than half knew about the virus’s mode of transmission and its relationship with cervical cancer. More than half of the participants were familiar with HPV’s relationship to male genital warts. Furthermore, participants’ level of awareness was low regarding the virus’s assessment method. Less than half of the participants recognized the vaccine’s role in preventing cervical cancer and male genital warts. Tobaiqy et al. ²¹ obtained similar findings in Saudi Arabia: about 11% of participants in their study had heard about HPV being associated with cervical cancer. Most of the participants (96.8%) had never heard of the HPV vaccine. Another study conducted in Saudi Arabia with 1,400 female university students revealed that 96% of participants lacked knowledge of cervical cancer and the significance of HPV as a risk factor for the disease [21]. Only 33.8% of nongynecological doctors thought that cervical cancer could be cured, and only 60.5% of them were aware that HPV is the main risk factor for the disease [22]. Comparably, among Polish students aged 17 to 26, there was not enough knowledge of cervical cancer. The study’s participants did not believe that HPV infection is the primary etiological cause [23]. A study conducted in Greece on health providers revealed a substantial HPV awareness gap, with just 30% of the sample appearing to be aware that HPV infection contributes significantly to carcinogenesis [24].

Regarding the educational program effect, the current study showed a significant improvement in parents’ knowledge of the HPV infection and vaccine at both the individual item and overall level. Parents with a low education level showed the highest improvement because their baseline knowledge was very low compared to that of highly educated parents. Improvement was reported for parents’ awareness of the virus, its morbidity hazards, and the vaccine’s role and efficacy. A similar study revealed that parents’ awareness, knowledge, and views of HPV infection, cervical cancer, and HPV vaccine were significantly improved following the structured educational intervention [25]. Acceptability of the HPV vaccine rose from 74.3% to 87.4% (p < 0.001), consistent with the current study’s findings. Previous studies in Indonesia revealed that parents’ baseline knowledge of HPV infection, cervical cancer, and the HPV vaccine was poor. Their knowledge and vaccine acceptability improved after a health education intervention. A school-based HPV vaccination education campaign that increased HPV vaccine uptake was implemented in Hong Kong for girls aged 9 to 14 and their parents [26, 27]. A hospital-based intervention with an HPV-focused program raised rural Chinese women’s knowledge of and acceptance of the HPV vaccine [10]. A notable improvement in vaccination knowledge was observed in another study in China, which evaluated a brief education seminar intended for caregivers with low levels of education [28]. All these findings confirmed the current study’s conclusion about the significant role of educational interventions in improving parents’ knowledge, perception, and acceptance of HPV vaccine and in preventing genital morbidity infections. The current study’s participants attributed their rejection of the vaccine to concerns about its efficacy, safety, and source and their belief that HPV is not common in Saudi Arabia. These were still their highest reported concerns after the educational program, but their frequency was much lower. Other studies’ findings [21, 29] also showed that lack of knowledge of vaccine safety and efficacy were the most reported factors for refusing vaccination [30].

Practical implications

The findings carry important practical implications for public health practice in Saudi Arabia. The significant improvement in parental knowledge and vaccine acceptability demonstrates the effectiveness of structured educational programs in correcting misconceptions and addressing cultural barriers. Health-care providers, in partnership with community leaders, can play a pivotal role in delivering accurate, culturally sensitive information to parents. Implementing similar educational interventions on a larger scale may enhance HPV vaccine uptake and contribute to reducing the long-term burden of HPV-related diseases in the Kingdom.

Conclusions

The current study aims to evaluate the effectiveness of an educational intervention designed to enhance parental knowledge, perception, and acceptability of HPV vaccination. Interestingly, the findings indicate a significant positive impact on parents’ knowledge, perception, and acceptability of HPV vaccination.

The intervention, which included structured educational lectures, PowerPoint presentations, workshops, and discussions resulted in a marked increase in parental knowledge of HPV and the associated risks of cervical cancer. Pre- and postintervention assessments showed that parental understanding of HPV transmission and vaccine benefits improved substantially following the intervention. The proportion of parents demonstrating adequate understanding increased from 17% to 87%.

Moreover, the intervention successfully improved parental perceptions of the HPV vaccine. Preintervention, many parents expressed hesitation because of their misconceptions about vaccine safety and necessity. Postintervention surveys indicated that 87.1% of participants were knowledgeable about HPV vaccination and its associated factors and were more likely to encourage vaccination among their children.

Acceptability of the HPV vaccine also saw significant growth, with a 18% increase in parents indicating they would consider vaccinating their children following the educational sessions. This shift suggests that well-structured educational programs can effectively address knowledge gaps and misconceptions, leading to greater acceptance of preventive health measures.

In conclusion, the educational intervention enhanced parental knowledge and positively influenced their perceptions and willingness to accept the HPV vaccine for their children. These results underscore the importance of targeted educational efforts in public health initiatives to improve vaccination rates and ultimately reduce HPV-related health risks in the community.

Although the findings of this study provide valuable insights into the effectiveness of educational interventions in improving parental knowledge, perception, and acceptability of the HPV vaccine, its limitations should be acknowledged: the use of purposive convenience sampling in a single hospital setting in Makkah may limit the generalizability of the findings to other regions or populations of Saudi Arabia. Participants may not represent the country’s broader demographic and cultural diversity. Future research should consider employing randomized controlled designs, including diverse geographic and demographic populations, and incorporating long-term follow-up to assess sustained impact and actual vaccination rates.

Authors’ contributions

Conceptualization, NA, SF, AA, and KB, methodology, NA.; software, AA and KB.; validation, NA and KB; formal analysis, AA and KB.; investigation, SF and AA; writing—original draft preparation, SF, AA; writing—review and editing, NA and KB; visualization, NA; supervision, NA and KB; project administration, NA.

Funding

This research received no external funding.

Data availability

The datasets generated and/or analyzed as part of the current study are not publicly available because of confidentiality agreements with subjects. However, they can be made available solely for the purpose of review and not for the purpose of publication from the corresponding author upon reasonable request.

Declarations

Ethics approval and consent to participate

The study was conducted in accordance with Umm Al-Qura University’s ethical regulations and guidelines. Approval was obtained from the IRB ethical committee at Umm Al-Qura University (HAPO-02-K-012-2024-01-1961) on 15 January 2024. The study also adhered to the principles outlined in the Declaration of Helsinki. Before the study was conducted, participants were informed of its purpose and contents. They were also made aware that their participation was voluntary and that they had the right to withdraw at any time. Informed consent was obtained from all participants prior to their inclusion in the study. Confidentiality and anonymity were ensured by removing personal identifiers from the collected data.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.