1633 - DIGITAL HEALTH LITERACY INTERVENTIONS FOR ENHANCING CERVICAL CANCER PREVENTION AMONG VULNERABLE WOMEN - A SYSTEMATIC REVIEW AND META-ANALYSIS

Session: D08S0013 - Digital Media, Technology & Health 3
AUTHORS:
Albu Anca (Babes-Bolyai University ~ Cluj-Napoca ~ Romania) , Baban Adriana (Babes-Bolyai University ~ Cluj-Napoca ~ Romania) , Pintea Sebastian (Babes-Bolyai University ~ Cluj-Napoca ~ Romania) , Taut Diana (Babes-Bolyai University ~ Cluj-Napoca ~ Romania) , Alemany Laia (The Catalan Institute of Oncology ~ Barcelona ~ Spain) , Andersen Berit (Department of Public Health Programs, Randers Regional Hospital ~ Randers ~ Denmark) , Ruiz-Carrasco Javier (The Catalan Institute of Oncology ~ Barcelona ~ Spain) , Dillner Joakim (Karolinska Institute ~ Stockholm ~ Sweden) , Elfström Miriam (Karolinska Institute ~ Stockholm ~ Sweden) , Franc Carine (Centre for Epidemiology and Population Health, Inserm UMR 1018, Paris-Saclay University & University of Versailles Saint Quentin ~ Paris ~ France) , Hassine Amir (CHU Dijon Bourgogne ~ Dijon ~ France) , Jaffal Zohra (CHU Dijon Bourgogne ~ Dijon ~ France) , Kirkegaard Pia (Department of Public Health Programs, Randers Regional Hospital ~ Randers ~ Denmark) , Lamy Sébastien (Claudius Regaud Institute ~ Toulouse ~ France) , Menvielle Gwenn (Centre for Epidemiology and Population Health, Inserm UMR 1018, Paris-Saclay University, Gustave Roussy ~ Paris ~ France) , Moore Rebecca (European Institute of Women's Health Company Limited by Guarantee ~ Dublin ~ Ireland) , Moore Vanessa (European Institute of Women's Health Company Limited by Guarantee ~ Dublin ~ Ireland) , Moreno Deborah (The Catalan Institute of Oncology ~ Barcelona ~ Spain) , Montserrat Mireia (The Catalan Institute of Oncology ~ Barcelona ~ Spain) , Muresan Daniel (Iuliu Ha?ieganu University of Medicine and Pharmacy ~ Cluj-Napoca ~ Romania) , Peremiquel Trillas Paula (The Catalan Institute of Oncology ~ Barcelona ~ Spain) , Robles Claudia (The Catalan Institute of Oncology ~ Barcelona ~ Spain) , Rotar Ioana Cristina (Iuliu Ha?ieganu University of Medicine and Pharmacy ~ Cluj-Napoca ~ Romania) , Tranberg Mette (Department of Public Health Programs, Randers Regional Hospital ~ Randers ~ Denmark) , Ure Agustin (Karolinska Institute ~ Stockholm ~ Sweden) , Uusküla Anneli (Institute of Family Medicine and Public Health, University of Tartu ~ Tartu ~ Estonia) , Bardou Marc (Centre for Epidemiology and Population Health, Inserm UMR 1018 & National Institute of Health and Medical Research ~ Paris ~ France)
Abstract text:
Introduction: Digital interventions have emerged as a promising strategy to improve vaccination rates; however, evidence regarding their effectiveness among vulnerable populations is limited.

Purpose: A mixed-methods synthesis approach was employed, combining meta-analysis where sufficient data were available, with narrative synthesis, in order to synthesize the impact of digital interventions on Human papillomavirus (HPV) vaccination and awareness among women at increased risk for poor health due to socioeconomic, cultural, or structural disadvantages.


Method: Four databases were searched and 21 eligible papers were identified. Inclusion criteria required that studies (1) evaluated the effectiveness of digital interventions targeting HPV-related outcomes; (2) focused on women from vulnerable populations, defined as having at least one marker of vulnerability such as low socioeconomic status, low health literacy or minority status; and (3) reported clear sociodemographic characteristics of participants. Primary outcomes were HPV-related knowledge, vaccination uptake and cervical cancer screening, while secondary outcomes included behavioral intentions, self-efficacy, attitudes and beliefs toward HPV.


Results: Interventions varied in format and intensity and consisted of SMS campaigns, m-Health applications, web-based educational platforms, videos or social media outreach. Meta-analytic results indicated a large, statistically significant overall effect of digital interventions (d = 0.67, 95% CI [0.45, 0.88]; Z = 6.22, p < 0.001). The greatest effect sizes were observed for knowledge acquisition (d = 0.951, 95% CI [0.655, 1.246]; Z = 6.302, p < 0.001) and behavioral outcomes (d = 0.603, 95% CI [0.367, 0.840]; Z = 4.996, p < 0.001), while smaller yet meaningful improvements were found in attitudes and self-efficacy. Intervention effects were most prominent immediately after implementation, with diminished effects at follow-up, indicating challenges in maintaining long-term behavior change.


Conclusions: These findings support the potential of digital interventions to enhance HPV-related knowledge and behaviors among vulnerable women, particularly when targeting immediate outcomes.