Comprehensive Cancer Center Support Grant

Cervical cancer elimination as a public health problem has become a reality if we focus on the uptake of three evidence-based tools: HPV vaccination, cervical cancer screening, and appropriate follow-up and treatment for abnormal cervical cancer screening results. Despite multiple efforts, Alabama still ranks third in cervical cancer

mortality and sixth in incidence nationally with great disparities within the state, particularly between urban and rural counties. In order to address this public health challenge, organizations have come together and developed a statewide action plan to eliminate cervical cancer as a public health problem in Alabama by 2033.

This plan was officially launched by the State Health Officer in May 2023 as a partnership between government, academia, civic, and non-profit organizations and is known as OPERATION WIPE OUT. While the plan includes specific evidence-based strategies to promote HPV vaccination and cervical cancer screening/follow-up, the evidence on multi-channel communication interventions (besides provider-focused

interventions) to promote uptake of these tools at the population level is scarce and the results are mixed, particularly regarding HPV vaccination. We are currently examining the feasibility of a theory-driven, multi- channel communication campaign to promote HPV vaccination uptake with high school students being agents

of change and preliminary results are encouraging. Thus, the overall goal of this supplement is to expand, implement, and examine the feasibility and scalability of a theory-driven (Social Cognitive Theory), participatory multi-channel communication campaign to promote HPV vaccination, cervical cancer screening/follow-up that

is designed and delivered by high school students with the support of OPERATION WIPE OUT partners and linked to access to these tools (i.e., school-based vaccination, increased access to HPV vaccination, cervical cancer screening, and follow-up in the community) as well as create a toolkit for other school districts and

Rotary Clubs to implement the program in their communities. Key components will include: (a) continued capacity building of senior high school students (the ones who are already engaged in the campaign), providing them with knowledge, skills, and support to mentor junior high school students on the expansion of

the campaign as well as developing an implementation toolkit for other school districts; (b) capacity building of junior high school students to develop and implement the new components of the campaign; (c) engagement of parents, teachers, school nurses, and school administrators; and (d) provision of school-based vaccination

and increased availability of HPV vaccination, cervical cancer screening, and follow-up in the community. The primary outcomes will be: (1) HPV vaccination uptake at the school level. Alabama has a robust vaccine registry managed by the Alabama Department of Public Health that can provide data on HPV vaccination

uptake at the school level; and (2) Cervical cancer screening uptake by un/under-insured women and adherence to follow-up at the county level (Alabama Breast and Cervical Cancer Early Detection Program).