Does electronic consent improve the logistics and uptake of HPV vaccination in adolescent girls? A mixed-methods theory informed evaluation of a pilot intervention

Objectives To evaluate the usability and acceptability of an electronic consent pilot intervention for school-based immunisations and assess its impact on consent form returns and human papilloma virus (HPV) vaccine uptake.Design Mixed-methods theory-informed study applying qualitative methods to ex...

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Main Authors: Michael Edelstein, Sadie Bell, Sandra Mounier-Jack, Rosie Cooper, Tracey Chantler, Ellen Pringle, Emily Edmundson, Heidi Nielsen, Sheila Roberts
Format: Article
Language:English
Published: BMJ Publishing Group 2020-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/11/e038963.full
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author Michael Edelstein
Sadie Bell
Sandra Mounier-Jack
Rosie Cooper
Tracey Chantler
Ellen Pringle
Emily Edmundson
Heidi Nielsen
Sheila Roberts
author_facet Michael Edelstein
Sadie Bell
Sandra Mounier-Jack
Rosie Cooper
Tracey Chantler
Ellen Pringle
Emily Edmundson
Heidi Nielsen
Sheila Roberts
author_sort Michael Edelstein
collection DOAJ
description Objectives To evaluate the usability and acceptability of an electronic consent pilot intervention for school-based immunisations and assess its impact on consent form returns and human papilloma virus (HPV) vaccine uptake.Design Mixed-methods theory-informed study applying qualitative methods to examine the usability and acceptability of the intervention and quantitative methods to assess its impact.Setting and participants The intervention was piloted in 14 secondary schools in seven London boroughs in 2018. Intervention schools were matched with schools using paper consent based on the proportion of students with English as a second language and students receiving free school meals. Participants included nurses, data managers, school-link staff, parents and adolescents.Interventions An electronic consent portal where parents could record whether they agreed to or declined vaccination, and nurses could access data to help them manage the immunisation programme.Primary and secondary outcome measures Comparison of consent form return rates and HPV vaccine uptake between intervention and matched schools.Results HPV vaccination uptake did not differ between intervention and matched schools, but timely consent form return was significantly lower in intervention schools (73.3% vs 91.6%, p=0.008). The transition to using electronic consent was not straightforward, while schools and staff understood the potential benefits, they found it difficult to adapt to new ways of working which removed some level of control from schools. Reasons for lower consent form return in e-consent schools included difficulties encountered by some parents in accessing and using the intervention. Adolescents highlighted the potential for electronic consent to by-pass their information needs.Conclusions The pilot intervention did not improve consent form return or vaccine uptake due to challenges encountered in transitioning to new working practice. New technologies require embedding before they become incorporated in everyday practice. A re-evaluation once stakeholders are accustomed with electronic consent may be required to understand its impact.
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spelling doaj-art-e77a0fb9c716401d9a1028aeff7790c22024-11-26T10:20:08ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-038963Does electronic consent improve the logistics and uptake of HPV vaccination in adolescent girls? A mixed-methods theory informed evaluation of a pilot interventionMichael Edelstein0Sadie Bell1Sandra Mounier-Jack2Rosie Cooper3Tracey Chantler4Ellen Pringle5Emily Edmundson6Heidi Nielsen7Sheila Roberts8Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UKDepartment of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UKDepartment of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UKUniversity Hospitals of Derby and Burton NHS Foundation Trust, Derby, UKNational Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Vaccinations and Immunisation, London School of Hygiene & Tropical Medicine, London, UKDepartment of Immunisation, Hepatitis and Blood Safety, Public Health England, London, UKHounslow and Richmond Community Healthcare NHS Trust, Teddington, Greater London, UKHounslow and Richmond Community Healthcare NHS Trust, Teddington, Greater London, UKHounslow and Richmond Community Healthcare NHS Trust, Teddington, Greater London, UKObjectives To evaluate the usability and acceptability of an electronic consent pilot intervention for school-based immunisations and assess its impact on consent form returns and human papilloma virus (HPV) vaccine uptake.Design Mixed-methods theory-informed study applying qualitative methods to examine the usability and acceptability of the intervention and quantitative methods to assess its impact.Setting and participants The intervention was piloted in 14 secondary schools in seven London boroughs in 2018. Intervention schools were matched with schools using paper consent based on the proportion of students with English as a second language and students receiving free school meals. Participants included nurses, data managers, school-link staff, parents and adolescents.Interventions An electronic consent portal where parents could record whether they agreed to or declined vaccination, and nurses could access data to help them manage the immunisation programme.Primary and secondary outcome measures Comparison of consent form return rates and HPV vaccine uptake between intervention and matched schools.Results HPV vaccination uptake did not differ between intervention and matched schools, but timely consent form return was significantly lower in intervention schools (73.3% vs 91.6%, p=0.008). The transition to using electronic consent was not straightforward, while schools and staff understood the potential benefits, they found it difficult to adapt to new ways of working which removed some level of control from schools. Reasons for lower consent form return in e-consent schools included difficulties encountered by some parents in accessing and using the intervention. Adolescents highlighted the potential for electronic consent to by-pass their information needs.Conclusions The pilot intervention did not improve consent form return or vaccine uptake due to challenges encountered in transitioning to new working practice. New technologies require embedding before they become incorporated in everyday practice. A re-evaluation once stakeholders are accustomed with electronic consent may be required to understand its impact.https://bmjopen.bmj.com/content/10/11/e038963.full
spellingShingle Michael Edelstein
Sadie Bell
Sandra Mounier-Jack
Rosie Cooper
Tracey Chantler
Ellen Pringle
Emily Edmundson
Heidi Nielsen
Sheila Roberts
Does electronic consent improve the logistics and uptake of HPV vaccination in adolescent girls? A mixed-methods theory informed evaluation of a pilot intervention
BMJ Open
title Does electronic consent improve the logistics and uptake of HPV vaccination in adolescent girls? A mixed-methods theory informed evaluation of a pilot intervention
title_full Does electronic consent improve the logistics and uptake of HPV vaccination in adolescent girls? A mixed-methods theory informed evaluation of a pilot intervention
title_fullStr Does electronic consent improve the logistics and uptake of HPV vaccination in adolescent girls? A mixed-methods theory informed evaluation of a pilot intervention
title_full_unstemmed Does electronic consent improve the logistics and uptake of HPV vaccination in adolescent girls? A mixed-methods theory informed evaluation of a pilot intervention
title_short Does electronic consent improve the logistics and uptake of HPV vaccination in adolescent girls? A mixed-methods theory informed evaluation of a pilot intervention
title_sort does electronic consent improve the logistics and uptake of hpv vaccination in adolescent girls a mixed methods theory informed evaluation of a pilot intervention
url https://bmjopen.bmj.com/content/10/11/e038963.full
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