Social value case study: Working with children and young people on vaccine awareness

Social value case study: Working with children and young people on a vaccine awareness campaign

A smiling school girl with the text 'HPV Vaccine: Big protection in one small vaccine'

This project was undertaken by East of England Community and School Aged Immunisation Service (CSAIS) with support by NHS England and involved the Clinical Quality Lead, Clinical Lead Team, Project Support, HCT Communications Team, Social Change UK, children and young people who participated, CSAIS teams across Hertfordshire and West Essex, Cambridge, Peterborough, Norfolk and Suffolk and education providers who allowed us to attend and hold the focus groups on premises.

This project is important as it aims to improve vaccination uptake among children and young people, reduce health inequalities, build trust through engagement and supports CSAIS future delivery plans by utilising evidence-based and user informed campaigns.

its aims were:

To facilitate the co-design and production of promotional materials for children and young people, with a particular focus on teenage vaccinations (HPV, Td/IPV and MenACWY) as well as a reminder for the MMR vaccine. This included creating materials or content informed by the focus group outcomes.
To use engagement and co-design activities to inform CSAIS future delivery plans and service approach for promoting and delivering vaccinations to children and young people. The goal was to ensure that the service is shaped by the perspectives of children, their families, education providers and practitioners within the service, making vaccination information more accessible, appealing and effective to the target audiences.
To have materials available for services to use at the end of the project, translated into the most popular languages across the East of England.

The challenge

Vaccination uptake among children and young people for school-aged vaccinations such as HPV/Td/IPV and MenACWY and also MMR was not optimal. National and local data trends showed variation in vaccination uptake particularly in certain communities.

Focus groups identified that there was limited awareness and understanding among young people and their families when it came to these immunisations. Existing materials were described as boring, too wordy and hard to understand by children and young people. We also identified that between areas, there was inconsistent engagement between CSAIS practitioners, schools and families as well as a lack of presence online by our service.

We also appreciate that there are health inequalities across different socio-economic areas within our region that all require tailored approaches. This was identified through focus groups with CSAIS practitioners, education providers and young people.

Early discussions with NHSE and CSAIS highlighted the need for co-designed, youth-friendly materials to improve trust, relatability and accessibility.

Project description

Planning and set up:

We held preliminary meetings with NHSE and CSAIS leads to agree on engagement methods. We developed co-design templates and identified target schools in differing socio-economic areas (areas of deprivation, affluence and mid range). Established engagement questions and methods (interviews and email surveys).

Engagement:

We held engagement focus groups with secondary school pupils in year 8, 9, 10 and 11 ensuring all our CSAIS regions were covered. We sent email questionnaires to education providers and CSAIS staff.

Design and verification:

We analysed engagement findings to inform design, we worked with Social Change UK and HCT Comms to create draft materials and verified these with NHS and CSAIS senior leadership and then tested these out with young people. We incorporated feedback and produced the final materials (video and written/social media materials).

Key contributors were CSAIS clinical quality lead, clinical leads, project managers and communications partners, HCT Comms and Social Change UK as well as the children and young people, education providers and CSAIS practitioners across HCT regions.

Innovative approaches from this project include:

Co-design methodology meant we had direct involvement of young people in shaping content, making materials more relevant and appealing.
We used multi-channel engagement which combined traditional methods such as leaflets and posters with digital strategies such as videos and social media assets based on youth feedback.
Inclusive design to consider accessibility by making the materials accessible to other languages (we selected the most popular languages reported within East of England according to local and national data).
We also took a cross-sector collaboration approach by working with creative agencies and NHS communications teams to ensure professional, impactful outputs.

Outcomes and impact:

Final deliverables included a video and social media/written assets co-designed with input from young people, education and service providers.

This project is yet to be launched so evidence of post-implementation impact is limited at the present time. However, we can assume from the engagement process that the following differences have been made:

Children and young people reported existing materials were boring and hard to understand. Through co-design they suggested improvements which have been translated into the materials produced. This has made materials more appealing and accessible including those with a first language that is not English.
The broad participation we gained ensured that outputs reflected real user needs and were not based on assumptions.
The themes from responses show clear shifts in what would make them more likely to get vaccinated. These included visual and interactive formats such as videos and assemblies, a desire for practical information on side effects, what the vaccines are for, how it feels and how many they need to be protected. They also highlighted the importance of trusted messengers such as parents, teachers and community figures. Education providers echoed the need for timely, clear communication and supported the idea of assemblies and parent engagement.
CSAIS staff and educators confirmed that the new approach would improve communication and reduce confusion.

Lessons learned

What went well:

Strong engagement from children and young people:over 80 respondents provided detailed feedback, giving clear direction on preferred styles and content. We also saw many CYP volunteer to participate in the production of the video, with timely returns of the consents for filming.
Clear consensus on digital approach: 70% of CYP preferred the use of a video for delivery of information on vaccinations, which aligns with current trends in youth engagement.
Collaborative planning: frequent meetings between the Clinical Lead team, NHSE and the projects team ensured alignment and quick decision-making on deliverables and timelines.
Consolidating service understanding of what already works: 91% of CYP and 100% of education providers and staff agreed that parental involvement is helpful which reinforces the dual target approach for materials.

Challenges included:

Complex stakeholder engagement: coordinating input from three distinct groups (CYP, education providers and CSAIS staff) across 5 geographical locations was logistically complex and took time to plan. It was also challenging to gain participation from schools that were representative of the population we serve (in that they included areas of affluence and deprivation). All filming was planned to take place on the same day for logistical and budget reasons. We faced time constraints and pressures created some errors and oversights in content. We therefore needed to reshoot some content following the original filming date.
Balancing priorities: Children and young people asked for bright, digital, video-based content while staff and education providers emphasised assemblies and written materials. Aligning these preferences into a single coherent strategy was challenging.
Time constraints: The engagement phase overlapped with the many different commissioned programmes that run and there was the addition of Covid-19 vaccination delivery to many teams. This extended timelines and increased resource pressures as there were conflicting priorities.
Data synthesis: The choice to use semi-structured interviews and free text MS forms responses meant that there was a lot of qualitative feedback to collate. This was time consuming and complex.

7. Next steps

We will be launching the campaign shortly, and seeking to gain post-production feedback from children and young people, staff and education providers.