ArticleAJOG global reports2026
Teacher communication style and adolescent human papillomavirus vaccination in Bangkok schools.
Article in AJOG global reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHuman papillomavirus (HPV) vaccination is central to cervical cancer prevention, but uptake depends on communication as well as access. Teachers can shape how adolescents and families understand school-linked vaccination, although communication style has been studied less than clinician recommendation.
objectiveTo examine whether teacher advice and communication style were associated with adolescent HPV vaccination and whether associations differed between younger and older adolescents. STUDY
designWe conducted parallel cross-sectional surveys among parents or legal guardians and adolescents aged 13 to 17 years in 10 Bangkok secondary schools. The primary analysis used parent-reported data. Of 687 parent forms submitted, 30 respondents declined consent and were excluded, leaving 657 consenting records; 604 had complete data for regression. The study-specific Thai-language questionnaire was not a previously validated psychometric instrument. It assessed respondent characteristics, clinician and teacher advice, communication style, information sources, vaccination status, beliefs, and barriers. Multivariable logistic regression evaluated receipt of at least 1 HPV vaccine dose. A post hoc sensitivity analysis used 882 consenting adolescent surveys to compare ages 13 to 14 and 15 to 17 years while accounting for clinician advice, sex, and perceived peer influence.
resultsAmong 657 consenting parent respondents, 69.6% (457/657) reported that their adolescent had received at least 1 HPV vaccine dose. In the advice-exposure model, teacher advice was associated with vaccination (odds ratio [OR], 2.03; 95% confidence interval [CI], 1.31-3.14;
conclusionTeacher communication quality may be an actionable component of school-linked HPV vaccination. The findings extend prior teacher-perception literature by linking distinct communication styles with individual-level vaccination behavior, while also showing the need for validated instruments and prospective studies that measure age-specific access, autonomy, and peer networks.
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