A Community-Based Intervention in Middle Schools in Spain to Improve HPV Vaccination Acceptance: A "Pill of...

Objectives: Despite high overall vaccination coverage in Galicia, Spain, human papillomavirus (HPV) vaccine uptake remains below the 90% target set by the World Health Organization for 2030. This study aimed to assess baseline knowledge of HPV and attitudes towards HPV vaccination among Galician adolescents and to evaluate the impact of a brief educational intervention delivered as a "pill of knowledge". Methods: A quasi-experimental pre-/post-intervention study was conducted among 967 students aged 12-16 years from 16 secondary schools in Galicia during the 2023-2024 academic year. A concise, structured 15-min educational session termed a "pill of knowledge" was delivered, and HPV-related knowledge and vaccination intention were measured immediately before and after the intervention using a standardized questionnaire. Results: Following the "pill of knowledge", the mean proportion of correct responses increased by 30.1 ± 16.6% across all knowledge items. Among unvaccinated participants, intention to accept HPV vaccination rose from 77.7% to 94.4% in girls and from 64.7% to 85.8% in boys. Pre-intervention predictors of vaccination intention included perceived vaccine efficacy and baseline HPV knowledge. Post-intervention independent predictors comprised being female, younger age (12-13 years), and prior sexual education delivered by teachers or parents. The overall predictive accuracy of the logistic regression model for vaccination intention improved from 75.6% before the intervention to 92.7% afterwards. Conclusions: A brief, school-based "pill of knowledge" produced substantial and immediate improvements in HPV knowledge and vaccination acceptance among Galician adolescents. These findings strongly support the systematic incorporation of short, evidence-based educational interventions of this kind into the school setting as an effective public health measure to increase HPV vaccine coverage and advance progress toward WHO elimination targets.