Introduction/Background Despite the Human Papillomavirus (HPV) vaccine’s crucial role in curtailing HPV-related diseases, global uptake is far from ideal. This network meta-analysis aims to dissect and compare the effectiveness of boosting interventions, such as cancer and vaccine education provider training, and nudging interventions, like SMS or EHR reminder systems, in enhancing HPV vaccination rates.
Methodology An comprehensive search of databases, including PubMed, Embase, Cochrane Library, and Web of Science, was performed until January 2023. We included Randomized Controlled Trials (RCTs) that evaluated the effectiveness of boosting and nudging interventions to improve HPV vaccination rates. A Bayesian network meta-analysis approach was employed to synthesize both direct and indirect evidence. The GRADE approach was utilized to appraise the quality of the evidence.
Results Our network meta-analysis incorporated 30 RCTs, encompassing a total of 48,000 individuals. Boosting interventions improved HPV vaccination rates by 35% (OR=1.35, 95% CI 1.10 to 1.65), while nudging interventions, such as SMS or EHR reminder systems, amplified the rates by 50% (OR=1.50, 95% CI 1.30 to 1.73). Notably, nudging interventions demonstrated superior efficacy and were ranked as the most effective strategy. The certainty of evidence was rated as high.
Conclusion This robust network meta-analysis accentuates that both boosting and nudging interventions significantly elevate HPV vaccination uptake. However, nudging interventions, particularly SMS or EHR reminder systems, demonstrated superior efficacy. These findings underscore the potential of strategic interventions in combating HPV vaccine underutilization and offer valuable insights for future public health initiatives focused on increasing vaccination coverage.
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