Cultural Reflections on the Scottish HPV Vaccination Programme

Background: The Scottish HPV vaccination programme serves young women aged 11 to 18 years and reports consistently high uptake rates, yet these figures may conceal levels of understanding and antecedents to decision-making. Evidence from other European countries indicates that ethnicity may influence decision-making regarding vaccination. The aim of the study was to identify understandings and explanations for HPV-related health behaviours within differing cultural contexts by examining accounts of young people from Black, Asian and Minority Ethnic (BAME) communities. Methods: A critical qualitative exploratory study utilising Foucauldian discursive analysis was conducted. Seven focus groups and four paired interviews were conducted with 40 young people aged 16-26, from BAME communities: South Asian/Black African/Arab, Muslim/Sikh/Christian. Stimulus material was utilised to explore understandings of HPV, experiences of vaccine programme, views on universal vaccination. Results: Contrasting attitudes and perceptions across ethnicity and gender were observed: openness of Black African participants to information and partnership working; barriers to intergenerational dialogue expressed by Asian men; intracultural and intercultural opportunities for information-sharing proposed by Asian women. Participants identified solutions for sensitising formative public health interventions - how they are to be delivered and in which contexts including a flexible approach to offering information and the vaccine. Conclusions: Public health strategies should consider including: a staged and tailored approach to information-giving throughout school and beyond; extending the age of vaccination and including boys being offered the vaccine at a culturally acceptable stage and age; developing neutral and destigmatised messages in partnership with communities/elders; employing multi-media information campaigns for young men and women.