Human Pappillomavirus (HPV) Vaccine & Cervical Screening Survey
Human Papillomavirus (HPV) is a very common virus that can lead to cervical cancer and some other cancers. Cervical screening checks for HPV in the cervix, and the HPV vaccine helps protect against it. This survey aims to understand the awareness of Human Papillomavirus Vaccine (HPV) and cervical screening among residents in Walsall, as well as the cultural, social and practical factors that influence whether people choose to access these services. The findings will be shared with the NHS Black Country ICB for a co-production initiative aimed at interventions or activities that will support NHS improvements, facilitate change and address barriers to HPV vaccination and cervical screening across the Black Country.
Survey Date
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Month
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Day
Year
Date
Enter your Walsall Postcode (Please leave out the last letter of your post code. For example WS2 8H)
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Age group:
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Please Select
18 - 24
25 - 34
35 - 44
45 - 54
55 - 64
Cultural/ethnic background:
*
Please Select
White
Mixed or multiple ethnic groups
Asian or Asian British
Black/African/Caribbean/Black British
Other Ethnic Groups
Religion/Faith or belief
*
Please Select
Buddhist
Christian
Hindu
Jewish
Muslim
Sikh
Non-religious
Prefer not to say
Disability- Do you consider yourself to have a disability or long-term health condition that has an impact on your ability to carry out normal day-to-day activities? (This can be a physical, sensory or mental health condition.)
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Yes
No
Before today, have you heard of the HPV vaccine?
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Yes
No
Do you consider HPV vaccination to be important for your health?
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Yes
No
Unsure
How confident do you feel that you understand what the HPV vaccine does? Scale: 1 (Not at all) — 5 (Very confident)
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1 = Not confident at all
2 = Slightly confident
3 = Moderately confident
4 = Very confident
5 = Extremely confident
HPV Vaccine & Cervical Screening Awareness & Attitudes
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Rows
Yes
No
I think so, but don't remember
Have you been invited to take the HPV vaccine?
Have you had the HPV vaccine?
Have you been invited to a cervical screening?
Have you attended a cervical screening (also referred to as a smear test)?
HPV Vaccine & Cervical Screening Awareness & Attitudes for ages 12-18
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Rows
Yes
No
No daughter aged 12-18
If you had a daughter aged 12–18, would you consent for her to have the HPV Vaccine?
Have your daughter aged 12-18 been invited to take the HPV vaccine?
Has your daughter aged 12–18 had the HPV vaccine?
Do you consider the HPV vaccine important for your daughter's health ( aged 12–18)?
If you've attended a cervical screening, how would you describe your experience?
Positive
Neutral
Negative
I haven't attended
What might make women in your community NOT take on HPV VACCINE? (choose top 3 barriers that apply)
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Lack of information/ignorance
Fear/anxiety associated with physical pain
Cultural norm/influence
Religious beliefs/faith
Concerns about side effects
Embarrassment
Taking time off work
Childcare or family duties
Not trusting the health system
Perceived low risk of HPV
Transport
Cost (perceived or real)
Fear of being judged
Male practitioner
Concerns about confidentiality
Past negative healthcare experiences
Accessibility e.g no ramp to get into venue or hoist
Not being registered with a GP
Immigration concerns
Trauma history
Other – for any we may not have even thought of
What might make women in your community NOT take on CERVICAL SCREENING? (choose top 3 barriers that apply)
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Lack of information/ignorance
Fear/anxiety associated with physical pain
Cultural norm/influence
Religious beliefs/faith
Concerns about side effects
Embarrassment
Taking time off work
Childcare or family duties
Not trusting the health system
Perceived low risk of HPV
Transport
Cost (perceived or real)
Fear of being judged
Fear test result might be cancer
Male practitioner
Concerns about confidentiality
Past negative healthcare experiences
Accessibility e.g no ramp to get into venue or hoist
Not being registered with a GP
Immigration concerns
Trauma history
Other – for any we may not have even thought of
What might MOTIVATE women in your community take on HPV Vaccine? (choose top 3 that apply)
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Better information
Culturally sensitive communication
Religious organisation promotion
Flexible clinic hours
Female practitioners
Translation/interpretation support
Community-based delivery
Peer education
Peace of mind
Support from community leaders
Encouragement from healthcare professional
Encouragement from friends or family
Flexible locations (community venues, women‑only spaces)
Reminder to attend
Seeing representation (staff or advocates from similar backgrounds)
Other – for any we may not have even thought of
What might MOTIVATE women in your community take on CERVICAL SCREENING? (choose top 3 that apply)
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Better information
Culturally sensitive communication
Religious organisation promotion
Flexible clinic hours
Female practitioners
Translation/interpretation support
Community-based delivery
Peer education
Peace of mind
Support from community leaders
Encouragement from healthcare professional
Encouragement from friends or family
Flexible locations (community venues, women‑only spaces)
Reminder to attend
Seeing representation (staff or advocates from similar backgrounds)
Other – for any we may not have even thought of
If you could influence policy/practice on HPV Vaccine or cervical screening, what would you suggest?
0/50
Is there anything else you’d like to tell us about HPV Vaccine or Cervical screening?
0/50
If you would like to receive updates on HPV vaccine or cervical screening, leave a contact detail (email/phone nos) below?
Email/phone nos (optional)
Submit
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