Participatory implementation science to enhance knowledge and build the capacity to increase the uptake and sustainability of HPV vaccination among girls in Nigeria

Abstract

Human papillomavirus (HPV) vaccination can prevent cancer in low- and middle-income countries (LMICs), but its uptake remains low, especially in Nigeria. Understanding participatory approaches can help identify local strategies to increase, build capacity for, and sustain vaccine uptake. This study evaluated the effectiveness of an innovation bootcamp in enhancing the knowledge and skills of youth implementers about HPV and cervical cancer as a strategy to increase vaccine uptake among Nigerian girls aged 9–14 years. An innovation bootcamp is an intensive training program that engages end users to build capacity and skills. This was a five-week hybrid bootcamp guided by Youth Participatory Action Research (YPAR) and the PEN-3 cultural model at the Nigerian Institute of Medical Research in Lagos, Nigeria. Data were collected using pre- and post-training surveys to assess sociodemographic characteristics, participant preparation, motivations, support needs, baseline learning barriers, the bootcamp process, and knowledge and implementation science research skills (using 9-item and 22-item self-reported scales, respectively). We conducted descriptive analyses of quantitative data and thematic analysis for qualitative, open-ended responses, and we estimated changes in knowledge and skills using the Wilcoxon Signed-Rank test. Five teams comprised of 16 participants attended the bootcamp, and 13 completed the post-survey. Of the 16 participants, most were female (81%) with an average age of 22 years and resided in the following states: Osun (n = 5), Abuja (n = 4), Lagos (n = 2), Kwara (n = 2), Oyo (n = 2), and Plateau (n = 1). The PEN-3 cultural model highlighted the importance of training and enabling resources. Following the bootcamp, the median knowledge score increased from 34 (IQR 31.0–35.0) to 37 (IQR 35.0–40.0), but this change was not statistically significant (p = 0.086). In contrast, there was a significant increase in research skills score from 54 (IQR 43.0–61.0) to 82 (IQR 73.0–96.0) (p = 0.011). The bootcamp demonstrated that culturally structured participatory approaches can enhance engagement, knowledge, and skills while cultivating participatory learning communities. Empowering young people with appropriate resources and mentorship can propel sustainable HPV vaccination in Nigeria. This research underscores the importance of context-specific strategies in promoting HPV vaccination, especially in low- and middle-income countries. Our study highlights the importance of participatory approaches, such as innovation bootcamps, in empowering young people to address local challenges related to HPV vaccination uptake. Engaging youth implementers enhances their knowledge and skills while fostering a sense of ownership and uptake of evidence-based interventions within the community. The use of the PEN-3 cultural model to identify local barriers and facilitators can support the development of sustainable vaccination initiatives. Our research emphasizes the importance of involving diverse stakeholders, including healthcare professionals, religious leaders, and community leaders, and demonstrates the potential impact of youth-led initiatives on public health agendas.