1
|
Tsui J, Shin M, Sloan K, Martinez B, Palinkas LA, Baezconde-Garbanati L, Cantor JC, Hudson SV, Crabtree BF. Understanding Clinic and Community Member Experiences with Implementation of Evidence-Based Strategies for HPV Vaccination in Safety-Net Primary Care Settings. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:147-162. [PMID: 37368117 PMCID: PMC11133176 DOI: 10.1007/s11121-023-01568-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2023] [Indexed: 06/28/2023]
Abstract
HPV vaccination rates remain below target levels among adolescents in the United States, which is particularly concerning in safety-net populations with persistent disparities in HPV-associated cancer burden. Perspectives on evidence-based strategies (EBS) for HPV vaccination among key implementation participants, internal and external to clinics, can provide a better understanding of why these disparities persist. We conducted virtual interviews and focus groups, guided by the Practice Change Model, with clinic members (providers, clinic leaders, and clinic staff) and community members (advocates, parents, policy-level, and payers) in Los Angeles and New Jersey to understand common and divergent perspectives on and experiences with HPV vaccination in safety-net primary care settings. Fifty-eight interviews and seven focus groups were conducted (n = 65 total). Clinic members (clinic leaders n = 7, providers n = 12, and clinic staff n = 6) revealed conflicting HPV vaccine messaging, lack of shared motivation to reduce missed opportunities and improve workflows, and non-operability between clinic electronic health records and state immunization registries created barriers for implementing effective strategies. Community members (advocates n = 8, policy n = 11, payers n = 8, and parents n = 13) described lack of HPV vaccine prioritization among payers, a reliance on advocates to lead national agenda setting and facilitate local implementation, and opportunities to support and engage schools in HPV vaccine messaging and adolescents in HPV vaccine decision-making. Participants indicated the COVID-19 pandemic complicated prioritization of HPV vaccination but also created opportunities for change. These findings highlight design and selection criteria for identifying and implementing EBS (changing the intervention itself, or practice-level resources versus external motivators) that bring internal and external clinic partners together for targeted approaches that account for local needs in improving HPV vaccine uptake within safety-net settings.
Collapse
Affiliation(s)
- Jennifer Tsui
- University of Southern California, Los Angeles, CA, USA.
| | | | - Kylie Sloan
- University of Southern California, Los Angeles, CA, USA
| | | | | | | | - Joel C Cantor
- Rutgers the State University of New Jersey, New Brunswick, NJ, USA
| | - Shawna V Hudson
- Rutgers the State University of New Jersey, New Brunswick, NJ, USA
| | | |
Collapse
|
2
|
Kluczynski MA, Rodriguez EM, McGillicuddy CS, Schlecht NF. Human Papillomavirus Vaccination in Pediatric, Adolescent, and Young Adult Cancer Survivors-Opportunity to Address Gaps in Cancer Prevention and Survivorship. Vaccines (Basel) 2024; 12:114. [PMID: 38400098 PMCID: PMC10892003 DOI: 10.3390/vaccines12020114] [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: 11/07/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 02/25/2024] Open
Abstract
The risks of secondary cancers associated with human papillomavirus (HPV) infection are as much as three times higher for survivors of pediatric, adolescent, and young adult cancer (PYAC) compared to the general population. Despite this, HPV vaccination rates among PYAC survivors remain low. Whereas pediatric oncology providers endorse HPV vaccination of PYAC survivors, many lack the resources or opportunities to intervene. The responsibility of HPV vaccination, therefore, falls to primary care providers and practices. This article provides an overview of the challenges with HPV vaccination that are distinct to PYAC survivors and discusses potential strategies to increase HPV vaccine coverage in this population.
Collapse
Affiliation(s)
| | | | | | - Nicolas F. Schlecht
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Elm & Carlton Streets, Buffalo, NY 14263, USA; (M.A.K.); (E.M.R.); (C.S.M.)
| |
Collapse
|
3
|
Tsui J, Martinez B, Shin MB, Allee-Munoz A, Rodriguez I, Navarro J, Thomas-Barrios KR, Kast WM, Baezconde-Garbanati L. Understanding medical mistrust and HPV vaccine hesitancy among multiethnic parents in Los Angeles. J Behav Med 2023; 46:100-115. [PMID: 35107656 PMCID: PMC8808279 DOI: 10.1007/s10865-022-00283-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/03/2022] [Indexed: 01/26/2023]
Abstract
Determinants of parental HPV vaccine hesitancy, including medical mistrust and exposure to negative vaccine information, are understudied in racial/ethnic minority communities where vaccine uptake is low. We conducted a cross-sectional survey (March 2021) among parents of adolescents, ages 9-17 years, from an academic enrichment program serving low-income, first-generation, underrepresented minority families in Los Angeles to understand determinants of parental HPV vaccine hesitancy. Parents completed self-administered surveys, including a 9-item HPV vaccine hesitancy scale, in either English, Spanish, or Chinese. Logistic regression was used to identify individual and interpersonal factors associated with parental hesitancy and adolescent HPV vaccination. One-fifth of parents (n = 357) reported high HPV vaccine hesitancy and > 50% reported concerns about safety or side effects. High medical mistrust was associated with high parental HPV vaccine hesitancy (adjusted-OR 1.69, 95% CI: 1.13, 2.37). Community-tailored and multilevel strategies to increase vaccine confidence are needed to improve HPV and other adolescent vaccinations.
Collapse
Affiliation(s)
- Jennifer Tsui
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Bibiana Martinez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Michelle B Shin
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alec Allee-Munoz
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ivonne Rodriguez
- Leslie and William McMorrow Neighborhood Academic Initiative, University of Southern California, Los Angeles, CA, USA
| | - Jazmin Navarro
- Leslie and William McMorrow Neighborhood Academic Initiative, University of Southern California, Los Angeles, CA, USA
| | - Kim R Thomas-Barrios
- Leslie and William McMorrow Neighborhood Academic Initiative, University of Southern California, Los Angeles, CA, USA
| | - W Martin Kast
- Department of Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lourdes Baezconde-Garbanati
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
4
|
Yarıcı F, Mammadov B. An analysis of the knowledge of adults aged between 18 and 45 on HPV along with their attitudes and beliefs about HPV vaccine: the Cyprus case. BMC Womens Health 2023; 23:70. [PMID: 36793099 PMCID: PMC9933404 DOI: 10.1186/s12905-023-02217-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 02/08/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND The aim of this research is to analyze knowledge of adults between 18 and 45 years of age and living in the Northern Cyprus about Human Papilloma Virus (HPV) along with their attitudes and beliefs towards HPV vaccine. MATERIALS AND METHODS The research, which was planned as a descriptive and cross-sectional, was executed on the web. The research was completed with 1108 women and men adults between 18 and 45 years of age, living in the Northern Cyprus and volunteered to participate in the study. RESULTS 51.90% of the adults participating in the study were found to be women, 8.84% had a Sexually transmitted disease (STD) before and 63.27% of the individuals who had a sexually transmitted disease before also had had HPV and they knew it, 77.55% had undergone a treatment for their disease, 59.18% were found to be actively infected with HPV. Statistically significant and positive correlations were determined between the overall scores of the participants from the Human Papillomavirus Knowledge Questionnaire (HPV-KQ) and their scores in the perceived severity, perceived benefits and perceived susceptibility sub-dimensions of the Health Belief Model Scale for Human Papilloma Virus and Its Vaccination (HBMS-HPVV) (p < 0.05). There was a statistically significant and negative correlation between HPV-KQ scores, questions on Current HPV Vaccination Program and the perceived barriers sub-dimension of the HBMS-HPVV whereas there was a statistically significant and positive correlation between the HPV-KQ scores, questions on Current HPV Vaccination Program and the perceived benefits and perceived susceptibility sub-dimensions of the HBMS-HPVV (p < 0.05). CONCLUSIONS It has emerged that the participants do not have enough information about HPV, they do not know the ways and symptoms of protection from HPV, they do not have enough information about early diagnosis and screening, and they know very little about the HPV vaccine. Health policies should be developed to increase the awareness of individuals about HPV, to increase education and to provide free vaccines.
Collapse
Affiliation(s)
- Filiz Yarıcı
- Faculty of Healty, Near East University, Near East Boulevard, 99138, Nicosia, TRNC Mersin 10, Turkey.
| | - Betül Mammadov
- grid.412132.70000 0004 0596 0713Faculty of Healty, Near East University, Near East Boulevard, 99138 Nicosia, TRNC Mersin 10 Turkey
| |
Collapse
|
5
|
Shin MB, Ko LK, Ibrahim A, Mohamed FB, Lin J, Celentano I, Shankar M, Amsalu F, Ali AA, Richardson BA, Taylor VM, Winer RL. The Impact of a Comic Book Intervention on East African-American Adolescents' HPV Vaccine-Related Knowledge, Beliefs and Intentions. J Immigr Minor Health 2022; 24:1489-1500. [PMID: 35357620 PMCID: PMC10129048 DOI: 10.1007/s10903-022-01359-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2022] [Indexed: 11/27/2022]
Abstract
HPV vaccine uptake is low among East African-American (EAA) adolescents. We developed a comic book and evaluated the impact on HPV/HPV-vaccine knowledge, beliefs and vaccine intentions. The intervention was delivered to HPV-unvaccinated EAA adolescents attending educational dinners with their mothers. Adolescents aged 14-17 were sequentially assigned alternately to a pre- or post-test. Results were compared with chi-squared tests and generalized estimating equation models adjusted for age, gender, and mother's language. Among 136 (pre-test = 64, post-test = 72) participants (90% Somali), pre/post differences were observed for proportions of correct responses to questions on HPV (44.0% vs. 82.9%, RR:1.87[95%CI 1.54-2.27]), HPV-vaccine knowledge (42.8% vs. 75.4%, RR:1.74[95%CI 1.46-2.07]), comfort discussing HPV/HPV vaccine with parents (57.8% vs. 90.3% somewhat/very comfortable, RR:1.55[95%CI 1.24-1.94]), and willingness (37.5% vs. 83.3% probably/definitely willing, RR:2.16[95%CI 1.55-3.01]) and intention (34.4% vs. 86.1% somewhat/very likely, RR:2.38[95%CI:1.69-3.37]) to get vaccinated. The intervention improved participants' HPV/HPV-vaccine knowledge, beliefs and vaccine intentions. Similar interventions could be adapted for other racial/ethnic minorities.
Collapse
Affiliation(s)
- Michelle B Shin
- School of Nursing, University of Washington, Seattle, WA, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Linda K Ko
- Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Anisa Ibrahim
- Harborview Medical Center, Department of Pediatrics, University of Washington, Seattle, WA, USA
- Somali Health Board, Seattle, WA, USA
| | | | - John Lin
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Isabelle Celentano
- Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA
| | - Megha Shankar
- Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Medicine, University of California, San Diego, CA, USA
| | - Fanaye Amsalu
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | | | - Barbra A Richardson
- Department of Biostatistics, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Victoria M Taylor
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Rachel L Winer
- Department of Epidemiology, University of Washington, Seattle, WA, USA.
- Department of Epidemiology, University of Washington School of Public Health, 3980 15th Ave NE, Box 351619, Seattle, WA, 98195, USA.
| |
Collapse
|
6
|
Ortiz AC, Akgün KM, Bazan IS. Embracing the Diversity of Latinx Communities to Promote Vaccinations. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2022; 95:257-263. [PMID: 35782479 PMCID: PMC9235259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
While vaccine hesitancy is well documented in the literature among the Latinx community, little attention or effort is given to the nuances among the members of individual communities, such as country of origin, immigration status, generational status, primary language, race, age, sex, gender, or rural residence and how these complexities affect vaccine messaging and uptake. We have evidence that this heterogeneity causes differences in access to healthcare, attitudes towards vaccines, and degree of health disparities. In this review we will describe their impact on vaccination rates in the Latinx community, highlighting missed opportunities for public health outreach, and how targeted messaging could improve vaccine uptake.
Collapse
Affiliation(s)
- Alexander C. Ortiz
- Department of Medicine, Yale School of Medicine, New
Haven, CT, USA,To whom all correspondence should be addressed:
Alexander Ortiz, MD, MS, Department of Internal Medicine, Yale University School
of Medicine;
| | - Kathleen M. Akgün
- Pulmonary, Critical Care and Sleep Medicine, VA
Connecticut Healthcare System, West Haven, CT, USA,Section of Pulmonary, Critical Care, & Sleep
Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Isabel S. Bazan
- Section of Pulmonary, Critical Care, & Sleep
Medicine, Yale University School of Medicine, New Haven, CT, USA
| |
Collapse
|
7
|
Kepka D, Christini K, McGough E, Wagner A, Del Fiol G, Gibson B, Ayres S, Brandt HM, Mann S, Petrik AF, Coronado GD. Successful Multi-Level HPV Vaccination Intervention at a Rural Healthcare Center in the Era of COVID-19. Front Digit Health 2021; 3:719138. [PMID: 34713184 PMCID: PMC8521914 DOI: 10.3389/fdgth.2021.719138] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/21/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives: To develop and test a human papillomavirus (HPV) vaccination intervention that includes healthcare team training activities and patient reminders to reduce missed opportunities and improves the rate of appointment scheduling for HPV vaccination in a rural medical clinic in the United States. Methods: The multi-level and multi-component intervention included healthcare team training activities and the distribution of patient education materials along with technology-based patient HPV vaccination reminders for parents/caregivers and young adult patients. Missed vaccination opportunities were assessed pre- and post-intervention (n = 402 and n = 99, respectively) by retrospective chart review and compared using Pearson χ2. The patient parent/caregiver and young adult patient population (n = 80) was surveyed following the reminder messages and penalized logistic regression quantified unadjusted odds of scheduling a visit. Results: Missed opportunities for HPV vaccination declined significantly from the pre-intervention to the post-intervention period (21.6 vs. 8.1%, respectively, p = 0.002). Participants who recalled receipt of a vaccination reminder had 7.0 (95% CI 2.4–22.8) times higher unadjusted odds of scheduling a visit compared with those who did not recall receiving a reminder. The unadjusted odds of confirming that they had scheduled or were intending to schedule a follow-up appointment to receive the HPV vaccine was 4.9 (95% CI 1.51–20.59) times greater among those who had not received the vaccine for themselves or for their child. Conclusions: Results from this intervention are promising and suggest that vaccination interventions consisting of provider and support staff education and parent/caregiver and patient education materials, and reminders can reduce missed opportunities for vaccinations in rural settings.
Collapse
Affiliation(s)
- Deanna Kepka
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States.,College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Kaila Christini
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Emily McGough
- Telluride Regional Medical Center, Telluride, CO, United States
| | - Anna Wagner
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Guilherme Del Fiol
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States
| | - Bryan Gibson
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States
| | - Shauna Ayres
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, United States
| | - Heather M Brandt
- St. Jude Children's Research Hospital and Comprehensive Cancer Center, Memphis, TN, United States
| | - Sara Mann
- School of Medicine, University of Utah, Salt Lake City, UT, United States
| | - Amanda F Petrik
- Kaiser Permanente Center for Health Research, Portland, OR, United States
| | - Gloria D Coronado
- Kaiser Permanente Center for Health Research, Portland, OR, United States
| |
Collapse
|
8
|
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).
Collapse
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
| |
Collapse
|
9
|
Chu H, Ko LK, Ibrahim A, Mohamed FB, Lin J, Shankar M, Amsalu F, Ali AA, Richardson BA, Taylor VM, Winer RL. The impact of an educational forum intervention on East African mothers' HPV vaccine-related knowledge, attitudes, and intentions to vaccinate their adolescent children. Vaccine 2021; 39:3767-3776. [PMID: 34053792 PMCID: PMC9984200 DOI: 10.1016/j.vaccine.2021.05.029] [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] [Received: 12/07/2020] [Revised: 04/09/2021] [Accepted: 05/08/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE HPV vaccine uptake in U.S. East African adolescents is low. We developed and evaluated a culturally-targeted interactive educational intervention for East African immigrant mothers to increase HPV-vaccine-related knowledge, attitudes, and intentions to vaccinate adolescent children. METHODS Eligible mothers had ≥ 1 11-17-year-old child and reported all children's HPV vaccination status as unvaccinated or unknown. The intervention was delivered via 10 dinners in the Seattle metropolitan area (8 with the Somali community, 2 with the Ethiopian community). Educational presentations and pre/post-tests on knowledge, attitudes, and intentions were conducted in the participants' native language by a co-ethnic physician. Pre/post differences in responses were evaluated with McNemar's tests and GEE models. HPV vaccination uptake 6-months post-intervention was evaluated using state immunization registry data. RESULTS Of 115 participating mothers, most (84%) were Somali and < 40 years of age (60%). Median years of formal education was 8 (range 0-16), and 61% reported a household income <$25,000. Knowledge of HPV/HPV-vaccines was low pre-intervention, with correct responses ranging from 4% to 39% (61%-91% of responses were "not sure"); correct post-intervention responses ranged from 29% to 97%. Pre-intervention, only 12% of mothers thought they had enough information to make a decision about vaccination, compared to 90% post-intervention. Pre-intervention, only 16% of mothers reported that they were somewhat or very likely to vaccinate their child, compared to 83% post-intervention. All pre/post comparisons were statistically significantly different (p < 0.0001). Although mothers were more likely to report correct HPV-related knowledge and positive vaccine attitudes and intentions post-intervention, only two mothers' children initiated HPV vaccination within 6 months after the intervention. CONCLUSIONS Results illustrate that a culturally targeted educational intervention effectively increased East African mothers' HPV vaccine-related knowledge, attitudes, and intentions to vaccinate their adolescent children. Future research should identify additional intervention components that can bridge the gap between intention and behavior to facilitate HPV vaccine uptake.
Collapse
Affiliation(s)
- Huong Chu
- Department of Global Health, University of Washington School of Public Health, 3980 15(th) Ave NE, Box 351620, Seattle, WA 98195, USA.
| | - Linda K. Ko
- Department of Health Services, University of Washington School of Public Health, 3980 15th Ave NE Box 357660, Seattle, WA 98195 USA.,Division of Public Health Services, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N. M3-B232, Seattle, WA 98102 USA
| | - Anisa Ibrahim
- Department of Pediatrics, University of Washington, Harborview Medical Center, 325 9(th) Ave, Seattle, WA 98104, USA; Somali Health Board, 7050 32nd AVE S. Seattle, WA 98118, USA.
| | - Farah Bille Mohamed
- Department of Epidemiology, University of Washington School of Public Health, 3980 15th Ave NE, Box 351619, Seattle, WA 981195 USA
| | - John Lin
- Department of Epidemiology, University of Washington School of Public Health, 3980 15th Ave NE, Box 351619, Seattle, WA 98195, USA.
| | - Megha Shankar
- Department of Medicine, University of Washington, 1959 NE Pacific St, Box 356421, Seattle, WA 98195, USA.
| | - Fanaye Amsalu
- Department of Epidemiology, University of Washington School of Public Health, 3980 15th Ave NE, Box 351619, Seattle, WA 98195, USA.
| | - Ahmed A. Ali
- Somali Health Board, 7050 32nd AVE S. Seattle, WA 98118 USA
| | - Barbra A. Richardson
- Department of Global Health, University of Washington School of Public Health, 3980 15th Ave NE, Box 351620, Seattle, WA 98195, USA.,Department of Biostatistics, University of Washington School of Public Health, 3980 15th Ave NE, Box 351617, Seattle, WA 98195 USA
| | - Victoria M. Taylor
- Division of Public Health Services, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N. M3-B232, Seattle, WA 98102 USA
| | - Rachel L. Winer
- Department of Epidemiology, University of Washington School of Public Health, 3980 15th Ave NE, Box 351619, Seattle, WA 981195 USA
| |
Collapse
|
10
|
Mansfield LN, Vance A, Nikpour JA, Gonzalez-Guarda RM. A systematic review of human papillomavirus vaccination among US adolescents. Res Nurs Health 2021; 44:473-489. [PMID: 33860541 DOI: 10.1002/nur.22135] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 03/29/2021] [Accepted: 04/02/2021] [Indexed: 11/07/2022]
Abstract
The human papillomavirus (HPV) causes many anogenital and oral cancers affecting young adults in the United States. Vaccination during adolescence can prevent HPV-associated cancers, but vaccine uptake among adolescents is low and influenced by factors serving as barriers and facilitators to HPV vaccination. In this systematic review, we synthesized research using the socioecological framework model to examine individual-level, relationship-level, community-level, and societal-level factors that influence HPV vaccine initiation and completion among US adolescents. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to guide the methodology for this review. An electronic search was conducted in January 2020 using PubMed, Cumulative Index of Nursing and Allied Health Literature, ProQuest Central, Scopus, and American Psychological Association PsycInfo databases. The Joanna Briggs Institute tools were used to assess the quality for the 57 studies included in this review. The most consistent influences of HPV vaccination included age at vaccination, awareness, and knowledge about HPV vaccination, socioeconomic status, insurance status, race/ethnicity, and preventative care behaviors at the individual level. Provider recommendation, familial/peer support of vaccination, and parental health behaviors were influences at the relationship level. Although fewer findings elucidated community-level and societal-level influences, high-poverty areas, high-risk communities with large proportions of racial/ethnic minority groups, healthcare facilities servicing children, and combined health policies appear to serve as facilitators of HPV initiation and completion. Findings from this review can inform culturally relevant and age-specific interventions and multi-level policies aiming to improve HPV vaccination coverage in the United States.
Collapse
Affiliation(s)
- Lisa N Mansfield
- School of Nursing, Duke University, Durham, North Carolina, USA.,Division of General Internal Medicine and Health Services Research, National Clinician Scholars Program, University of California, Los Angeles, Los Angeles, California, USA
| | - Ashlee Vance
- Institute for Healthcare Policy and Innovation, National Clinical Scholars Program, University of Michigan, Ann Arbor, Michigan, USA
| | | | | |
Collapse
|
11
|
Morales-Campos DY, Snipes SA, Villarreal EK, Crocker LC, Guerrero A, Fernandez ME. Cervical cancer, human papillomavirus (HPV), and HPV vaccination: exploring gendered perspectives, knowledge, attitudes, and cultural taboos among Mexican American adults. ETHNICITY & HEALTH 2021; 26:206-224. [PMID: 29998738 PMCID: PMC6330137 DOI: 10.1080/13557858.2018.1494821] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 06/11/2018] [Indexed: 06/08/2023]
Abstract
Background: Gendered perspectives may be particularly important in shaping norms and values around HPV and HPV vaccination, as previous research suggests that sexuality taboos (e.g. promiscuity) may contribute to low perceived risk among adolescent and young adult Hispanic females. However, research to date focuses primarily on Hispanic mothers, adolescent females, and women of HPV vaccine-eligible age. Hispanic father's perspectives are relatively unknown despite father's important role in shaping norms for their female children. Objective: To close this gap, this study examines gendered perspectives in knowledge, beliefs, and attitudes about HPV and HPV vaccination from Hispanic parents (mothers and fathers), women of vaccine-eligible age (18-26 years old), and women eligible for Pap Test screening (>26 years old) living in two counties along the Texas-Mexico border. Design: We conducted eight focus groups. Research staff transcribed audio recordings verbatim and uploaded them into Atlas(ti) 5.0 for analysis. The research team analyzed the data for content, meaning, patterns and themes using the constant comparison approach. Results: Perspectives were highly gendered. Women's (all groups combined) beliefs focused on misconceptions around how the HPV virus is contracted (e.g. toilet surfaces). Women also linked HPV-related sexual risk to adultery and indiscretion of male partners. Fathers (men) were more likely to link risk to female promiscuity. Fathers also worried that HPV vaccination might increase promiscuity. All groups believe that HPV vaccination is a way to protect Hispanic females in the face of beliefs around sexual behavior and risk of contracting HPV. Conclusion: Results suggest gendered differences in risk beliefs concerning HPV among Hispanics living along the Texas-Mexico border. Researchers can use these findings to address barriers to HPV vaccination, as well as to create culturally appropriate prevention messages that may help reduce disparities in HPV among Hispanic women.
Collapse
Affiliation(s)
- Daisy Y. Morales-Campos
- Department of Mexican American and Hispanic/a Studies, The
University of Texas at Austin, Austin, USA
| | - S. A. Snipes
- Department of Biobehavioral Health, The Pennsylvania State
University, University Park, USA
| | | | - L. C. Crocker
- Department of Health Services Research, The University of Texas MD
Anderson Cancer Center, USA
| | - A. Guerrero
- Department of Mexican American and Hispanic/a Studies, The
University of Texas at Austin, Austin, USA
| | - M. E. Fernandez
- Department of Health Promotion and Behavioral Sciences, The
University of Texas School of Public Health, Houston, USA
| |
Collapse
|
12
|
Austin JD, Rodriguez SA, Savas LS, Megdal T, Ramondetta L, Fernandez ME. Using Intervention Mapping to Develop a Provider Intervention to Increase HPV Vaccination in a Federally Qualified Health Center. Front Public Health 2020; 8:530596. [PMID: 33392125 PMCID: PMC7775559 DOI: 10.3389/fpubh.2020.530596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 11/18/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: A healthcare provider's ability to give a strong recommendation for the HPV vaccine is of utmost importance in increasing HPV vaccination. To reduce the burden of HPV-related cancers, there is a critical need to develop and implement theory-based interventions aimed at strengthening healthcare providers' communication about the HPV vaccine. Methods: We used Intervention Mapping (IM) steps 1-5 to develop and implement a provider-level intervention that aligns with the priorities and needs of a large, urban Federally Qualified Health Center (FQHC). Results: In step 1, a diverse planning group identified barriers to HPV vaccination in clinical settings and generated process maps and a logic model of the problem. Step 2 outlined outcomes and provider performance objectives of the intervention and identified knowledge, skills, self-efficacy, outcome expectations, and normative beliefs as modifiable targets that need to change for providers to deliver strong recommendations for the HPV vaccine to parents and patients. In step 3, the planning group mapped the methods of persuasive communication, information, and modeling and skills training to behavioral targets and outlined the program practical applications (strategies) components, scope, and sequence. In steps 4 and 5, the planning group produced the intervention and planned for program implementation. The iterative and participatory process of IM resulted in modifications to the initial intervention that aligned with the needs of the FQHC. Discussion: IM provided a systematic, participatory, and iterative approach for developing a theory-based provider-level intervention aimed at strengthening healthcare providers' ability to provide a strong recommendation for the HPV vaccine to eligible patients and parents served by a large FQHC. IM assisted with the identification of behavioral targets and methods that move beyond HPV knowledge and reminders to create behavior change. IM can help researchers and planners describe the processes and rational behind developing interventions and may help to facilitate implementation in real-world clinical settings by tailoring intervention components to the needs of the population.
Collapse
Affiliation(s)
- Jessica D Austin
- The University of Texas Health Science Center School of Public Health, Dallas Regional Campus, Dallas, TX, United States
| | - Serena A Rodriguez
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Lara S Savas
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
| | - Tina Megdal
- Legacy Community Health, Houston, TX, United States
| | - Lois Ramondetta
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Maria E Fernandez
- Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
| |
Collapse
|
13
|
CELLA PAOLA, VOGLINO GIANLUCA, BARBERIS ILARIA, ALAGNA ENRICO, ALESSANDRONI CLAUDIA, CUDA ALESSANDRO, D’ALOISIO FRANCESCO, DALLAGIACOMA GIULIA, DE NITTO SARA, DI GASPARE FRANCESCA, GALLIPOLI ORIANA, GENTILE LEANDRO, KUNDISOV LUCIA, NAVARO MONICA, PROVENZANO SANDRO, SANTANGELO OMARENZO, STEFANIZZI PASQUALE, GIANFREDI VINCENZA. Resources for assessing parents' vaccine hesitancy: a systematic review of the literature. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 61:E340-E373. [PMID: 33150224 PMCID: PMC7595070 DOI: 10.15167/2421-4248/jpmh2020.61.3.1448] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 07/22/2020] [Indexed: 11/17/2022]
Abstract
The concept of Vaccine Hesitancy has begun to appear in the scientific landscape, referring to the reluctance of a growing proportion of people to accept the vaccination offer. A variety of factors were identified as being associated with vaccine hesitancy but there was no universal algorithm and currently there aren’t any established metrics to assess either the presence or impact of vaccine hesitancy. The aim of this study was to systematically review the published questionnaires evaluating parental vaccine hesitancy, to highlight the differences among these surveys and offer a general overview on this matter. This study offers a deeper perspective on the available questionnaires, helping future researches to identify the most suitable one according to their own aim and study setting.
Collapse
Affiliation(s)
- PAOLA CELLA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Medicine and Surgery, University of Parma, Italy
| | - GIANLUCA VOGLINO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, University of Turin, Italy
| | - ILARIA BARBERIS
- Health Science Department, University of Genoa, Italy
- Correspondence: Ilaria Barberis, Health Science Department, University of Genoa, largo Rosanna Benzi 10, Pad. 3 San Martino Hospital, Italy - Tel./Fax +39 010 3538502 - E-mail:
| | - ENRICO ALAGNA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Italy
| | - CLAUDIA ALESSANDRONI
- Post Graduate School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, Rome, Italy
| | - ALESSANDRO CUDA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - FRANCESCO D’ALOISIO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Life, Health and Environmental Sciences, University of L’Aquila, Italy
| | - GIULIA DALLAGIACOMA
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - SARA DE NITTO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Italy
| | - FRANCESCA DI GASPARE
- Post Graduate School of Hygiene and Preventive Medicine, University of Rome Tor Vergata, Rome, Italy
| | - ORIANA GALLIPOLI
- Post Graduate School of Hygiene and Preventive Medicine, Department of Life, Health and Environmental Sciences, University of L’Aquila, Italy
| | - LEANDRO GENTILE
- Post Graduate School of Hygiene and Preventive Medicine, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy
| | - LUCIA KUNDISOV
- Post Graduate School of Public Health, University of Siena, Italy
| | - MONICA NAVARO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Experimental Medicine, University of Campania “L. Vanvitelli”, Italy
| | - SANDRO PROVENZANO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Italy
| | - OMAR ENZO SANTANGELO
- Post Graduate School of Hygiene and Preventive Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, Italy
| | - PASQUALE STEFANIZZI
- Post Graduate School of Hygiene and Preventive Medicine, Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Italy
| | - VINCENZA GIANFREDI
- Post Graduate School of Hygiene and Preventive Medicine, Department of Experimental Medicine, University of Perugia, Italy
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
| |
Collapse
|
14
|
Reiter PL, Pennell ML, Martinez GA, Perkins RB, Katz ML. HPV vaccine coverage across Hispanic/Latinx subgroups in the United States. Cancer Causes Control 2020; 31:905-914. [PMID: 32748100 DOI: 10.1007/s10552-020-01331-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/24/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE Research on HPV vaccine coverage in the United States has typically aggregated Hispanic/Latinx individuals into a single group for analyses, an approach that has potentially masked variation between Hispanic/Latinx subgroups. To address this limitation, we examined HPV vaccine coverage across Hispanic/Latinx subgroups. METHODS We analyzed data on Hispanic/Latinx adolescents ages 13-17 (n = 16,335) from the 2012-2016 National Immunization Survey-Teen. Each adolescent was categorized into a subgroup: Mexican, Cuban, Puerto Rican, Central American, South American, other Spanish origin, or multi-subgroup. We examined HPV vaccine initiation (receipt of one or more doses) and completion (receipt of three doses) for males and females separately. Analyses used weighted logistic regression. RESULTS Vaccine coverage among males was highest among Central Americans (initiation: 57.5%; completion: 31.1%) and lowest among multi-subgroup males (initiation: 46.3%; completion: 19.9%). Among females, initiation ranged from 63.4% among Cubans to 71.2% among Puerto Ricans, and completion ranged from 33.6% among multi-subgroup females to 48.7% among South Americans. Hispanic/Latinx subgroups were similar on these outcomes in regression models. However, within several subgroups, vaccine coverage was higher among adolescents whose parents' preferred language was Spanish (i.e., potentially less acculturated) compared to those whose parents' preferred language was English. CONCLUSIONS Modest variation in HPV vaccine coverage exists across Hispanic/Latinx subgroups, with differences found by preferred language within several subgroups. Findings provide insight into HPV vaccine coverage among Hispanic/Latinx subgroups and can help guide future surveillance efforts and vaccination interventions.
Collapse
Affiliation(s)
- Paul L Reiter
- College of Public Health, The Ohio State University, Columbus, OH, USA.
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
| | - Michael L Pennell
- College of Public Health, The Ohio State University, Columbus, OH, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Glenn A Martinez
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Department of Spanish and Portuguese, The Ohio State University, Columbus, OH, USA
| | | | - Mira L Katz
- College of Public Health, The Ohio State University, Columbus, OH, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| |
Collapse
|
15
|
Btoush R, Brown DR, Tsui J, Toler L, Bucalo J. Knowledge and Attitudes Toward Human Papillomavirus Vaccination Among Latina Mothers of South American and Caribbean Descent in the Eastern US. Health Equity 2019; 3:219-230. [PMID: 31289782 PMCID: PMC6608702 DOI: 10.1089/heq.2018.0058] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Purpose: The purpose of this study was to examine knowledge, attitudes, barriers, and facilitators for human papillomavirus (HPV) vaccination among Latina mothers of HPV vaccine-eligible children in low-income urban areas, as well as useful strategies to improve HPV vaccination. Methods: The study included 132 Latina mothers of HPV vaccine-eligible children, interviewed in 14 focus groups. Using semi-structured discussions, mothers were asked about their knowledge about HPV infection and vaccine, views toward HPV vaccination, barriers for HPV vaccine initiation as well as completion, and opinions on strategies to improve HPV vaccination. Results: Only 55% of mothers reported having ever heard of the HPV vaccine, 27% of mothers indicated initiating the HPV vaccine, and 14% indicated completing the multi-dose series. Mothers generally lacked knowledge about HPV infection and vaccination, with varying degrees by Latino descent. Health care provider (HCP) recommendation was the strongest barrier/facilitator for HPV vaccination. Useful strategies to improve HPV vaccine initiation and completion that the mothers suggested included strong recommendation from HCPs and addressing side effects and safety concerns. Other useful strategies included community and school-based approaches and the use of text messaging and smartphone technology to educate mothers and send vaccine reminders. Conclusion: The findings provide insight for the development of interventions targeting low-income Latina mothers and the need to improve HCP communication on HPV vaccination.
Collapse
Affiliation(s)
- Rula Btoush
- School of Nursing, Rutgers University, Newark, New Jersey
| | - Diane R Brown
- School of Public Health, Rutgers University, Newark, New Jersey
| | - Jennifer Tsui
- Cancer Institute of New Jersey, Rutgers University, New Brunswick, New Jersey
| | - Lindsey Toler
- School of Public Health, Rutgers University, Piscataway, New Jersey
| | - Jennifer Bucalo
- School of Graduate Studies, Rutgers University, Newark, New Jersey
| |
Collapse
|
16
|
Naleway AL, Mittendorf KF, Irving SA, Henninger ML, Crane B, Smith N, Daley MF, Gee J. Primary Ovarian Insufficiency and Adolescent Vaccination. Pediatrics 2018; 142:peds.2018-0943. [PMID: 30131438 PMCID: PMC6719304 DOI: 10.1542/peds.2018-0943] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Published case series have suggested a potential association between human papillomavirus (HPV) vaccination and primary ovarian insufficiency (POI). We describe POI incidence and estimate POI risk after HPV; tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed (Tdap); inactivated influenza (II); and meningococcal conjugate (MenACWY) vaccination. METHODS We searched Kaiser Permanente Northwest electronic health records for outpatient diagnoses suggestive of POI in female patients aged 11 to 34 years between 2006 and 2014. We reviewed and adjudicated the medical record to confirm diagnoses and estimate symptom onset dates. We excluded cases with known causes and calculated the incidence of idiopathic POI. We estimated risk by calculating hazard ratios and 95% confidence intervals (CIs). RESULTS From a cohort of 199 078 female patients, we identified 120 with diagnoses suggestive of POI. After adjudication and exclusion of 26 POI cases with known causes, we confirmed 46 idiopathic POI cases. POI incidence was low in 11- to 14-year-olds (0.87 per 1 000 000 person-months) and increased with age. One confirmed case patient received the HPV vaccine 23 months before the first clinical evaluation for delayed menarche. The adjusted hazard ratio was 0.30 (95% CI: 0.07-1.36) after HPV, 0.88 (95% CI: 0.37-2.10) after Tdap, 1.42 (95% CI: 0.59-3.41) after II, and 0.94 (95% CI: 0.27-3.23) after MenACWY vaccination. CONCLUSIONS We did not find a statistically significant elevated risk of POI after HPV, Tdap, II, or MenACWY vaccination in this population-based retrospective cohort study. These findings should lessen concern about POI risk after adolescent vaccination.
Collapse
Affiliation(s)
- Allison L. Naleway
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon
| | | | | | | | - Bradley Crane
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon
| | - Ning Smith
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon
| | - Matthew F. Daley
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado;,Department of Pediatrics, School of Medicine, University of Colorado, Aurora, Colorado
| | - Julianne Gee
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
17
|
Lai D, Bodson J, Davis FA, Lee D, Tavake-Pasi F, Napia E, Villalta J, Mukundente V, Mooney R, Coulter H, Stark LA, Sanchez-Birkhead AC, Kepka D. Diverse Families' Experiences with HPV Vaccine Information Sources: A Community-Based Participatory Approach. J Community Health 2018; 42:400-412. [PMID: 27734247 DOI: 10.1007/s10900-016-0269-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Current sources of publicly available human papillomavirus (HPV) information may not adequately meet the needs of diverse families. This study sought to describe associations between sociodemographic and acculturation factors, and sources of HPV information among diverse parents and caregivers. Community organizations purposively recruited participants from African American, African refugee, Hispanic/Latino, American Indian, and Native Hawaiian and Pacific Islander communities for a 21-item survey (N = 228). Ninenty-three of these participants also participated in ten focus groups conducted in three languages. Descriptive statistics and Fishers' Exact Test for Count Data were produced and triangulated with focus group data to provide additional context. Overall, HPV vaccine awareness and knowledge in the five communities was low. This study found that a greater proportion of lower-acculturated participants had heard of HPV through personal networks (foreign-born = 50 % vs US-born = 30 %, p < 0.05; medium acculturation = 60 % vs high acculturation = 26 %, p = 0.01), while greater proportions of US-born participants reported media sources (49 % vs foreign-born = 29 %, p < 0.05). Across communities, healthcare system sources were described as important and preferred sources of HPV information. Hearing about the HPV vaccine from healthcare settings was significantly associated with increased accuracy in HPV vaccine knowledge (p < 0.05). Communities described a need for more in-depth information about the HPV vaccine, and culturally and linguistically appropriate educational materials. Culturally-competent delivery of HPV information through the healthcare system sources may be important in improving knowledge and acceptability of the HPV vaccine among diverse families.
Collapse
Affiliation(s)
- Djin Lai
- Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Room 4127, Salt Lake City, UT, 84112, USA. .,College of Nursing, University of Utah, Salt Lake City, UT, USA.
| | - Julia Bodson
- Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Room 4127, Salt Lake City, UT, 84112, USA
| | - France A Davis
- Community Faces of Utah, Salt Lake City, UT, USA.,Calvary Baptist Church, Salt Lake City, UT, USA
| | - Doriena Lee
- Community Faces of Utah, Salt Lake City, UT, USA.,Calvary Baptist Church, Salt Lake City, UT, USA
| | - Fahina Tavake-Pasi
- Community Faces of Utah, Salt Lake City, UT, USA.,National Tongan American Society, Salt Lake City, UT, USA
| | - Edwin Napia
- Community Faces of Utah, Salt Lake City, UT, USA.,Urban Indian Center, Salt Lake City, UT, USA
| | - Jeannette Villalta
- Community Faces of Utah, Salt Lake City, UT, USA.,Hispanic Healthcare Task Force, Salt Lake City, UT, USA
| | - Valentine Mukundente
- Community Faces of Utah, Salt Lake City, UT, USA.,Best of Africa, West Valley, UT, USA
| | - Ryan Mooney
- Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Room 4127, Salt Lake City, UT, 84112, USA
| | - Heather Coulter
- Community Outreach and Collaboration Core, Center for Clinical and Translational Science, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Louisa A Stark
- Community Outreach and Collaboration Core, Center for Clinical and Translational Science, School of Medicine, University of Utah, Salt Lake City, UT, USA.,Department of Human Genetics, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Ana C Sanchez-Birkhead
- College of Nursing, University of Utah, Salt Lake City, UT, USA.,Community Faces of Utah, Salt Lake City, UT, USA.,Hispanic Healthcare Task Force, Salt Lake City, UT, USA
| | - Deanna Kepka
- Cancer Control and Population Sciences, Huntsman Cancer Institute, 2000 Circle of Hope, Room 4127, Salt Lake City, UT, 84112, USA.,College of Nursing, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
18
|
Loke AY, Kwan ML, Wong YT, Wong AKY. The Uptake of Human Papillomavirus Vaccination and Its Associated Factors Among Adolescents: A Systematic Review. J Prim Care Community Health 2017; 8:349-362. [PMID: 29161946 PMCID: PMC5932744 DOI: 10.1177/2150131917742299] [Citation(s) in RCA: 121] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background: The purpose of this review was to explore the uptake of the human papillomavirus (HPV) vaccination, its associated factors, and the facilitators of and barriers to HPV vaccination among adolescents. Methods: A comprehensive literature search was conducted through 5 electronic databases, including PubMed, CINAHL, Cochrane Library, Medline, and PsycInfo from January 2006 to March 2015 for studies examining the uptake, awareness, knowledge, acceptability, and intention of adolescents with regard to HPV vaccination. Results: Twenty-eight studies were identified and included. The HPV vaccination uptake rate (at least 1 dose) varied significantly among countries, ranging from 2.4% to 94.4%. Scotland achieved the highest uptake of all the studies included in this review, while Hong Kong had the lowest, at 2.4% to 9.1%. This review also showed that adolescents had limited awareness and knowledge of HPV infections and vaccines, even 10 years after the vaccine had become available. Conclusions: It is recommended that barriers to the uptake of the vaccine should be addressed, and that school-based sexual health education of HPV infection and vaccine promotion should be reinforced.
Collapse
Affiliation(s)
- Alice Yuen Loke
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR
| | - Miu Ling Kwan
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR.,2 Tuen Mun Hospital, Hospital Authority, Hong Kong SAR
| | - Yuen-Ting Wong
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR
| | - Alice Kar Yan Wong
- 1 The Hong Kong Polytechnic University, Kowloon, Hung Hom, Hong Kong SAR
| |
Collapse
|
19
|
Persuasive texts for prompting action: Agency assignment in HPV vaccination reminders. Vaccine 2017; 35:4295-4297. [PMID: 28673483 DOI: 10.1016/j.vaccine.2017.06.080] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 06/22/2017] [Accepted: 06/23/2017] [Indexed: 11/22/2022]
Abstract
Vaccination reminders must both inform and persuade, and text messages designed for this purpose must do so in 160 characters or less. We tested a strategy for improving the impact of HPV vaccination text message reminders through strategic wording. In an experiment conducted in community settings, 167 Spanish-speaking Latina mothers reviewed text message reminders that assigned the cause or "agency" for HPV transmission to their daughters or the virus, and assigned protection agency to the mothers or the vaccine. Reminder messages framing transmission as an action of the virus prompted mothers to perceive the threat as more severe than messages describing their daughters as the cause. Assigning transmission agency to the virus also held a persuasive advantage in boosting mothers' intentions to seek vaccination, particularly when the message cast mothers as agents of protection rather than the vaccine.
Collapse
|
20
|
Maertens JA, Jimenez-Zambrano AM, Albright K, Dempsey AF. Using Community Engagement to Develop a Web-Based Intervention for Latinos about the HPV Vaccine. JOURNAL OF HEALTH COMMUNICATION 2017; 22:285-293. [PMID: 28276945 DOI: 10.1080/10810730.2016.1275890] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Human papillomavirus (HPV) infection is pervasive among sexually active women and men, and Hispanic women are at particularly high risk as they have higher rates of invasive cervical cancer compared to other racial or ethnic groups in the United States. There is a need for interventions to increase HPV vaccination among this high-risk population. This study investigated how to modify a previously developed web-based intervention that provided individually tailored information about HPV to improve its use among the Latino population. A community-oriented modification approach incorporated feedback from a community advisory committee, and focus groups among the Latino population, to modify the intervention. Several themes emerged including a need for basic information about HPV and HPV vaccination, changes to make the intervention appear less clinical, and incorporation of information addressing barriers specific to the Latino community. This work was done in preparation for a randomized trial to assess the impact of this modified intervention on HPV vaccination attitudes and uptake among Latino young adults and parents of adolescents. If effective, our intervention could be a resource for reducing HPV vaccination concerns, improving immunization rates, and educating Latinos about HPV and the HPV vaccine outside of the time boundaries of the traditional clinical encounter.
Collapse
Affiliation(s)
- Julie A Maertens
- a Adult and Child Consortium for Health Outcomes Research and Delivery Science , University of Colorado Denver , Denver , Colorado , USA
| | - Andrea M Jimenez-Zambrano
- a Adult and Child Consortium for Health Outcomes Research and Delivery Science , University of Colorado Denver , Denver , Colorado , USA
| | - Karen Albright
- b Department of Sociology and Criminology , University of Denver , Denver , Colorado , USA
| | - Amanda F Dempsey
- a Adult and Child Consortium for Health Outcomes Research and Delivery Science , University of Colorado Denver , Denver , Colorado , USA
| |
Collapse
|
21
|
Ribisl KM, Fernandez ME, Friedman DB, Hannon PA, Leeman J, Moore A, Olson L, Ory M, Risendal B, Sheble L, Taylor VM, Williams RS, Weiner BJ. Impact of the Cancer Prevention and Control Research Network: Accelerating the Translation of Research Into Practice. Am J Prev Med 2017; 52:S233-S240. [PMID: 28215371 PMCID: PMC5812747 DOI: 10.1016/j.amepre.2016.08.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/29/2016] [Accepted: 08/18/2016] [Indexed: 12/18/2022]
Abstract
The Cancer Prevention and Control Research Network (CPCRN) is a thematic network dedicated to accelerating the adoption of evidence-based cancer prevention and control practices in communities by advancing dissemination and implementation science. Funded by the Centers for Disease Control and Prevention and National Cancer Institute, CPCRN has operated at two levels: Each participating network center conducts research projects with primarily local partners as well as multicenter collaborative research projects with state and national partners. Through multicenter collaboration, thematic networks leverage the expertise, resources, and partnerships of participating centers to conduct research projects collectively that might not be feasible individually. Although multicenter collaboration is often advocated, it is challenging to promote and assess. Using bibliometric network analysis and other graphical methods, this paper describes CPCRN's multicenter publication progression from 2004 to 2014. Searching PubMed, Scopus, and Web of Science in 2014 identified 249 peer-reviewed CPCRN publications involving two or more centers out of 6,534 total. The research and public health impact of these multicenter collaborative projects initiated by CPCRN during that 10-year period were then examined. CPCRN established numerous workgroups around topics such as: 2-1-1, training and technical assistance, colorectal cancer control, federally qualified health centers, cancer survivorship, and human papillomavirus. This paper discusses the challenges that arise in promoting multicenter collaboration and the strategies that CPCRN uses to address those challenges. The lessons learned should broadly interest those seeking to promote multisite collaboration to address public health problems, such as cancer prevention and control.
Collapse
Affiliation(s)
- Kurt M Ribisl
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Maria E Fernandez
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas
| | - Daniela B Friedman
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina
| | - Peggy A Hannon
- Department of Health Services, University of Washington, Seattle, Washington
| | - Jennifer Leeman
- Department of Health Care Environments, University of North Carolina School of Nursing, Chapel Hill, North Carolina
| | - Alexis Moore
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Lindsay Olson
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Marcia Ory
- Department of Health Promotion and Community Health Sciences, Texas A&M University, College Station, Texas
| | - Betsy Risendal
- Department of Community and Behavioral Health, University of Colorado Denver, Denver, Colorado
| | - Laura Sheble
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Vicky M Taylor
- Department of Health Services, University of Washington, Seattle, Washington
| | - Rebecca S Williams
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Bryan J Weiner
- Department of Health Policy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| |
Collapse
|
22
|
Lechuga J, Vera-Cala L, Martinez-Donate A. HPV Vaccine Awareness, Barriers, Intentions, and Uptake in Latina Women. J Immigr Minor Health 2017; 18:173-8. [PMID: 25432149 DOI: 10.1007/s10903-014-0139-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Latina women are at heightened risk of cervical cancer incidence and mortality. The human papillomavirus (HPV) is the principal cause of the majority of cervical cancer cases. A vaccine that protects against HPV was licensed in 2006. Eight years post-licensure, mixed research findings exist regarding the factors that predict vaccine uptake in Latinas. We conducted a population-based phone survey with a random sample of 296 Latinas living in a Midwestern U.S. City. Intention to vaccinate was significantly associated with health care provider recommendations, worry about side effects, knowing other parents have vaccinated, perceived severity of HPV, and worry that daughter may become sexually active following vaccination. Worry that daughter may become sexually active was the only factor related to vaccine uptake. Findings suggest that training providers to discuss the low risk of severe side effects, consequences of persistent HPV, and sexuality related concerns with Latino women may encourage vaccination.
Collapse
Affiliation(s)
- Julia Lechuga
- Psychology Department, The University of Texas at El Paso, 500 W. University Avenue, El Paso, TX, 79912, USA.
| | - Lina Vera-Cala
- Department of Public Health, Universidad Industrial de Santander, Bucaramanga, Colombia
- Department of Population Health Sciences, University of Wisconsin-Madison, 610 Walnut St., 605 WARF, Madison, WI, 53705, USA
| | - Ana Martinez-Donate
- Department of Population Health Sciences, University of Wisconsin-Madison, 610 Walnut St., 605 WARF, Madison, WI, 53705, USA
| |
Collapse
|
23
|
Abstract
OBJECTIVES To provide an overview of human papillomavirus (HPV) vaccination as cancer prevention with current strategies that nurses can use to help patients and parents overcome barriers to HPV vaccination. DATA SOURCES Peer-reviewed literature, presentation abstracts, and current immunization recommendations from the Advisory Council on Immunization Practice. CONCLUSION Nurses can help prevent cancer by encouraging HPV vaccination during routine immunization and make HPV vaccination normal and routine. IMPLICATIONS FOR NURSING PRACTICE A vaccine to reduce/eliminate HPV-related cancers enables nurses' at all educational levels to advocate for cancer prevention through initiation and completion of the HPV vaccine series.
Collapse
Affiliation(s)
- Tami L. Thomas
- Nicole Wertheim College of Nursing and Health Sciences, Florida International University, 11200 SW 8 Street, AHC -3, Miami, Florida 33199
| |
Collapse
|
24
|
Chan A, Brown B, Sepulveda E, Teran-Clayton L. Evaluation of fotonovela to increase human papillomavirus vaccine knowledge, attitudes, and intentions in a low-income Hispanic community. BMC Res Notes 2015; 8:615. [PMID: 26514184 PMCID: PMC4625467 DOI: 10.1186/s13104-015-1609-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 10/19/2015] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND It has nearly been a decade since the introduction of the vaccine against human papillomavirus (HPV), yet vaccination rates in the United States have remained suboptimal, particularly among Hispanics. Culturally and linguistically relevant health education tools targeting Hispanics are needed to increase the current rate of HPV vaccination. This article evaluates a theory-informed, evidence-guided fotonovela (photographic short story) intervention to improve HPV vaccination knowledge, attitudes, and intention among young adults. METHODS Young adults (N = 41, aged 18-26 years) in a low-income primary care clinic in Southern California were administered pre- and post-intervention surveys to measure changes in perceived susceptibility to HPV, perceived benefit of vaccination in committed relationship, intention to vaccinate, intention to encourage social networks to vaccinate, and attitude towards vaccination. Post-intervention survey also examined attitudes towards fotonovela. Relationships between attitudes towards fotonovela and demographic characteristics were assessed with Fisher's exact test. Self-reported gains in knowledge were categorized and tabulated. Changes in perceptions and intentions were analyzed with the marginal homogeneity test. RESULTS The majority of participants were female (78.0%), Latino/Hispanic (92.7%), single (70.7%), and had at least a college education (61.0%). The mean age was 21.9 years (SD 0.4). The fotonovela was viewed as entertaining (95.1%), educational (97.6%), and easy to read (100 %). Following the intervention, Hispanic participants improved in all five variables of interest measured in the survey, including perceived susceptibility (+10.5%, p = 0.03), benefit of vaccination (+7.8%, p = 0.25), intent to vaccinate (+18.4%, p = 0.06), intent to encourage others to vaccinate (+10.5%, p = 0.14) and attitude towards vaccination (+13.1%, p = 0.05). Improvements in perceived susceptibility and attitude towards vaccination reached statistical significance (p < 0.05). The most frequent gains in knowledge were the risk of HPV infection despite condom use (N = 16) and relationship status (N = 8), three-dose vaccine administration schedule (N = 13), and burden of HPV infection among males (N = 9). CONCLUSION Results are promising because they demonstrate that health messages delivered through a narrative format can promote positive changes in knowledge, attitudes, and intentions. The fotonovela may be a powerful vehicle for HPV education, particularly among Hispanics.
Collapse
Affiliation(s)
- Alvin Chan
- School of Medicine, University of California, Irvine, Irvine, CA, USA.
| | - Brandon Brown
- Center for Healthy Communities, School of Medicine, University of California, Riverside, Riverside, CA, USA.
| | - Enedina Sepulveda
- Department of Population Health and Disease Prevention, Program in Public Health, University of California, Irvine, Irvine, CA, USA.
| | | |
Collapse
|
25
|
Fernández ME, Le YCL, Fernández-Espada N, Calo WA, Savas LS, Vélez C, Aragon AP, Colón-López V. Knowledge, attitudes, and beliefs about human papillomavirus (HPV) vaccination among Puerto Rican mothers and daughters, 2010: a qualitative study. Prev Chronic Dis 2014; 11:E212. [PMID: 25474384 PMCID: PMC4264466 DOI: 10.5888/pcd11.140171] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Introduction The incidence of human papillomavirus (HPV) infection and cervical cancer can be reduced by increasing vaccination for HPV. Yet vaccination uptake and completion of the 3-dose series remain low among Puerto Rican females. This study explored psychosocial factors associated with HPV vaccination uptake decisions among Puerto Rican mothers and daughters. Methods We conducted 7 focus groups with young women aged 16 to 24 (n = 21) and their mothers (n = 9) to assess knowledge, attitudes, and beliefs related to cervical cancer, HPV, and HPV vaccination. We analyzed the focus group transcripts and identified themes by using a constant comparison method of qualitative data analysis and interpretation, guided by a grounded theory approach. Results The analysis identified several emergent themes related to vaccine uptake: 1) low knowledge about cervical cancer, HPV, and the HPV vaccine; 2) inconsistent beliefs about susceptibility to HPV infection and cervical cancer; 3) vaccine effectiveness; 4) vaccine safety and side effects; 5) concerns that the vaccine promotes sexual disinhibition; and 6) availability of insurance coverage and overall cost of the vaccine. Conclusion Our study found that adolescent girls and young women in Puerto Rico have low levels of knowledge about HPV and cervical cancer, low perceived susceptibility to HPV, and concerns about the safety and efficacy of the vaccine, and these factors may influence uptake and completion of HPV vaccination. Interventions are needed for both mothers and daughters that address these psychosocial factors and increase access to vaccination.
Collapse
Affiliation(s)
- María E Fernández
- The University of Texas School of Public Health, Center for Health Promotion and Prevention Research, 7000 Fannin UCT no. 2558, Houston, TX 77030. E-mail:
| | - Yen-Chi L Le
- The University of Texas School of Public Health, Center for Health Promotion and Prevention Research, Houston, Texas
| | - Natalie Fernández-Espada
- The University of Texas School of Public Health, Center for Health Promotion and Prevention Research, Houston, Texas
| | - William A Calo
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Lara S Savas
- The University of Texas School of Public Health, Center for Health Promotion and Prevention Research, Houston, Texas
| | | | | | | |
Collapse
|
26
|
Glenn BA, Tsui J, Singhal R, Sanchez L, Nonzee NJ, Chang LC, Taylor VM, Bastani R. Factors associated with HPV awareness among mothers of low-income ethnic minority adolescent girls in Los Angeles. Vaccine 2014; 33:289-93. [PMID: 25434792 DOI: 10.1016/j.vaccine.2014.11.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 10/29/2014] [Accepted: 11/18/2014] [Indexed: 11/26/2022]
Abstract
Among caregivers of adolescent girls, awareness of human papillomavirus (HPV) is strongly associated with vaccine uptake. Little is known, however, about the predictors of HPV awareness among low-income ethnic minority groups in the U.S. The purpose of this study is to understand demographic factors associated with HPV awareness among low-income, ethnic minority mothers in Los Angeles County. We conducted a cross-sectional study of caregivers of adolescent girls through the Los Angeles County Department of Public Health Office of Women's Health's hotline. The majority of the participants were foreign-born (88%), one quarter lacked a usual source of care, and one quarter lacked public or private health insurance for their daughter. We found that one in three participants had never heard of HPV or the vaccine. Mothers that were unaware of HPV were significantly more likely to conduct the interview in a language other than English and to lack health insurance for their daughters. HPV vaccine awareness was much lower in our caregiver sample (61%) than in a simultaneous national survey of caregivers (85%). The associations between lack of awareness and use of a language other than English, as well as lack of health insurance for their daughter indicate the need for HPV vaccine outreach efforts tailored to ethnic minority communities in the U.S.
Collapse
Affiliation(s)
- Beth A Glenn
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, 650 Charles Young Drive South, A2-125 CHS, Los Angeles, CA 90095-6900, USA; Cancer Prevention and Control Research Center, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 650 Charles Young Drive South, A2-125 CHS, Los Angeles, CA 90095-6900, USA.
| | - Jennifer Tsui
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, 650 Charles Young Drive South, A2-125 CHS, Los Angeles, CA 90095-6900, USA; Cancer Prevention and Control Research Center, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 650 Charles Young Drive South, A2-125 CHS, Los Angeles, CA 90095-6900, USA.
| | - Rita Singhal
- Office of Women's Health, Los Angeles County Department of Public Health, 3400 Aerojet, 3rd Floor, El Monte, CA 91731-2803, USA.
| | - Leah Sanchez
- Cancer Prevention and Control Research Center, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 650 Charles Young Drive South, A2-125 CHS, Los Angeles, CA 90095-6900, USA.
| | - Narissa J Nonzee
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, 650 Charles Young Drive South, A2-125 CHS, Los Angeles, CA 90095-6900, USA; Cancer Prevention and Control Research Center, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 650 Charles Young Drive South, A2-125 CHS, Los Angeles, CA 90095-6900, USA.
| | - L Cindy Chang
- Cancer Prevention and Control Research Center, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 650 Charles Young Drive South, A2-125 CHS, Los Angeles, CA 90095-6900, USA.
| | - Victoria M Taylor
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, (M3-B232), Seattle, WA 98109-4433, USA.
| | - Roshan Bastani
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, 650 Charles Young Drive South, A2-125 CHS, Los Angeles, CA 90095-6900, USA; Cancer Prevention and Control Research Center, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 650 Charles Young Drive South, A2-125 CHS, Los Angeles, CA 90095-6900, USA.
| |
Collapse
|