Annals of Medicine (Dec 2025)
Co-design as a participatory approach for enhancing HPV health literacy among youths: a program evaluation
Abstract
Background Despite decades of vaccine availability and the potential consequences of infection, human papillomavirus (HPV) vaccination among youth in the United States remains below herd immunity threshold. In response to suboptimal HPV vaccination rates the Vaccine Literacy Campaign (VLC) implemented a five-week series of HPV vaccination education co-design workshops to engage youth in creating peer vaccine communication. The co-design cohort included thirteen 16 to18-year-olds recruited from a community organization. The goals of the pilot were two-fold: 1) engage participants in co-design activities to co-create resource that promote health literacy, and 2) increase youth confidence and health literacy in relation to HPV vaccination.Methods Each co-design session was evaluated with a mixed-methods questionnaire to collect participant feedback on implementation and co-design content. Evaluation measured changes in confidence on HPV vaccine knowledge and satisfaction of co-design sessions. Qualitative evaluations focused on best practices for youth engagement strategies and understanding the root of youth vaccine hesitancy and perceived vaccine myths. Each session included co-collaboration amongst participants to develop an educational product promoting uptake of the HPV vaccine.Results Participant knowledge and confidence scales on HPV vaccination increased during the five-week cohort. Participants co-created a website to educate peers about HPV.Conclusions Participants responded to and preferred prevention-focused language. Many participants had no prior HPV-related education and were concerned about associated risks of contracting HPV, with minimal participants expressing vaccine hesitancy specifically. Workshop best practices include providing clear explanations of activities, time for information processing, and encouraging participants to ask questions.
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