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Urrutia MT, Araya AX, Gajardo M, Chepo M, Torres R, Schilling A. Acceptability of HPV Vaccines: A Qualitative Systematic Review and Meta-Summary. Vaccines (Basel) 2023; 11:1486. [PMID: 37766161 PMCID: PMC10536942 DOI: 10.3390/vaccines11091486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/14/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
In 2006, the human papillomavirus (HPV) vaccine was approved for use as an effective intervention for reducing the risk of developing cervical cancer; however, its successful implementation is dependent on acceptability. This study aims to provide a comprehensive understanding of the reasons that favor or do not favor the acceptability of HPV vaccines. METHODS We conducted a systematic review and meta-summary of qualitative research on 16 databases. A total of 32 articles that considered the perspectives of vaccine users, their parents, and the professionals who care for them were reviewed. Synthesis was conducted as described by Sandelowski and Barroso. RESULTS We used inductive and deductive methods to obtain a total of 22 dimensions, out of which three issues stood out that should be considered to improve acceptability and are formed by three groups of study, namely, information about the vaccine, fears and side effects, and sexuality associated with the vaccine. CONCLUSIONS Acceptability, as well as adherence to HPV vaccination, is a complex concept. This review highlights the perspectives of the three sets of actors involved in the process (i.e., users, parents, and professionals) and views these factors in relation to acceptability as a guide for new interventions.
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Affiliation(s)
- María-Teresa Urrutia
- School of Nursing, Universidad Andrés Bello, Santiago 8370134, Chile; (A.-X.A.); (M.C.)
| | | | - Macarena Gajardo
- School of Medicine, Universidad de Chile, Santiago 9170022, Chile;
| | - Macarena Chepo
- School of Nursing, Universidad Andrés Bello, Santiago 8370134, Chile; (A.-X.A.); (M.C.)
| | - Romina Torres
- Sistema de Bibliotecas UC, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile;
| | - Andrea Schilling
- Clinical Research Center, Institute of Science and Innovation in Medicine, Facultad de Medicina, Clinica Alemana Universidad del Desarrollo, Santiago 7610315, Chile;
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Mitchell H, Lim R, Gill PK, Dhanoa J, Dubé È, Bettinger JA. What do adolescents think about vaccines? Systematic review of qualitative studies. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001109. [PMID: 36962668 PMCID: PMC10022047 DOI: 10.1371/journal.pgph.0001109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 09/02/2022] [Indexed: 11/19/2022]
Abstract
Adolescence presents a key opportunity to build vaccine-related health literacy and promote vaccine confidence and uptake. Although adolescents are central to vaccination programs, their views around vaccines are frequently underrepresented in qualitative literature. We reviewed qualitative studies to systematically identify and summarize existing evidence on adolescents' own understanding of vaccines and experiences with vaccine decision-making, including self-consent when applicable. CINAHL; Embase; Ovid Medline; and Psych Info database searches were last updated on May 28, 2022. Data pertaining to general study characteristics, participant demographics, and qualitative content were extracted independently by two reviewers and analyzed using textual narrative synthesis. Out of 3559 individual records, 59 studies were included. The majority of the studies were conducted in high-income countries and 75% focused on human papilloma virus vaccines, with the remaining studies looking at COVID-19, meningococcal, hepatitis B and influenza vaccines or adolescent experiences with vaccines in general. Adolescent self-consent was explored in 7 studies. Perspectives from sexual and gender minorities were lacking across studies. Adolescents often had limited understanding of different vaccines and commonly perceived vaccine information to be directed towards their parents rather than themselves. Many adolescents felt school-based vaccine education and information available through healthcare providers were insufficient to make informed decisions about vaccines. While adolescents described obtaining vaccine information from traditional and online media, face-to-face interactions and opinions from trusted adults remained important. Adolescents generally relied on their parents for vaccine-decision making, even when self-consent was an option. A notable exception to this included marginalized adolescents who could not rely on parents for health-related advice. Qualitative literature about adolescent vaccines would be enriched by studies examining vaccines other than the HPV vaccine, studies examining adolescent vaccine programs in low and middle-income countries, and by deliberately eliciting vaccine experiences of adolescent with diverse sexual orientation and gender identities.
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Affiliation(s)
- Hana Mitchell
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Rebecca Lim
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Prubjot K Gill
- University of British Columbia Library, University of British Columbia, Vancouver, BC, Canada
| | - Joban Dhanoa
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Ève Dubé
- Institut National de Santé Publique du Québec, Québec City, Canada
| | - Julie A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada
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Kepka D, Bodson J, Lai D, Sanchez-Birkhead AC, Davis FA, Lee D, Tavake-Pasi F, Napia E, Villalta J, Mukundente V, Mooney R, Coulter H, Stark LA. Diverse caregivers' HPV vaccine-related awareness and knowledge. ETHNICITY & HEALTH 2021; 26:811-826. [PMID: 30589389 PMCID: PMC6597331 DOI: 10.1080/13557858.2018.1562052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 11/08/2018] [Indexed: 06/09/2023]
Abstract
Objectives: To assess factors associated with HPV vaccine-related awareness and knowledge among caregivers of adolescents from five ethnic community groups in Utah.Design: For this community-based participatory research study, we surveyed N = 228 caregivers of teens aged 11-17 years from African American, African refugee, American Indian/Alaskan Native, Hispanic/Latino, and Native Hawaiian/Pacific Islander community groups in Utah about their HPV vaccine awareness and knowledge.Results: Participants exhibited high awareness of cervical cancer (71.05%), moderate awareness of HPV (53.95%), and low awareness of the HPV vaccine (46.49%). HPV vaccine-related knowledge was mostly worse, with fewer than half the participants reporting knowing that HPV can cause cervical cancer (46.93%), that most people are infected with HPV at some point in their lives (28.95%), that HPV is asymptomatic in females (36.40%) and males (37.28%), that the HPV vaccine is recommended for adolescent females (41.67%) and males (36.40%), and that the HPV vaccine requires more than one dose (27.19%). HPV vaccine-related awareness and knowledge were significantly associated with race/ethnicity, educational attainment, income, occupation, birthplace, parents' birthplace, English usage, health insurance coverage, type of health insurance, and child having a primary care provider (all p < 0.05). HPV vaccine-related knowledge (p < 0.05) and awareness (p < 0.05) of caregivers were associated with a child in the household receiving the HPV vaccine.Conclusion: Our findings indicate a need to develop educational interventions in collaboration with diverse communities in Utah. We underscore the importance of promoting knowledge about the existence of the HPV vaccine, as well as deeper HPV vaccine-related issues (e.g. HPV risks, treatment, and recommendations).
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Affiliation(s)
- Deanna Kepka
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah, USA
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Julia Bodson
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Djin Lai
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
- Community Faces of Utah, Salt Lake City, Utah, USA
| | - Ana C. Sanchez-Birkhead
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
- Community Faces of Utah, Salt Lake City, Utah, USA
- Hispanic Health Care Task Force, Salt Lake City, Utah, USA
| | - France A. Davis
- Community Faces of Utah, Salt Lake City, Utah, USA
- Calvary Baptist Church, Salt Lake City, Utah, USA
| | - Doriena Lee
- Community Faces of Utah, Salt Lake City, Utah, USA
- Calvary Baptist Church, Salt Lake City, Utah, USA
| | - Fahina Tavake-Pasi
- Community Faces of Utah, Salt Lake City, Utah, USA
- National Tongan American Society, Salt Lake City, Utah, USA
| | - Edwin Napia
- Community Faces of Utah, Salt Lake City, Utah, USA
- Urban Indian Center, Salt Lake City, Utah, USA
| | - Jeannette Villalta
- Community Faces of Utah, Salt Lake City, Utah, USA
- Hispanic Health Care Task Force, Salt Lake City, Utah, USA
| | - Valentine Mukundente
- Community Faces of Utah, Salt Lake City, Utah, USA
- Best of Africa, West Valley City, Utah, USA
| | - Ryan Mooney
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Heather Coulter
- Center for Clinical and Translational Science, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Louisa A. Stark
- Center for Clinical and Translational Science, School of Medicine, University of Utah, Salt Lake City, Utah, USA
- Department of Human Genetics, School of Medicine, University of Utah, Salt Lake City, Utah, USA
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Frounfelker RL, Santavicca T, Li ZY, Miconi D, Venkatesh V, Rousseau C. COVID-19 Experiences and Social Distancing: Insights From the Theory of Planned Behavior. Am J Health Promot 2021; 35:1095-1104. [PMID: 34074154 PMCID: PMC8679169 DOI: 10.1177/08901171211020997] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Purpose: The objective of this study is to identify the relationship between COVID-19
experiences, perceived COVID-19 behavioral control, social norms and
attitudes, and future intention to follow social distancing guidelines. Design: This is a cross-sectional study. Setting: Participants responded to an on-line survey in June 2020. Subjects: The study included 3,183 residents within Quebec, Canada aged 18 and
over. Measures: Measures include perceived COVID-19 related discrimination, fear of COVID-19
infection, prior exposure to COVID-19, and prior social distancing behavior.
Participants self-reported attitudes, perceived behavioral control, and
perceived norms related to social distancing. Finally, we measured social
distancing behavioral intention. Analysis: We evaluated a theory of planned behavior (TPB) measurement model of social
distancing using confirmatory factor analysis (CFA). The association between
COVID-19 perceived discrimination, fear of infection, previous social
distancing behavior, exposure to COVID-19, TPB constructs and behavioral
intentions to social distance were estimated using SEM path analysis. Results: TPB constructs were positively associated with intention to follow social
distancing guidelines. Fear of COVID-19 infection and prior social
distancing behavior were positively associated with behavioral intentions.
In contrast, perceived discrimination was negatively associated with the
outcome. Associations between fear of COVID-19, perceived COVID-19
discrimination and behavioral intentions were partially mediated by
constructs of TPB. Conclusions: COVID-19 prevention efforts designed to emphasize positive attitudes,
perceived control, and social norms around social distancing should
carefully balance campaigns that heighten fear of infection along with anti-
discrimination messaging.
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Affiliation(s)
| | - Tara Santavicca
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Zhi Yin Li
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Diana Miconi
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Vivek Venkatesh
- Department of Art Education, Concordia University, Montreal, Quebec, Canada
| | - Cecile Rousseau
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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Boatman DD, Eason S, Conn ME, Kennedy-Rea SK. Human Papillomavirus Vaccine Messaging on TikTok: Social Media Content Analysis. Health Promot Pract 2021; 23:382-387. [PMID: 33969725 PMCID: PMC8578596 DOI: 10.1177/15248399211013002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The human papillomavirus (HPV) vaccine is viewed as a critical tool to protect against six HPV-related cancers. Vaccination is recommended from early adolescence through age 26 years. As young people have become increasingly involved in personal health-related decisions, there is a need to tailor HPV vaccine messaging and reach this priority population on social media and digital outlets. TikTok is a growing social media platform with approximately 70% of its users between the ages of 13 and 24 years. PURPOSE The aim of this study was to understand HPV vaccine messaging and interactions on TikTok as a needed first step to identifying effective strategies to reach young people with important health messaging. METHODS Content analysis was performed on 170 top TikToks focused on the HPV vaccine. TikToks were assessed for content, classification type, and number of interactions. RESULTS Most TikToks were provaccine, while antivaccine TikToks had more user interactions. Cancer and prevention were the main content areas of the analyzed provaccine TikToks, while the side effects were the primary focus of antivaccine messages. Approximately 30% of all top TikToks analyzed were developed by health professionals. TikToks without an explicit vaccine opinion primarily described personal experiences and mentioned side effects most often. IMPLICATIONS TikTok is a growing social media platform that can be used to reach young people and encourage HPV vaccine uptake. Health professionals need to consider the interest that users have in personal experiences and address antivaccine narratives related to side effects.
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Affiliation(s)
| | - Susan Eason
- West Virginia University Cancer Institute, Morgantown, WV, USA
| | - Mary Ellen Conn
- West Virginia University Cancer Institute, Morgantown, WV, USA
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Amboree TL, Darkoh C. Barriers to Human Papillomavirus Vaccine Uptake Among Racial/Ethnic Minorities: a Systematic Review. J Racial Ethn Health Disparities 2020; 8:1192-1207. [PMID: 33025422 DOI: 10.1007/s40615-020-00877-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/21/2020] [Accepted: 09/16/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) is associated with poor health outcomes, including cervical cancer. Racial/ethnic minority populations experience poor health outcomes associated with HPV at higher rates. A vaccine is available to protect against HPV infections and prevent HPV-related sequelae; however, vaccination rates have remained low in the United States (U.S.) population. Thus, there is an urgent need to increase the HPV vaccination rate. Moreover, little is known about barriers to HPV vaccination in racial/ethnic minority groups. This paper highlights the most recent findings on barriers experienced by these groups. METHODS The PubMed database was searched on July 30, 2020, for peer-reviewed articles and abstracts that had been published in English from July 2010 to July 2020 and covered racial/ethnic disparities in HPV vaccination. RESULTS Similar findings were observed among the articles reviewed. The low HPV vaccination initiation and completion rates among racial/ethnic minority populations were found to be associated with lack of provider recommendations, inadequate knowledge and awareness of HPV and HPV vaccination, medical mistrust, and safety concerns. CONCLUSIONS Provider recommendations and accurate distribution of information must be increased and targeted to racial/ethnic minority populations in order to bolster the rate of vaccine uptake. To effectively target these communities, multi-level interventions need to be established. Further, research to understand the barriers that may affect unvaccinated adults in the catch-up age range, including males, may be beneficial, as majority of the previous studies focused on either parents of adolescents or women.
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Affiliation(s)
- Trisha L Amboree
- Department of Epidemiology, Human Genetics and Environmental Sciences, Center for Infectious Diseases, University of Texas Health Science Center at Houston, School of Public Health, 1200 Pressler Street, Room E715, Houston, TX, 77030, USA
| | - Charles Darkoh
- Department of Epidemiology, Human Genetics and Environmental Sciences, Center for Infectious Diseases, University of Texas Health Science Center at Houston, School of Public Health, 1200 Pressler Street, Room E715, Houston, TX, 77030, USA. .,Microbiology and Infectious Diseases Program, University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA.
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Beliefs around childhood vaccines in the United States: A systematic review. Vaccine 2019; 37:6793-6802. [PMID: 31562000 DOI: 10.1016/j.vaccine.2019.08.068] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 07/30/2019] [Accepted: 08/26/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND While childhood vaccines are safe and effective, some parents remain hesitant to vaccinate their children, which has led to outbreaks of vaccine preventable diseases. The goal of this systematic review was to identify and summarize the range of beliefs around childhood vaccines elicited using open-ended questions, which are better suited for discovering beliefs compared to closed-ended questions. METHODS PubMed, Embase, and PsycINFO were searched using keywords for childhood vaccines, decision makers, beliefs, and attitudes to identify studies that collected primary data using a variety of open-ended questions regarding routine childhood vaccine beliefs in the United States. Study designs, population characteristics, vaccine types, and vaccine beliefs were abstracted. We conducted a qualitative analysis to conceptualize beliefs into themes and generated descriptive statistics. RESULTS Of 1727 studies identified, 71 were included, focusing largely on parents (including in general, and those who were vaccine hesitant or at risk of hesitancy). Seven themes emerged: Adverse effects was most prominent, followed by mistrust, perceived lack of necessity, pro-vaccine opinions, skepticism about effectiveness, desire for autonomy, and morality concerns. The most commonly described beliefs included that vaccines can cause illnesses; a child's immune system can be overwhelmed if receiving too many vaccines at once; vaccines contain harmful ingredients; younger children are more susceptible to vaccine adverse events; the purpose of vaccines is profit-making; and naturally developed immunity is better than that acquired from vaccines. Nearly a third of the studies exclusively assessed minority populations, and more than half of the studies examined beliefs only regarding HPV vaccine. CONCLUSIONS Few studies used open-ended questions to elicit beliefs about vaccines. Many of the studies that did so, focused on HPV vaccine. Concerns about vaccine safety were the most commonly stated beliefs about childhood vaccines, likely because studies were designed to capture barriers and challenges to vaccination.
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Lavelle TA, Messonnier M, Stokley S, Kim D, Ramakrishnan A, Gebremariam A, Simon NJE, Rose AM, Prosser LA. Use of a choice survey to identify adult, adolescent and parent preferences for vaccination in the United States. J Patient Rep Outcomes 2019; 3:51. [PMID: 31359289 PMCID: PMC6663948 DOI: 10.1186/s41687-019-0135-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 06/19/2019] [Indexed: 01/03/2023] Open
Abstract
Background Adult and adolescent vaccination rates are far below coverage targets in the United States. Our objective was to identify the most influential factors related to vaccine uptake among adults, adolescents, and parents of adolescents (parents) in the United States. Methods We used a fractional factorial design to create a binary choice survey to evaluate preferences for vaccination. The national survey was fielded to a sample of adults, adolescents ages 13–17 years, and parents, using a national probability-based online research panel in November 2015. Respondents were presented with 5 profiles of a hypothetical vaccine and asked in a series of questions whether they would accept each vaccine. We analyzed the binary choice data using logistic regression in STATA v13 (College Station, TX) to calculate the odds that a participant would choose to accept the vaccine. Results We received completed responses from 334 (51%) of 652 adults, 316 (21%) of 1516 adolescents, and 339 (33%) of 1030 parents. Respondents were generally representative of the U.S. population. Vaccine effectiveness was the most influential factor in the choice to vaccinate for all groups. Other most influential factors were primary care provider (PCP) recommendation and the out-of-pocket cost of the vaccine. Other factors such as risk of illness, risk of vaccine side effects, vaccination location, and time for vaccination were not important in the decision to get vaccinated. Conclusions Adults, adolescents, and parents are most sensitive to vaccine effectiveness, PCP recommendation, and out-of-pocket cost for vaccination in their decision to get vaccinated. Strong PCP recommendations that focus on vaccine effectiveness and health care policies that minimize out-of-pocket costs for vaccinations may increase vaccine uptake by adults and adolescents. Electronic supplementary material The online version of this article (10.1186/s41687-019-0135-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tara A Lavelle
- Center for the Evaluation of Value and Risk in Health (CEVR), Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington St, Boston, MA, 02111, USA.
| | - Mark Messonnier
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Shannon Stokley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - David Kim
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | | | - Achamyeleh Gebremariam
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, Medical School, University of Michigan, 300 North Ingalls St, Ann Arbor, MI, 48109, USA
| | - Norma-Jean E Simon
- Ann and Robert H. Lurie Children's Hospital, 225 East Chicago Ave, Chicago, IL, 60611, USA
| | - Angela M Rose
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, Medical School, University of Michigan, 300 North Ingalls St, Ann Arbor, MI, 48109, USA
| | - Lisa A Prosser
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, Medical School, University of Michigan, 300 North Ingalls St, Ann Arbor, MI, 48109, USA.,Department of Health Management and Policy, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
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Bernichon E, Espenel S, Méry B, Trone JC, Rehalia-Blanchard A, He YM, Rancoule C, Magné N. [HPV: Carcinogenic implications and preventive measures]. Presse Med 2019; 48:756-766. [PMID: 31307878 DOI: 10.1016/j.lpm.2019.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 02/13/2019] [Accepted: 05/15/2019] [Indexed: 11/25/2022] Open
Abstract
Human oncogenic papillomaviruses (HPV) have an increasingly prominent role in the genesis of many cancers. The oncogenic mechanisms associated with HPV are now better known and make it possible to explain the etiopathogenesis of the association. HPV status is now sought for certain cancers and conditions both prognosis and management of patients. Preventive antiviral vaccination has become a real public health issue and aims to effectively reduce the prevalence of cervical, anal and oropharynx cancer, HPV-associated. However, vaccination against HPV still lags behind. The purpose of this review is to redefine the involvement of HPV in several cancers as well as current therapeutic challenges of HPV-related cancers, notably in term of prevention.
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Affiliation(s)
- Emilie Bernichon
- Institut de cancérologie Lucien-Neuwirth, département d'oncologie médicale, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Sophie Espenel
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France; Laboratoire de radiobiologie cellulaire et moléculaire de Lyon Sud, CNRS UMR 5822, 165, chemin du grand Revoyet, BP 12, 69921 Oullins cedex, France
| | - Benoite Méry
- Institut de cancérologie Lucien-Neuwirth, département d'oncologie médicale, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France; Laboratoire de radiobiologie cellulaire et moléculaire de Lyon Sud, CNRS UMR 5822, 165, chemin du grand Revoyet, BP 12, 69921 Oullins cedex, France
| | - Jane-Chloé Trone
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Amel Rehalia-Blanchard
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Yuan Ming He
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France
| | - Chloé Rancoule
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France; Laboratoire de radiobiologie cellulaire et moléculaire de Lyon Sud, CNRS UMR 5822, 165, chemin du grand Revoyet, BP 12, 69921 Oullins cedex, France
| | - Nicolas Magné
- Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France; Laboratoire de radiobiologie cellulaire et moléculaire de Lyon Sud, CNRS UMR 5822, 165, chemin du grand Revoyet, BP 12, 69921 Oullins cedex, France.
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Carvalho M, Queiroz A, Ferreira M, Moura M, Pinto C, Vieira B. Ineffectiveness of information and access to health services: vulnerability to human papillomavirus. Int Nurs Rev 2019; 66:280-289. [DOI: 10.1111/inr.12500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M.C.M.P. Carvalho
- Ministry of Health, Member of the Sexual and Reproductive Health Group of the Human Groups, CNPq Rio de Janeiro Brazil
- Member of the Ethics and Research Committee of the Federal Hospital of Ipanema Ministry of Health Rio de JaneiroBrazil
| | - A.B.A. Queiroz
- Anna Nery School of Nursing of the Federal University of Rio de Janeiro Rio de Janeiro Brazil
- Anna Nery School of Nursing Federal University of Rio de Janeiro. Head of the Research Group on Sexual and Reproductive Health of Human Groups Groups/CNPq Rio de JaneiroBrazil
| | - M.A. Ferreira
- Anna Nery School of Nursing of the Federal University of Rio de Janeiro Rio de Janeiro Brazil
- Anna Nery School of Nursing Federal University of Rio de Janeiro. Level 1C Researcher National Council for Scientific and Technological Development/CNPq Rio de Janeiro Brazil
| | - M.A.V. Moura
- Anna Nery School of Nursing of the Federal University of Rio de Janeiro Rio de Janeiro Brazil
- Anna Nery School of Nursing Federal University of Rio de Janeiro. Member of the Research Group on Sexual and Reproductive Health of Human Groups, CNPq Rio de Janeiro Brazil
| | - C.B. Pinto
- Anna Nery School of Nursing of the Federal University of Rio de Janeiro Rio de Janeiro Brazil
- Member of the Research Group on Sexual and Reproductive Health of Human Groups, CNPq Rio de Janeiro Brazil
| | - B.D.G. Vieira
- Anna Nery School of Nursing Federal University of Rio de Janeiro. Level 1C Researcher National Council for Scientific and Technological Development/CNPq Rio de Janeiro Brazil
- Aurora School of Nursing Afonso Costa. Federal Fluminense University (UFF). Member of the Research Group on Sexual and Reproductive Health of Human Groups / CNPq Rio de Janeiro Brazil
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11
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Lacombe-Duncan A, Newman PA, Baiden P. Human papillomavirus vaccine acceptability and decision-making among adolescent boys and parents: A meta-ethnography of qualitative studies. Vaccine 2018; 36:2545-2558. [PMID: 29625768 DOI: 10.1016/j.vaccine.2018.02.079] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 11/04/2017] [Accepted: 02/19/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Genital warts and human papillomavirus (HPV)-associated cancers in men can be substantially reduced through HPV vaccination; yet, globally, HPV vaccine uptake among boys remains low. This meta-ethnography synthesizes qualitative studies to understand, in-depth, HPV vaccine acceptability and decision-making among adolescent boys and/or their parents. METHODS A systematic search identified qualitative studies examining HPV vaccines from the perspectives of boys and/or boys' parents. The Consolidated Criteria for Reporting Qualitative Research (COREQ) 32-item checklist was used to assess quality of reporting. Using meta-ethnographic techniques, we conducted a structured and iterative process of data analysis, coded original studies, and then developed descriptive and analytic themes to synthesize the findings. RESULTS Review of 15 eligible studies (n = 3362 parents, n = 39 boys) revealed multilevel factors that influence HPV vaccine acceptability and decision-making among adolescent boys and their parents: (1) individual, e.g., low HPV vaccine knowledge/awareness, (2) interpersonal, e.g., key relationships between parents, sons, and healthcare providers (HCP), (3) community/societal, e.g., parental duty to protect, and (4) systemic, e.g., HPV vaccine messaging. Parents generally accepted adolescent boys' sexuality and the need for vaccination, motivated by wanting to protect their sons from HPV and HPV-associated cancers, and valued HCP-initiated discussion and recommendation. Acceptability was mitigated by low awareness/knowledge of HPV vaccines and low perceived benefits for boys, lack of HCP-initiated discussion, out-of-pocket costs, multiple doses, stigma, and mixed messages about HPV. CONCLUSIONS Multilevel factors influence HPV vaccine acceptability and decision-making among parents and their adolescent sons. Providing clear and unambiguous messages about HPV vaccines-for whom (boys and girls), for what (genital warts and cancers in men), and when (before sexual debut)-through increased HCP-initiated discussion and targeted public health campaigns may support HPV vaccine uptake among boys. Future research should consistently disaggregate findings by sex of child and parent, and explore effective messaging tailored for boys and parents.
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Affiliation(s)
- Ashley Lacombe-Duncan
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario M5S 1V4, Canada.
| | - Peter A Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario M5S 1V4, Canada.
| | - Philip Baiden
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper Street, Box 19129, Arlington, Texas, USA.
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Abstract
We believe that public health efforts to address issues of vaccine hesitancy should increase their focus on childhood education. An opportunity exists to create positive, accurate vaccine attitudes through fun and interactive approaches early in life. Leveraging digital technologies may provide a way to deliver these messages to children in a way that complements immune system and immunization education in school curricula. We recommend that public health officials explore and identify the most effective ways to deliver positive digital messages to children in hopes of "inoculating" the next generation against vaccine hesitancy.
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Affiliation(s)
- Kumanan Wilson
- a Ottawa Hospital Research Institute , Ottawa , Canada.,b Departments of Medicine , Epidemiology and Community Medicine, University of Ottawa , Ottawa , Canada
| | - Katherine Atkinson
- a Ottawa Hospital Research Institute , Ottawa , Canada.,c Department of Public Health Sciences , Karolinska Institutet , Stockholm , Sweden
| | - Natasha Crowcroft
- d Clinical Public Health and Epidemiology , University of Toronto, Dalla Lana School of Public Health , Toronto , Canada.,e Applied Immunization Research , Public Health Ontario , Toronto , Canada
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Marra E, Alberts CJ, Zimet GD, Paulussen TGWM, Heijman T, Hogewoning AA, Sonder GJB, Fennema JS, de Vries HJC, Schim van der Loeff MF. HPV vaccination intention among male clients of a large STI outpatient clinic in Amsterdam, the Netherlands. PAPILLOMAVIRUS RESEARCH 2016; 2:178-184. [PMID: 29074179 PMCID: PMC5886895 DOI: 10.1016/j.pvr.2016.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 11/01/2016] [Accepted: 11/03/2016] [Indexed: 12/12/2022]
Abstract
We explored HPV vaccination intention and its determinants among male clients of the sexually transmitted infections (STI) clinic in Amsterdam. In 2015, male clients aged ≥18 years were invited to complete a web-based questionnaire regarding HPV vaccination intention and socio-psychological determinants. Determinants (scale -3 to +3) were assessed with linear regression, stratified for men who have sex with men (MSM) (including men who have sex with men and women) and men who only have sex with women (MSW). Additionally, we explored the effect of out-of-pocket payment on intention. Of 1490 participants (median age 33 years [IQR:25-44]), 1,053(71%) were MSM. HPV vaccination intention was high (mean 1.68, 95%CI:1.55-1.81 among MSW; mean 2.35, 95%CI:2.29-2.42 among MSM). In multivariable analyses, socio-psychological determinants had similar effects on intention in both groups (R2=0.70 among MSW; R2=0.68 among MSM), except for subjective norms, self-efficacy, and HPV knowledge (significantly stronger associations among MSW). HPV vaccination intention decreased significantly when vaccination would require out-of-pocket payment; intention was negative at the current list price (€350). HPV vaccination intention among male clients of the Amsterdam STI-clinic is high and variance in intention was mostly be explained by socio-psychological factors. Out-of-pocket payment had a strong negative effect on HPV vaccination intention.
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Affiliation(s)
- E Marra
- Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018 WT Amsterdam, the Netherlands
| | - C J Alberts
- Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018 WT Amsterdam, the Netherlands; Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - G D Zimet
- Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - T G W M Paulussen
- Expertise Center Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, the Netherlands
| | - T Heijman
- Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018 WT Amsterdam, the Netherlands
| | - A A Hogewoning
- Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018 WT Amsterdam, the Netherlands; Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - G J B Sonder
- Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018 WT Amsterdam, the Netherlands; Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - J S Fennema
- Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018 WT Amsterdam, the Netherlands
| | - H J C de Vries
- Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018 WT Amsterdam, the Netherlands; Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands; Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - M F Schim van der Loeff
- Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018 WT Amsterdam, the Netherlands; Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
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Bodson J, Warner EL, Kepka D. Moderate Awareness and Limited Knowledge Relating to Cervical Cancer, HPV, and the HPV Vaccine Among Hispanics/Latinos in Utah. Health Promot Pract 2016; 17:548-56. [PMID: 27160078 DOI: 10.1177/1524839916640271] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND We investigate the demographic factors associated with human papillomavirus (HPV) vaccine-related awareness and knowledge in an emerging (rather than established) Hispanic/Latino population. METHOD We surveyed 119 Spanish-speaking, mostly low-income and immigrant, Hispanic/Latino parents and guardians of adolescents 11 to 17 years old (i.e., eligible to receive the HPV vaccine) about their HPV vaccine-related awareness and knowledge. Data collection took place between August 2013 and October 2013 in Salt Lake City, Utah. RESULTS Participants had moderately high awareness scores, with more than half the participants reporting having heard of cervical cancer (84.5%), HPV (76.4%), and the HPV vaccine (67.3%). HPV vaccine-related knowledge was low, with fewer than half the participants reporting they knew that most people are infected with HPV (32.7%), that HPV is asymptomatic among women (16.4%), that the HPV vaccine requires more than one dose (33.6%), and that the HPV vaccine is recommended for adolescent girls (47.3%) and boys (35.5%). Combined awareness and knowledge was significantly associated with educational attainment (p = .02) and country of origin (p = .03). CONCLUSION Results demonstrate moderate to high HPV vaccine-related awareness and limited HPV vaccine-related knowledge among Hispanic/Latino parents living in Utah. These findings will inform educational interventions to improve the HPV vaccine-related awareness and knowledge in this vulnerable population.
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Affiliation(s)
- Julia Bodson
- Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Echo L Warner
- Huntsman Cancer Institute, Salt Lake City, Utah, USA University of Utah College of Nursing, Salt Lake City, Utah, USA
| | - Deanna Kepka
- Huntsman Cancer Institute, Salt Lake City, Utah, USA University of Utah College of Nursing, Salt Lake City, Utah, USA
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Bailey HH, Chuang LT, duPont NC, Eng C, Foxhall LE, Merrill JK, Wollins DS, Blanke CD. American Society of Clinical Oncology Statement: Human Papillomavirus Vaccination for Cancer Prevention. J Clin Oncol 2016; 34:1803-12. [PMID: 27069078 DOI: 10.1200/jco.2016.67.2014] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
American Society of Clinical Oncology (ASCO), the leading medical professional oncology society, is committed to lessening the burden of cancer and as such will promote underused interventions that have the potential to save millions of lives through cancer prevention. As the main providers of cancer care worldwide, our patients, their families, and our communities look to us for guidance regarding all things cancer related, including cancer prevention. Through this statement and accompanying recommendations, ASCO hopes to increase awareness of the tremendous global impact of human papillomavirus (HPV) -caused cancers, refocus the discussion of HPV vaccination on its likely ability to prevent millions of cancer deaths, and increase HPV vaccination uptake via greater involvement of oncology professionals in ensuring accurate public discourse about HPV vaccination and calling for the implementation of concrete strategies to address barriers to vaccine access and acceptance.
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Affiliation(s)
- Howard H Bailey
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR.
| | - Linus T Chuang
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
| | - Nefertiti C duPont
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
| | - Cathy Eng
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
| | - Lewis E Foxhall
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
| | - Janette K Merrill
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
| | - Dana S Wollins
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
| | - Charles D Blanke
- Howard H. Bailey, University of Wisconsin Carbone Cancer Center, Madison, WI; Linus T. Chuang, Mount Sinai School of Medicine, New York, NY; Nefertiti C. duPont, Gynecologic Surgeons of North Houston, Shenandoah; Cathy Eng and Lewis E. Foxhall, MD Anderson Cancer Center, Houston, TX; Janette K. Merrill and Dana S. Wollins, American Society of Clinical Oncology, Alexandria, VA; and Charles D. Blanke, Oregon Health and Science University, Portland, OR
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Nelson EJ, Hughes J, Oakes JM, Pankow JS, Kulasingam SL. Geospatial patterns of human papillomavirus vaccine uptake in Minnesota. BMJ Open 2015; 5:e008617. [PMID: 26316652 PMCID: PMC4554895 DOI: 10.1136/bmjopen-2015-008617] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 07/24/2015] [Accepted: 08/12/2015] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To identify factors associated with human papillomavirus (HPV) vaccination and to determine the geographic distribution of vaccine uptake while accounting for spatial autocorrelation. DESIGN This study is cross-sectional in design using data collected via the Internet from the Survey of Minnesotans About Screening and HPV study. SETTING AND PARTICIPANTS The sample consists of 760 individuals aged 18-30 years nested within 99 ZIP codes surrounding the downtown area of Minneapolis, Minnesota. RESULTS In all, 46.2% of participants had received ≥ 1 dose of HPV vaccine (67.7% of women and 13.0% of men). Prevalence of HPV vaccination was found to exhibit strong spatial dependence ([Formula: see text] = 0.9951) across ZIP codes. Accounting for spatial dependence, age (OR=0.76, 95% CI 0.70 to 0.83) and male gender (OR=0.04, 95% CI 0.03 to 0.07) were negatively associated with vaccination, while liberal political preferences (OR=4.31, 95% CI 2.32 to 8.01), and college education (OR=2.58, 95% CI 1.14 to 5.83) were found to be positively associated with HPV vaccination. CONCLUSIONS Strong spatial dependence and heterogeneity of HPV vaccination prevalence were found across ZIP codes, indicating that spatial statistical models are needed to accurately identify and estimate factors associated with vaccine uptake across geographic units. This study also underscores the need for more detailed data collected at local levels (eg, ZIP code), as patterns of HPV vaccine receipt were found to differ significantly from aggregated state and national patterns. Future work is needed to further pinpoint areas with the greatest disparities in HPV vaccination and how to then access these populations to improve vaccine uptake.
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Affiliation(s)
- Erik J Nelson
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri, USA
| | - John Hughes
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - J Michael Oakes
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - James S Pankow
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Shalini L Kulasingam
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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Berenson AB. An update on barriers to adolescent human papillomavirus vaccination in the USA. Expert Rev Vaccines 2015; 14:1377-84. [PMID: 26292763 DOI: 10.1586/14760584.2015.1078240] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Human papillomavirus is the most common sexually transmitted infection in the USA. It is the primary cause of almost all cervical cancers as well as several other cancers that affect both men and women. Adolescents of both genders can now prevent transmission of the most common oncogenic strains of human papillomavirus by obtaining a safe, three-dose vaccine series. However, despite its potential to save lives and reduce severe morbidity, many US adolescents have not been vaccinated. This is in contrast to other countries where high rates of vaccination are already reducing rates of cervical intra-epithelial neoplasia and genital warts. This article describes barriers recently reported among families in the USA and concludes with suggestions for improving uptake.
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Affiliation(s)
- Abbey B Berenson
- a The University of Texas Medical Branch at Galveston, Center for Interdisciplinary Research in Women's Health, Department of Obstetrics and Gynecology, 301 University Boulevard, Mail Route 0587, Galveston, TX 77555-0587, USA
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Agénor M, Peitzmeier S, Gordon AR, Haneuse S, Potter JE, Austin SB. Sexual Orientation Identity Disparities in Awareness and Initiation of the Human Papillomavirus Vaccine Among U.S. Women and Girls: A National Survey. Ann Intern Med 2015; 163:99-106. [PMID: 25961737 PMCID: PMC4509853 DOI: 10.7326/m14-2108] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Lesbians and bisexual women are at risk for human papillomavirus (HPV) infection from female and male sexual partners. OBJECTIVE To examine the association between sexual orientation identity and HPV vaccination among U.S. women and girls. DESIGN Cross-sectional, using 2006-2010 National Survey of Family Growth data. SETTING U.S. civilian noninstitutionalized population. PARTICIPANTS The 2006-2010 National Survey of Family Growth used stratified cluster sampling to establish a national probability sample of 12,279 U.S. women and girls aged 15 to 44 years. Analyses were restricted to 3253 women and girls aged 15 to 25 years who were asked about HPV vaccination. MEASUREMENTS Multivariable logistic regression was used to obtain prevalence estimates of HPV vaccine awareness and initiation adjusted for sociodemographic and health care factors for each sexual orientation identity group. RESULTS Among U.S. women and girls aged 15 to 25 years, 84.4% reported having heard of the HPV vaccine; of these, 28.5% had initiated HPV vaccination. The adjusted prevalence of vaccine awareness was similar among heterosexual, bisexual, and lesbian respondents. After adjustment for covariates, 8.5% (P = 0.007) of lesbians and 33.2% (P = 0.33) of bisexual women and girls who had heard of the vaccine had initiated vaccination compared with 28.4% of their heterosexual counterparts. LIMITATION Self-reported, cross-sectional data, and findings may not be generalizable to periods after 2006 to 2010 or all U.S. lesbians aged 15 to 25 years (because of the small sample size for this group). CONCLUSION Adolescent and young adult lesbians may be less likely to initiate HPV vaccination than their heterosexual counterparts. Programs should facilitate access to HPV vaccination services among young lesbians. PRIMARY FUNDING SOURCE National Cancer Institute.
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Affiliation(s)
- Madina Agénor
- From Harvard T.H. Chan School of Public Health, Dana-Farber Cancer Institute, Harvard Medical School, Fenway Health, Beth Israel Deaconess Medical Center, and Boston Children's Hospital, Boston, Massachusetts, and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Sarah Peitzmeier
- From Harvard T.H. Chan School of Public Health, Dana-Farber Cancer Institute, Harvard Medical School, Fenway Health, Beth Israel Deaconess Medical Center, and Boston Children's Hospital, Boston, Massachusetts, and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Allegra R. Gordon
- From Harvard T.H. Chan School of Public Health, Dana-Farber Cancer Institute, Harvard Medical School, Fenway Health, Beth Israel Deaconess Medical Center, and Boston Children's Hospital, Boston, Massachusetts, and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Sebastien Haneuse
- From Harvard T.H. Chan School of Public Health, Dana-Farber Cancer Institute, Harvard Medical School, Fenway Health, Beth Israel Deaconess Medical Center, and Boston Children's Hospital, Boston, Massachusetts, and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jennifer E. Potter
- From Harvard T.H. Chan School of Public Health, Dana-Farber Cancer Institute, Harvard Medical School, Fenway Health, Beth Israel Deaconess Medical Center, and Boston Children's Hospital, Boston, Massachusetts, and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - S. Bryn Austin
- From Harvard T.H. Chan School of Public Health, Dana-Farber Cancer Institute, Harvard Medical School, Fenway Health, Beth Israel Deaconess Medical Center, and Boston Children's Hospital, Boston, Massachusetts, and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Mullins TLK, Widdice LE, Rosenthal SL, Zimet GD, Kahn JA. Risk perceptions, sexual attitudes, and sexual behavior after HPV vaccination in 11-12 year-old girls. Vaccine 2015; 33:3907-12. [PMID: 26116249 DOI: 10.1016/j.vaccine.2015.06.060] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 06/11/2015] [Accepted: 06/12/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Among 11-12 year-old girls who received the human papillomavirus (HPV) vaccine, we explored, over the subsequent 30 months: (1) trajectories of knowledge about HPV/HPV vaccines and vaccine-related risk perceptions; (2) whether knowledge and risk perceptions impacted sexual attitudes and sexual experience; (3) whether mothers, clinicians, and media influenced girls' risk perceptions, attitudes, and behavior. METHODS Girls and mothers (n=25dyads) completed separate, semi-structured interviews within 2 days of, and 6, 18, and 30 months after, their first HPV vaccine dose. Knowledge, risk perceptions related to HPV and other sexually transmitted infections (STIs), and attitudes about sexual behaviors were assessed. Sexual experience was assessed at girls' 30 month interviews. Clinicians completed interviews at baseline. Transcribed interviews were analyzed using framework analysis. RESULTS Girls' baseline knowledge was poor but often improved with time. Most girls (n=18) developed accurate risk perceptions about HPV but only half (n=12) developed accurate risk perceptions about other STIs by 30 months. The vast majority of girls thought that safer sex was still important, regardless of knowledge, risk perceptions, or sexual experience. Girls whose HPV knowledge was high at baseline or increased over time tended to articulate accurate risk perceptions; those who were able to articulate accurate risk perceptions tended to report not having initiated sexual activity. Girls whose mothers demonstrated higher knowledge and/or communication about HPV vaccination tended to articulate accurate risk perceptions, whereas clinicians and media exposure did not appear to influence risk perceptions. CONCLUSIONS Higher knowledge about HPV vaccines among mothers and girls was linked with more accurate risk perceptions among girls. Clinicians may play an important role in providing education about HPV vaccines to mothers and girls.
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Affiliation(s)
- Tanya L Kowalczyk Mullins
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, MLC 4000, Cincinnati, OH 45229, USA; University of Cincinnati College of Medicine, 3235 Eden Avenue, P.O. Box 670555, Cincinnati, OH 45267, USA.
| | - Lea E Widdice
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, MLC 4000, Cincinnati, OH 45229, USA; University of Cincinnati College of Medicine, 3235 Eden Avenue, P.O. Box 670555, Cincinnati, OH 45267, USA
| | - Susan L Rosenthal
- Departments of Pediatrics and Psychiatry, Columbia University and New York Presbyterian Morgan Stanley Children's Hospital, 622 West 168 Street, Vanderbilt Clinic 4th Floor, Room 402, New York, NY 10032, USA
| | - Gregory D Zimet
- Division of Adolescent Medicine, Indiana University, 410 West 10th Street, HS 1001, Indianapolis, IN 46202, USA
| | - Jessica A Kahn
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, MLC 4000, Cincinnati, OH 45229, USA; University of Cincinnati College of Medicine, 3235 Eden Avenue, P.O. Box 670555, Cincinnati, OH 45267, USA
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Bellinger JD, Millegan W, Abdalla AE. “I'm Not Ashamed to Talk on It!”: African-American Women's Decisions About Cervical Cancer Prevention and Control in South Carolina. Womens Health Issues 2015; 25:120-7. [DOI: 10.1016/j.whi.2014.10.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 10/23/2014] [Accepted: 10/27/2014] [Indexed: 10/24/2022]
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