[Preventing human papillomavirus in middle school: The role of an Escape Game].
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OBJECTIVE: Cervical cancer remains a major global health concern. In France, approximately 6400 cancer cases were attributable to human papillomavirus (HPV) in 2023, including 3159 cervical cancers and 1100 related deaths. HPV vaccination is the most effective primary prevention strategy, yet vaccination coverage remains low in France, particularly among boys. Innovative, school-based educational interventions may improve adolescents' knowledge and support vaccine uptake. This paper aims to describe baseline knowledge of HPV among middle school students in Marseille, France, and to assess the impact of an educational Escape Game led by healthcare students. METHODS: We conducted a longitudinal descriptive study in four Marseille middle schools between February and April 2025. Students completed pre- and post-intervention paper-based questionnaires assessing HPV knowledge. A composite knowledge score (range 0-8) was calculated. Analyses compared results by sex and grade. RESULTS: A total of 346 pre- and 333 post-intervention questionnaires were analyzed. At baseline, 58.4% of students had heard of HPV, mainly from family. The mean knowledge score was 3.76/8 (±1.23), higher in girls than boys (4.01 vs. 3.53; P<0.05), and in 8th graders (4.19) compared to 9th (3.71) and 6th graders (2.65) (P<0.001). After the Escape Game, the mean score increased significantly to 5.14/8 (±1.36) (P<0.001). Knowledge of sexual transmission, vaccination, and oncological risks improved significantly. CONCLUSIONS: Before the intervention, HPV-related knowledge among middle school students was limited. A significant increase in knowledge was observed following the intervention and represents a low-cost, innovative tool to strengthen adolescent health literacy and support national HPV prevention strategies.