{"id":"https://openalex.org/W7204160137","doi":"https://doi.org/10.1136/bmjph-2025-003253","title":"What are the barriers and enablers to the uptake of the HPV vaccine in Romania, Bulgaria and Croatia? A mixed methods systematic review","display_name":"What are the barriers and enablers to the uptake of the HPV vaccine in Romania, Bulgaria and Croatia? A mixed methods systematic review","publication_year":2026,"publication_date":"2026-07-01","ids":{"openalex":"https://openalex.org/W7204160137","doi":"https://doi.org/10.1136/bmjph-2025-003253","pmid":"https://pubmed.ncbi.nlm.nih.gov/42689009","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13536049"},"language":"en","primary_location":{"id":"doi:10.1136/bmjph-2025-003253","doi":"https://doi.org/10.1136/bmjph-2025-003253","is_oa":true,"landing_page_url":"https://doi.org/10.1136/bmjph-2025-003253","pdf_url":null,"source":{"id":"https://openalex.org/S4387288761","display_name":"BMJ Public Health","issn_l":"2753-4294","issn":["2753-4294"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319945","host_organization_name":"BMJ","host_organization_lineage":["https://openalex.org/P4310319945"],"host_organization_lineage_names":["BMJ"],"type":"journal"},"license":"cc-by-nc-sa","license_id":"https://openalex.org/licenses/cc-by-nc-sa","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMJ Public Health","raw_type":"journal-article"},"volume":null,"type":"review","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://doi.org/10.1136/bmjph-2025-003253","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5023538381","display_name":"Clare Louise Bennett","orcid":"https://orcid.org/0000-0002-5144-3894","observed_orcids":["https://orcid.org/0000-0002-5144-3894"]},"institutions":[{"id":"https://openalex.org/I1308923049","display_name":"University Hospitals Birmingham NHS Foundation Trust","ror":"https://ror.org/014ja3n03","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I1308923049"]},{"id":"https://openalex.org/I79510175","display_name":"Cardiff University","ror":"https://ror.org/03kk7td41","country_code":"GB","type":"education","lineage":["https://openalex.org/I79510175"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Clare Bennett","raw_affiliation_strings":["Health Innovation West Midlands, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK","School of Healthcare Sciences, Cardiff University, Cardiff, UK"],"raw_orcid":"https://orcid.org/0000-0002-5144-3894","affiliations":[{"raw_affiliation_string":"Health Innovation West Midlands, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK","institution_ids":["https://openalex.org/I1308923049"]},{"raw_affiliation_string":"School of Healthcare Sciences, Cardiff University, Cardiff, UK","institution_ids":["https://openalex.org/I79510175"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5068197757","display_name":"Hannah Kate Williams","orcid":"https://orcid.org/0009-0008-6058-1616","observed_orcids":["https://orcid.org/0009-0008-6058-1616"]},"institutions":[{"id":"https://openalex.org/I79510175","display_name":"Cardiff University","ror":"https://ror.org/03kk7td41","country_code":"GB","type":"education","lineage":["https://openalex.org/I79510175"]}],"countries":["GB"],"is_corresponding":true,"raw_author_name":"Hannah R Williams","raw_affiliation_strings":["School of Healthcare Sciences, Cardiff University, Cardiff, UK"],"raw_orcid":"https://orcid.org/0009-0008-6058-1616","affiliations":[{"raw_affiliation_string":"School of Healthcare Sciences, Cardiff University, Cardiff, UK","institution_ids":["https://openalex.org/I79510175"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5101650969","display_name":"Deborah J. Edwards","orcid":"https://orcid.org/0000-0003-1885-9297","observed_orcids":["https://orcid.org/0000-0003-1885-9297"]},"institutions":[{"id":"https://openalex.org/I79510175","display_name":"Cardiff University","ror":"https://ror.org/03kk7td41","country_code":"GB","type":"education","lineage":["https://openalex.org/I79510175"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Deborah Edwards","raw_affiliation_strings":["School of Healthcare Sciences, Cardiff University, Cardiff, UK"],"raw_orcid":"https://orcid.org/0000-0003-1885-9297","affiliations":[{"raw_affiliation_string":"School of Healthcare Sciences, Cardiff University, Cardiff, UK","institution_ids":["https://openalex.org/I79510175"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5049387306","display_name":"Elizabeth Gillen","orcid":"https://orcid.org/0000-0002-3700-3913","observed_orcids":["https://orcid.org/0000-0002-3700-3913"]},"institutions":[{"id":"https://openalex.org/I79510175","display_name":"Cardiff University","ror":"https://ror.org/03kk7td41","country_code":"GB","type":"education","lineage":["https://openalex.org/I79510175"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Elizabeth Gillen","raw_affiliation_strings":["School of Healthcare Sciences, Cardiff University, Cardiff, UK"],"raw_orcid":"https://orcid.org/0000-0002-3700-3913","affiliations":[{"raw_affiliation_string":"School of Healthcare Sciences, Cardiff University, Cardiff, UK","institution_ids":["https://openalex.org/I79510175"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5001533595","display_name":"Anne Rebafka","orcid":"https://orcid.org/0000-0002-0516-5248","observed_orcids":["https://orcid.org/0000-0002-0516-5248"]},"institutions":[{"id":"https://openalex.org/I161046081","display_name":"University of Freiburg","ror":"https://ror.org/0245cg223","country_code":"DE","type":"education","lineage":["https://openalex.org/I161046081"]},{"id":"https://openalex.org/I2801240073","display_name":"University Medical Center Freiburg","ror":"https://ror.org/03vzbgh69","country_code":"DE","type":"healthcare","lineage":["https://openalex.org/I2801240073"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Anne Rebafka","raw_affiliation_strings":["Medical Center and Faculty of Medicine \u2013 University of Freiburg, Freiburg, Germany"],"raw_orcid":"https://orcid.org/0000-0002-0516-5248","affiliations":[{"raw_affiliation_string":"Medical Center and Faculty of Medicine \u2013 University of Freiburg, Freiburg, Germany","institution_ids":["https://openalex.org/I161046081","https://openalex.org/I2801240073"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5092471913","display_name":"Marko Gangur","orcid":"https://orcid.org/0000-0003-1710-735X","observed_orcids":["https://orcid.org/0000-0003-1710-735X"]},"institutions":[{"id":"https://openalex.org/I2801222929","display_name":"European CanCer Organisation","ror":"https://ror.org/024e9aw38","country_code":"BE","type":"nonprofit","lineage":["https://openalex.org/I2801222929"]}],"countries":["BE"],"is_corresponding":false,"raw_author_name":"Marko Gangur","raw_affiliation_strings":["European Cancer Organisation, Brussels, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"European Cancer Organisation, Brussels, Belgium","institution_ids":["https://openalex.org/I2801222929"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5058740683","display_name":"Momchil Baev","orcid":"https://orcid.org/0000-0003-1142-416X","observed_orcids":["https://orcid.org/0000-0003-1142-416X"]},"institutions":[{"id":"https://openalex.org/I122492136","display_name":"New Bulgarian University","ror":"https://ror.org/002qhr126","country_code":"BG","type":"education","lineage":["https://openalex.org/I122492136"]}],"countries":["BG"],"is_corresponding":false,"raw_author_name":"Momchil Kostov Baev","raw_affiliation_strings":["Healthcare and Social Work, New Bulgarian University, Sofia, Bulgaria","Management Board, Astra Forum Foundation, Sofia, Bulgaria"],"raw_orcid":"https://orcid.org/0000-0003-1142-416X","affiliations":[{"raw_affiliation_string":"Healthcare and Social Work, New Bulgarian University, Sofia, Bulgaria","institution_ids":["https://openalex.org/I122492136"]},{"raw_affiliation_string":"Management Board, Astra Forum Foundation, Sofia, Bulgaria","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5090807973","display_name":"Alina Comanescu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2801222929","display_name":"European CanCer Organisation","ror":"https://ror.org/024e9aw38","country_code":"BE","type":"nonprofit","lineage":["https://openalex.org/I2801222929"]}],"countries":["BE"],"is_corresponding":false,"raw_author_name":"Alina Comanescu","raw_affiliation_strings":["European Cancer Organisation, Brussels, Belgium"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"European Cancer Organisation, Brussels, Belgium","institution_ids":["https://openalex.org/I2801222929"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5148171247","display_name":"Olivia Bell","orcid":"https://orcid.org/0009-0005-4589-3142","observed_orcids":["https://orcid.org/0009-0005-4589-3142"]},"institutions":[{"id":"https://openalex.org/I897542642","display_name":"University of Plymouth","ror":"https://ror.org/008n7pv89","country_code":"GB","type":"education","lineage":["https://openalex.org/I897542642"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Olivia Bell","raw_affiliation_strings":["University of Plymouth, Plymouth, UK"],"raw_orcid":"https://orcid.org/0009-0005-4589-3142","affiliations":[{"raw_affiliation_string":"University of Plymouth, Plymouth, UK","institution_ids":["https://openalex.org/I897542642"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5020791271","display_name":"Leanne Sawle","orcid":"https://orcid.org/0000-0001-8478-8816","observed_orcids":["https://orcid.org/0000-0001-8478-8816"]},"institutions":[{"id":"https://openalex.org/I79510175","display_name":"Cardiff University","ror":"https://ror.org/03kk7td41","country_code":"GB","type":"education","lineage":["https://openalex.org/I79510175"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Leanne Sawle","raw_affiliation_strings":["School of Healthcare Sciences, Cardiff University, Cardiff, UK"],"raw_orcid":"https://orcid.org/0000-0001-8478-8816","affiliations":[{"raw_affiliation_string":"School of Healthcare Sciences, Cardiff University, Cardiff, UK","institution_ids":["https://openalex.org/I79510175"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5148062284","display_name":"Georgi Kostov Baev","orcid":"https://orcid.org/0009-0000-9202-9836","observed_orcids":["https://orcid.org/0009-0000-9202-9836"]},"institutions":[{"id":"https://openalex.org/I297557266","display_name":"Vasil Levski National Military University","ror":"https://ror.org/00a9b0g29","country_code":"BG","type":"education","lineage":["https://openalex.org/I297557266"]}],"countries":["BG"],"is_corresponding":false,"raw_author_name":"Georgi Kostov Baev","raw_affiliation_strings":["National and Regional Security, Vasil Levski National Military University, Veliko Tarnovo, Bulgaria"],"raw_orcid":"https://orcid.org/0009-0000-9202-9836","affiliations":[{"raw_affiliation_string":"National and Regional Security, Vasil Levski National Military University, Veliko Tarnovo, Bulgaria","institution_ids":["https://openalex.org/I297557266"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5013372770","display_name":"Daniel M. Kelly","orcid":"https://orcid.org/0000-0002-1847-0655","observed_orcids":["https://orcid.org/0000-0002-1847-0655","https://orcid.org/0000-0002-7463-0692"]},"institutions":[{"id":"https://openalex.org/I122492136","display_name":"New Bulgarian University","ror":"https://ror.org/002qhr126","country_code":"BG","type":"education","lineage":["https://openalex.org/I122492136"]},{"id":"https://openalex.org/I79510175","display_name":"Cardiff University","ror":"https://ror.org/03kk7td41","country_code":"GB","type":"education","lineage":["https://openalex.org/I79510175"]}],"countries":["BG","GB"],"is_corresponding":false,"raw_author_name":"Daniel Kelly","raw_affiliation_strings":["New Bulgarian University, Sofia, Bulgaria","School of Healthcare Sciences, Cardiff University, Cardiff, UK"],"raw_orcid":"https://orcid.org/0000-0002-1847-0655","affiliations":[{"raw_affiliation_string":"New Bulgarian University, Sofia, Bulgaria","institution_ids":["https://openalex.org/I122492136"]},{"raw_affiliation_string":"School of Healthcare Sciences, Cardiff University, Cardiff, UK","institution_ids":["https://openalex.org/I79510175"]}]}],"institutions":[],"countries_distinct_count":4,"institutions_distinct_count":8,"corresponding_author_ids":["https://openalex.org/A5068197757"],"corresponding_institution_ids":["https://openalex.org/I79510175"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"4","issue":"3","first_page":"e003253","last_page":"e003253"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10146","display_name":"Cervical Cancer and HPV Research","score":0.9940999746322632,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10146","display_name":"Cervical Cancer and HPV Research","score":0.9940999746322632,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10833","display_name":"Vaccine Coverage and Hesitancy","score":0.004999999888241291,"subfield":{"id":"https://openalex.org/subfields/3306","display_name":"Health"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T13544","display_name":"Women's cancer prevention and management","score":0.0006000000284984708,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/human-papillomavirus-vaccine","display_name":"HPV vaccine","score":0.7990000247955322},{"id":"https://openalex.org/keywords/vaccine-uptake","display_name":"vaccine uptake","score":0.9120000004768372},{"id":"https://openalex.org/keywords/barriers-and-facilitators","display_name":"barriers and facilitators","score":0.9359999895095825},{"id":"https://openalex.org/keywords/vaccine-hesitancy","display_name":"vaccine hesitancy","score":0.9290000200271606},{"id":"https://openalex.org/keywords/trust-in-healthcare-providers","display_name":"trust in healthcare providers","score":0.6430000066757202},{"id":"https://openalex.org/keywords/vaccine-knowledge","display_name":"vaccine knowledge","score":0.503000020980835},{"id":"https://openalex.org/keywords/misconceptions","display_name":"misconceptions","score":0.5839999914169312},{"id":"https://openalex.org/keywords/gender-neutral-vaccination","display_name":"gender-neutral vaccination","score":0.4320000112056732},{"id":"https://openalex.org/keywords/cervical-cancer-prevention","display_name":"cervical cancer prevention","score":0.7900000214576721},{"id":"https://openalex.org/keywords/vaccination-coverage","display_name":"vaccination coverage","score":0.5580000281333923},{"id":"https://openalex.org/keywords/romania","display_name":"Romania","score":0.6179999709129333},{"id":"https://openalex.org/keywords/bulgaria","display_name":"Bulgaria","score":1.0},{"id":"https://openalex.org/keywords/croatia","display_name":"Croatia","score":0.8069999814033508},{"id":"https://openalex.org/keywords/socio-ecological-model","display_name":"socio-ecological model","score":0.925000011920929}],"concepts":[{"id":"https://openalex.org/C2778321746","wikidata":"https://www.wikidata.org/wiki/Q621922","display_name":"Distrust","level":2,"score":0.73089998960495},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7170000076293945},{"id":"https://openalex.org/C152541439","wikidata":"https://www.wikidata.org/wiki/Q5186693","display_name":"Critical appraisal","level":3,"score":0.6560999751091003},{"id":"https://openalex.org/C2778220009","wikidata":"https://www.wikidata.org/wiki/Q160105","display_name":"Cervical cancer","level":3,"score":0.5927000045776367},{"id":"https://openalex.org/C22070199","wikidata":"https://www.wikidata.org/wiki/Q192995","display_name":"Vaccination","level":2,"score":0.5820000171661377},{"id":"https://openalex.org/C189708586","wikidata":"https://www.wikidata.org/wiki/Q1504425","display_name":"Systematic review","level":3,"score":0.5476999878883362},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.5138000249862671},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.5011000037193298},{"id":"https://openalex.org/C2777466982","wikidata":"https://www.wikidata.org/wiki/Q5227287","display_name":"Data extraction","level":3,"score":0.48539999127388},{"id":"https://openalex.org/C2994532551","wikidata":"https://www.wikidata.org/wiki/Q184627","display_name":"Human papillomavirus","level":2,"score":0.4821000099182129},{"id":"https://openalex.org/C2780647465","wikidata":"https://www.wikidata.org/wiki/Q5065348","display_name":"Cervical screening","level":4,"score":0.47279998660087585},{"id":"https://openalex.org/C29456083","wikidata":"https://www.wikidata.org/wiki/Q1221899","display_name":"Gynecology","level":1,"score":0.43220001459121704},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.3822999894618988},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.3659999966621399},{"id":"https://openalex.org/C204787440","wikidata":"https://www.wikidata.org/wiki/Q188504","display_name":"Alternative medicine","level":2,"score":0.3386000096797943},{"id":"https://openalex.org/C95190672","wikidata":"https://www.wikidata.org/wiki/Q815382","display_name":"Meta-analysis","level":2,"score":0.33820000290870667},{"id":"https://openalex.org/C2778580637","wikidata":"https://www.wikidata.org/wiki/Q184627","display_name":"HPV infection","level":4,"score":0.3276999890804291},{"id":"https://openalex.org/C2780009117","wikidata":"https://www.wikidata.org/wiki/Q900189","display_name":"HPV vaccines","level":5,"score":0.30489999055862427},{"id":"https://openalex.org/C3019806175","wikidata":"https://www.wikidata.org/wiki/Q11974939","display_name":"Health professionals","level":3,"score":0.29829999804496765},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.2962000072002411},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.2840999960899353},{"id":"https://openalex.org/C46578552","wikidata":"https://www.wikidata.org/wiki/Q2725393","display_name":"Global health","level":3,"score":0.2639999985694885},{"id":"https://openalex.org/C2909042557","wikidata":"https://www.wikidata.org/wiki/Q900189","display_name":"Human papillomavirus vaccine","level":5,"score":0.2606000006198883},{"id":"https://openalex.org/C2780441014","wikidata":"https://www.wikidata.org/wiki/Q7907952","display_name":"Vaccine efficacy","level":3,"score":0.25200000405311584}],"mesh":[],"locations_count":5,"locations":[{"id":"doi:10.1136/bmjph-2025-003253","doi":"https://doi.org/10.1136/bmjph-2025-003253","is_oa":true,"landing_page_url":"https://doi.org/10.1136/bmjph-2025-003253","pdf_url":null,"source":{"id":"https://openalex.org/S4387288761","display_name":"BMJ Public Health","issn_l":"2753-4294","issn":["2753-4294"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319945","host_organization_name":"BMJ","host_organization_lineage":["https://openalex.org/P4310319945"],"host_organization_lineage_names":["BMJ"],"type":"journal"},"license":"cc-by-nc-sa","license_id":"https://openalex.org/licenses/cc-by-nc-sa","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMJ Public Health","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13536049","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13536049/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13536049/pdf/bmjph-4-3.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc-sa","license_id":"https://openalex.org/licenses/cc-by-nc-sa","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMJ Public Health","raw_type":"Text"},{"id":"pmid:42689009","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42689009","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMJ public health","raw_type":"Journal Article"},{"id":"pmh:oai:https://orca.cardiff.ac.uk:189237","doi":null,"is_oa":true,"landing_page_url":"https://orca.cardiff.ac.uk/id/eprint/189237/1/e003253.full.pdf","pdf_url":"https://orca.cardiff.ac.uk/id/eprint/189237/1/e003253.full.pdf","source":{"id":"https://openalex.org/S4306401195","display_name":"ORCA Online Research @Cardiff (Cardiff University)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I79510175","host_organization_name":"Cardiff University","host_organization_lineage":["https://openalex.org/I79510175"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc-sa","license_id":"https://openalex.org/licenses/cc-by-nc-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Article"},{"id":"pmh:oai:freidok.uni-freiburg.de:286063","doi":null,"is_oa":false,"landing_page_url":"https://nbn-resolving.org/urn:nbn:de:bsz:25-freidok-2860631","pdf_url":null,"source":{"id":"https://openalex.org/S4306401057","display_name":"FreiDok plus (Universit\u00e4tsbibliothek Freiburg)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I161046081","host_organization_name":"University of Freiburg","host_organization_lineage":["https://openalex.org/I161046081"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"BMJ public health. - 4, 3 (2026) , e003253, ISSN: 2753-4294","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1136/bmjph-2025-003253","doi":"https://doi.org/10.1136/bmjph-2025-003253","is_oa":true,"landing_page_url":"https://doi.org/10.1136/bmjph-2025-003253","pdf_url":null,"source":{"id":"https://openalex.org/S4387288761","display_name":"BMJ Public Health","issn_l":"2753-4294","issn":["2753-4294"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","vabb-shw"],"host_organization":"https://openalex.org/P4310319945","host_organization_name":"BMJ","host_organization_lineage":["https://openalex.org/P4310319945"],"host_organization_lineage_names":["BMJ"],"type":"journal"},"license":"cc-by-nc-sa","license_id":"https://openalex.org/licenses/cc-by-nc-sa","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMJ Public Health","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":1.0},{"display_name":"Reduced inequalities","id":"https://metadata.un.org/sdg/10","score":0.4000000059604645}],"study_designs":[{"display_name":"Systematic Review","id":"https://openalex.org/study-designs/systematic-review"}],"awards":[],"funders":[{"id":"https://openalex.org/F4320320350","display_name":"Cardiff University","ror":"https://ror.org/03kk7td41"}],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7204160137.pdf","grobid_xml":"https://content.openalex.org/works/W7204160137.grobid-xml"},"referenced_works_count":46,"referenced_works":["https://openalex.org/W819606680","https://openalex.org/W1967025906","https://openalex.org/W1967697602","https://openalex.org/W2031720106","https://openalex.org/W2067384918","https://openalex.org/W2073208297","https://openalex.org/W2076423178","https://openalex.org/W2084755490","https://openalex.org/W2087752419","https://openalex.org/W2106311978","https://openalex.org/W2157345779","https://openalex.org/W2260247523","https://openalex.org/W2300784061","https://openalex.org/W2510383356","https://openalex.org/W2553837482","https://openalex.org/W2560438049","https://openalex.org/W2605365014","https://openalex.org/W2795688818","https://openalex.org/W2989980939","https://openalex.org/W2991162618","https://openalex.org/W3092411035","https://openalex.org/W3105873966","https://openalex.org/W3116862386","https://openalex.org/W3117630409","https://openalex.org/W3118615836","https://openalex.org/W3120793693","https://openalex.org/W3133342588","https://openalex.org/W3165181699","https://openalex.org/W3194453053","https://openalex.org/W4206168924","https://openalex.org/W4210659847","https://openalex.org/W4220754619","https://openalex.org/W4229059061","https://openalex.org/W4291900452","https://openalex.org/W4297880420","https://openalex.org/W4306729364","https://openalex.org/W4311052278","https://openalex.org/W4312070007","https://openalex.org/W4384401407","https://openalex.org/W4386220704","https://openalex.org/W4386545831","https://openalex.org/W4387880989","https://openalex.org/W4388422763","https://openalex.org/W4394957977","https://openalex.org/W7124427393","https://openalex.org/W7165001040"],"related_works":["https://openalex.org/W1539656243","https://openalex.org/W2259330810","https://openalex.org/W4405770149","https://openalex.org/W3092017717","https://openalex.org/W7151002792","https://openalex.org/W4414962585","https://openalex.org/W4404739319","https://openalex.org/W7223268593","https://openalex.org/W4398201332","https://openalex.org/W7124473748"],"abstract_inverted_index":{"Introduction:":[0],"Eradication":[1],"of":[2,18,25,30,37,87,191,249,259,286,318],"human":[3],"papillomavirus":[4],"(HPV)":[5],"is":[6,13,51,322],"a":[7,34,185,210,247],"global":[8],"public":[9],"health":[10,252,280,291],"priority.":[11],"It":[12],"linked":[14],"to":[15,58,93,99,130,201,242,270,295,306],"approximately":[16],"5%":[17],"all":[19,23],"cancers,":[20],"causing":[21],"almost":[22],"cases":[24],"cervical":[26],"cancer,":[27],"nearly":[28],"90%":[29,49],"anal":[31],"cancers":[32],"and":[33,41,66,72,97,168,199,234,246,257,264,268,277,290,312],"significant":[35],"proportion":[36],"oropharyngeal,":[38],"penile,":[39],"vaginal":[40],"vulval":[42],"cancers.HPV":[43],"vaccination":[44,229],"can":[45],"provide":[46],"protection":[47],"when":[48],"coverage":[50,78,299],"reached.":[52],"However,":[53],"many":[54],"countries":[55],"are":[56,75,293],"yet":[57],"achieve":[59],"this":[60],"threshold.":[61],"Uptake":[62],"in":[63,103,209,240],"Romania,":[64],"Bulgaria":[65],"Croatia":[67],"has":[68],"been":[69],"low":[70],"historically,":[71],"although":[73],"rates":[74],"increasing,":[76],"vaccine":[77,101,261,272,298,321],"remains":[79],"significantly":[80],"lower":[81],"than":[82],"the":[83,95,255,260,284,301,309,319],"recommended":[84],"WHO":[85],"rate":[86],"90%.":[88],"This":[89],"systematic":[90,120],"review":[91],"sought":[92],"identify":[94],"barriers":[96],"enablers":[98,269],"HPV":[100,228,271,297,320],"uptake":[102,273],"these":[104],"three":[105,302],"countries.":[106,303],"Methods:":[107],"The":[108,217],"Joanna":[109],"Briggs":[110],"Institute":[111],"(JBI)":[112],"convergent":[113],"integrated":[114],"methodological":[115],"framework":[116],"for":[117],"mixed":[118],"methods":[119],"reviews":[121],"was":[122,154,173,182],"employed.":[123],"Seven":[124],"databases":[125],"were":[126,135,144,197,206,230],"searched":[127],"from":[128,194],"inception":[129],"April":[131],"2024.":[132],"No":[133],"restrictions":[134],"imposed":[136],"on":[137,162,275],"language":[138],"or":[139],"setting.":[140],"All":[141],"included":[142],"studies":[143,196],"critically":[145],"appraised":[146],"with":[147,159],"JBI":[148],"Critical":[149],"Appraisal":[150],"tools.":[151],"Data":[152],"extraction":[153],"performed":[155],"using":[156],"standardised":[157],"tools":[158],"an":[160],"emphasis":[161],"equity,":[163],"followed":[164],"by":[165,175,232],"data":[166,169],"transformation":[167],"synthesis.":[170],"Each":[171],"stage":[172],"conducted":[174],"two":[176],"independent":[177],"reviewers.":[178],"Bronfenbrenner's":[179],"socio-ecological":[180],"model":[181],"applied":[183],"as":[184],"theoretical":[186],"lens.":[187],"Results:":[188],"A":[189],"total":[190],"402":[192],"findings":[193],"31":[195],"extracted":[198],"aggregated":[200],"form":[202],"65":[203],"categories.":[204],"These":[205],"further":[207,307],"combined":[208],"meta-synthesis":[211],"which":[212],"yielded":[213],"13":[214],"synthesised":[215],"findings.":[216],"meta":[218],"synthesis":[219],"identified":[220],"commonalities":[221],"across":[222,300],"each":[223],"country's":[224],"findings:":[225],"attitudes":[226],"towards":[227],"characterised":[231],"distrust":[233],"misconceptions;":[235],"knowledge":[236,276],"deficits":[237],"existed":[238],"particularly":[239],"relation":[241],"gender":[243],"neutral":[244],"provision;":[245],"lack":[248],"consensus":[250],"among":[251],"professionals":[253,292],"concerning":[254],"efficacy":[256],"safety":[258],"impacted":[262],"intention":[263],"uptake.":[265],"Conclusions:":[266],"Barriers":[267],"centred":[274],"trust.":[278],"Public":[279],"interventions":[281],"that":[282,315],"address":[283],"concerns":[285],"young":[287],"people,":[288],"parents":[289],"pivotal":[294],"improving":[296],"Contemporaneous":[304],"research":[305],"explore":[308],"social,":[310],"cultural":[311],"political":[313],"factors":[314],"impede":[316],"acceptance":[317],"also":[323],"required.":[324],"PROSPERO":[325],"registration":[326],"number:":[327],"CRD42024523200.":[328]},"counts_by_year":[],"updated_date":"2026-11-10T11:39:43.021295","created_date":"2026-08-26T00:00:00"}