The acceptability and feasibility of an educational programme on cervical cancer prevention in Chinese- and non-Chinese-speaking female adolescent students in secondary schools

January 5th, 2021 in International News

Authors: Ms. Jenny YS Chan (Undergraduate Nursing Student), Dr. Dorothy NS Chan (RN, PhD), and Dr. Winnie KW So (RN, PhD) from The Nethersole School of Nursing, Faculty of Medicine, the Chinese University of Hong Kong

Cervical cancer is commonly affecting women globally and in Hong Kong (Hong Kong Cancer Registry, 2019; International Agency for Research on Cancer, 2016). Cervical cancer is majorly caused by the Human Papillomavirus (HPV) (Centre for Health Protection, 2018). Fortunately, the risk of having cervical cancer could be significantly lowered especially in females aged below 24 through HPV vaccination (Department of Health, 2018). Despite the effectiveness of vaccines, the uptake rate is generally low. A previous survey revealed that only around 12% of the secondary school students had received HPV vaccination (Family Planning Association, 2017). To boost vaccination uptake, some schools have organized educational programmes about HPV vaccination (Yuen, Lee, Chan, Tran, & Sayko, 2018). However, students who attended these programmes are mostly local Chinese speaking (CS) students, missing out the non-Chinese speaking (NCS) students (a group rapidly expanding in the past decades) (Census & Statistics Department, 2017). In view of the phenomenon, non-Chinese speaking students should have equal opportunities in accessing HPV vaccination and obtaining relevant knowledge to maintain health.

Therefore, we designed a one-group pretest and posttest study to examine the acceptability and feasibility in implementing an educational programme on cervical cancer prevention in a secondary school with CS and NCS students. We also aim to improve participants’ knowledge about cervical cancer and HPV vaccines, and their intention to vaccination. The programme was conducted in March to April 2019. It had two major parts: a 40-minute health talk and a 40-minute tutorial.  In the health talk, we introduced what cervical cancer was and emphasized on how to prevent it. While in the tutorial, we emphasized on introducing HPV vaccination and explaining myths about it to the participants through an interactive matching game. A health booklet about cervical cancer and HPV vaccination was then distributed and discussed. All teaching material was adjusted in a culturally sensitive way, for instance, simple sketching and laymen terms were used instead of detailed anatomical pictures and medical jargons, to minimize events of embarrassment.

A total of 27 grade 10-11 CS (n=11) and NCS (n=16) girls were recruited. Most of the students were satisfied with the programme and agreed that the programme content was easily understood. All NCS and most CS students reported that the programme was very good and interesting. It was noticed that there was a positive change in participants’ knowledge towards HPV vaccine and an apparent increase in intention after the programme.

Reflecting in this project, it succeeded in proving the feasibility of implementing such educational programmes for CS and NCS school-aged girls. At first, we were quite worried about the responses, however, it turned out that most participants were satisfied with the programme. However, we only evaluated the immediate intention of participants, there were no actual follow-up verifications in the change of HPV vaccine uptake rate. In the future, we would hope to conduct follow-up verification studies to enhance the impact of this programme and further expand the scope of the programme to more secondary schools with NCS students in Hong Kong.

References:

Census and Statistics Department. (2017). 2016 Population By-census. Thematic report: Ethnic minorities. Retrieved from https://www.statistics.gov.hk/pub/B11201002016XXXXB0100.pdf

Centre for Health Protection (2018). Joint Consensus Recommendation on the Use of 9-valent Human Papillomavirus Vaccine in Prevention of Cervical Cancer in Hong Kong. Retrieved from https://www.chp.gov.hk/files/pdf/joint_consensus_recommendation_on_the_use_of_9_valent_human_papillomavirus_vaccine_in_prevention_of_cervical_cancer_in_hong_.pdf

Department of Health (2018). Human Papillomavirus (HPV) Vaccine. Retrieved from https://www.cervicalscreening.gov.hk/english/hum/hum_ccv.html

Hong Kong Cancer Registry, Hospital Authority (2019). Leading cancer sites in Hong Kong 2017. Retrieved from https://www3.ha.org.hk/cancereg/pdf/top10/rank_2017.pdf

International Agency for Research on Cancer. (2016). Cancer fact sheets: Cervical cancer. Retrieved from http://gco.iarc.fr/today/data/pdf/fact-sheets/cancers/cancer-fact-sheets-16.pdf

The Family Planning Association of Hong Kong (2017). Press releases: Report of Youth Sexuality Study 2017. Retrieved from https://www.famplan.org.hk/en/media-centre/press-releases/detail/fpahk-report-on-youth-sexuality-study

Yuen, W.W.Y., Li, A., Chan, P.K.S., Trans, L., & Sayko, E. (2018). Uptake of human papillomavirus (HPV) vaccination in Hong Kong: Facilitators and barriers among adolescent girls and their parents. PLoS One, 13(3), e0194159.