Abstract
Objective
To evaluate the implementation of Ontario’s publicly-funded, school-based HPV immunization program through a process evaluation.
Participants
The immunization program targets grade 8 females. Ontario vaccine-preventable disease managers were the key informants for this evaluation.
Setting
Ontario, Canada.
Intervention
Ontario’s Public Health Units (HUs) are responsible for the local implementation of the immunization program. The process evaluation involved a telephone-based, semi-structured questionnaire which included questions on stakeholder engagement; school and school board participation; communication strategies; and processes for obtaining informed consent.
Outcomes
All 36 HUs participated; 16 (44%) reported difficulties receiving agreement from local school boards to administer HPV vaccine in schools. Two Catholic school boards have not permitted HPV vaccine clinics in their schools: 1 only during the first year and 1 in the second and third years. All HUs request parental consent for students to receive the HPV vaccine and 5/36 also request or encourage student consent; 14 HUs indicated they would immunize a grade 8 girl at a school clinic, in the absence of parental consent, if the student requested immunization and was judged capable of providing informed consent.
Conclusion
Many HUs reported challenges in receiving support from local school boards. Despite this, vaccine clinics have been offered in all but 2 public school boards since 2007. All HUs request parental consent before HPV immunization at school-based clinics; 39% would consider immunizing in absence of parental consent. The results of this process evaluation will inform the HPV immunization program evaluation that is currently underway in Ontario.
Keywords: Human papillomavirus vaccines, school health services, adolescent health services, public health practice, vaccination
Résumé
Objectif
Évaluer la mise en œuvre du programme ontarien de vaccination en milieu scolaire contre le VPH (un programme subventionné par l’État) au moyen d’une évaluation en cours d’exécution.
Participants
Le programme cible les filles en 8e année. Nos informateurs pour cette évaluation étaient les gestionnaires ontariens des maladies évitables par la vaccination.
Lieu
Ontario (Canada).
Intervention
Les bureaux de santé publique (BSP) de l’Ontario sont chargés de la mise en œuvre du programme de vaccination sur le terrain. Notre évaluation en cours d’exécution comportait un questionnaire téléphonique semi-structuré avec des questions sur la mobilisation des intervenants; la participation des écoles et des conseils scolaires; des stratégies de communication; et un processus d’obtention d’un consentement éclairé.
Résultats
Les 36 BSP ont participé à l’étude; 16 d’entre eux (44%) ont fait état de difficultés à obtenir l’accord des conseils scolaires locaux pour administrer le vaccin anti-VPH dans les écoles. Deux conseils scolaires catholiques n’ont pas autorisé la présence de cliniques de vaccination contre le VPH dans leurs écoles: un la première année seulement et un autre la deuxième et la troisième année. Tous les BSP demandent le consentement parental à ce que l’élève reçoive le vaccin anti-VPH, et 5 sur 36 demandent et encouragent aussi le consentement de l’élève; 14 BSP ont dit qu’ils vaccineraient une élève de 8e année à la clinique de l’école en l’absence de consentement parental si l’élève elle-même demandait à être vaccinée et qu’elle était jugée capable de donner un consentement éclairé.
Conclusion
De nombreux BSP ont fait état de difficultés à obtenir l’appui des conseils scolaires locaux. Malgré cela, les cliniques de vaccination ont été tenues dans tous les conseils scolaires sauf deux depuis 2007. Tous les BSP demandent le consentement parental à la vaccination contre le VPH à l’école; 39% des BSP songeraient à vacciner une élève en l’absence de consentement parental. Nos résultats viendront étayer l’évaluation du programme de vaccination contre le VPH en cours d’exécution en Ontario.
Mots clés: vaccins contre le virus du papillome humain, service hygiène scolaire, service santé adolescent, pratique en santé publique, vaccination
Footnotes
Conflict of Interest: None to declare.
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