期刊
GYNECOLOGIC ONCOLOGY
卷 164, 期 3, 页码 675-690出版社
ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.ygyno.2021.12.021
关键词
Cervical cancer; School-based education; Screening; HPV vaccination; Review
资金
- University of Newcastle Postgraduate Research Scholarship (UNIPRS)
- Priority Research Centre for Health Behaviour (PRCHB from the University of Newcastle)
- National Health & Medical Research Council Early Career Fellowship [APP1073317]
- Australian National Breast Cancer Foundation [PF-16-011]
- University of Newcastle Research Scholarship Central (UNRSC)
School-based education is effective in improving knowledge about cervical cancer and HPV infection, as well as increasing knowledge and intentions toward HPV vaccination. However, it has limited impact on risk perceptions and attitudes, although printed education materials focused on HPV-related content may have a positive effect on risk perceptions. School-based education does not significantly increase HPV vaccination uptake.
Objective. Schools are an ideal environment for promoting cervical cancer prevention among young women. This systematic review and meta-analysis aimed to examine: 1) the effectiveness of school-based education for improving i) knowledge and perceptions of cervical cancer, HPV infection and vaccination, and cervical cancer screening; ii) attitudes and intentions toward, and uptake of HPV vaccination and cervical cancer screening among female students; and 2) the methodological quality of studies testing school-based cervical cancer education. Methods. Medline, EMBASE, CENTRAL, PsydNFO, CINAHL, Web of Science, and ERIC literature databases were searched from inception to November 2020. English language publications describing RCTs of any form of cervical cancer education delivered to female students in a school setting were eligible for indusion. Included studies were assessed for methodological quality using the revised Cochrane risk of bias tool for randomized trials and the GRADE approach. Standardized Mean Differences and Odds Ratios were calculated and meta-analytically pooled using random-effects models. Subgroup analysis explored heterogeneity. Results. Of the 13 included studies, only one study was judged overall as having a low risk of bias. School-based education improved knowledge about cervical cancer and HPV infection. It also improved knowledge of and intentions toward HPV vaccination. Although education was ineffective in improving cervical cancer and HPV infection risk perceptions, and attitudes about HPV vaccination, a subgroup analysis found printed education materials focused on HPV-related content may have significant positive effects on risk perceptions. School-based education did not significantly increase HPV vaccination uptake; however, a face-to-face active approach seemed beneficial in a subgroup analysis. Heterogeneity (I-2) ranged between 0% to 93%, and the quality of evidence was rated from low to moderate. Conclusions. High-quality evidence from methodologically rigorous studies is needed to provide stronger guidance regarding the benefits of school-based education in improving knowledge and behaviours toward cervical cancer prevention. (C) 2021 Elsevier Inc. All rights reserved.
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