Questionnaires, data collection and management
HPV-related disease, ’
SEXUALLY TRANSMITTED INFECTIONS
The questionnaire included questions on socio-educational characteristics of the adolescents’ family, awareness, knowledge, perceptions and behaviour around HPV-related disease and vaccination, their self-declared HPV vaccination status and intention to get vaccinated. We assessed intention to get vaccinated among unvaccinated adolescents aware of HPV vaccine as follows: refusal (‘HPV vaccination is not relevant for me’), indecision (‘I consider HPV vaccination as relevant for me, but I am not sure about getting vaccinated’) or intention (‘I have the intention to soon get vaccinated’). More details can be seen in To assess the socio-educational characteristics, we collected individual and ecological variables. Educational level of the mother and the father was grouped as ’below or equal to high school’, ‘above high school’ and ‘do not know’. We assessed language by the question ‘Do you commonly speak another language than French at home’ (French or other languages). For specific analyses, we collated parental education (the highest achieved level among parents) and language. We assumed that the relevance of a multilingual family environment for vaccine uptake depends on the level of parental education.As an ecological study, we used the 2015 French deprivation index (Fdep) [Knowledge on health-related subjects covered at school was assessed as remembering specific topics taught during school lessons (bacteria and viruses, vaccination in general; human reproduction, sexual education and sexually transmitted infections). In France, these topics can be addressed in biology classes in middle schools, but the content or the format is not harmonised. We assessed whether the students had seen their GP during the past 12 months and whether the GP had offered HPV vaccination. In the French context, the gatekeeper function of family physicians comprises mostly GPs. Although other medical specialities (e.g. paediatricians) can take this role, for simplicity, we refer here to GPs. Adolescents commonly visit GPs for acute or chronic health issues and for medical certificates of fitness to participate in sports. Three GP visits dedicated to health promotion, including vaccination, are fully reimbursed for children between the ages of 8 and 16 years. For specific analyses, we collated these variables into one variable (no visit/visit with a vaccine offer/visit without a vaccine offer). Most questions included a ‘do not know’ modality, which was included into ‘no’. More information can be seen in Additionally, we collected variables not part of the main hypothesis but known to impact health behaviour [