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Choi J, Cuccaro P, Markham C, Kim S, Tamí-Maury I. Human papillomavirus (HPV) vaccination in males: Associations of HPV-related knowledge and perceptions with HPV vaccination intention among Korean mothers of boys. Prev Med Rep 2024; 37:102566. [PMID: 38205168 PMCID: PMC10776780 DOI: 10.1016/j.pmedr.2023.102566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
Objectives Human papillomavirus (HPV) vaccination rates among males are suboptimal worldwide. In South Korea, little is known about parents' intention to vaccinate boys against HPV. Therefore, we examined the associations of HPV-related knowledge and perceptions with vaccination intention among Korean mothers of boys. Methods From August to December 2021, eligible mothers were surveyed about HPV-related knowledge, perceptions, and intention to vaccinate their sons against HPV. Mothers were categorized into no intention, contemplating, and intention to vaccinate groups. Using analysis of variance, we compared the groups' scores on the scales measuring HPV-related knowledge, attitudes, and beliefs. We conducted a multinomial logistic regression analysis to assess the associations between the variables and vaccination intention. Results Among 361 mothers, 43.9 % had no intention, 60.7 % were contemplating, and 4.4 % intended to vaccinate their sons. The mean percentage of correct answers on the HPV and vaccine knowledge scales were 52.5 % and 62.3 %, respectively. The mean scores on the HPV attitudes and beliefs subscales were significantly different. Higher scores on benefits (OR = 3.04, 95 % CI 1.96 - 4.70; OR = 3.94, 95 % CI 1.54 - 10.70) and influence (OR = 1.48, 95 % CI 1.03 - 2.13; OR = 2.97, 95 % CI 1.44 - 6.14) were associated with contemplating the vaccine and intending to vaccinate sons. Knowledge was not associated with mothers' vaccination intention. Conclusions Public health authorities and healthcare providers in Korea can use the results of this study to implement effective interventions that emphasize the importance of male HPV vaccination and encourage parent-son communication about the vaccine.
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Affiliation(s)
- Jihye Choi
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Paula Cuccaro
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Christine Markham
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Sooyoun Kim
- Institute of Health and Environment, Seoul National University, Seoul, South Korea
| | - Irene Tamí-Maury
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center at Houston, Houston, TX, United States
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Restivo V, Bruno A, Minutolo G, Pieri A, Riggio L, Zarcone M, Candiloro S, Caldarella R, Immordino P, Amodio E, Casuccio A. Changes in Students' Perceptions Regarding Adolescent Vaccinations through a Before-After Study Conducted during the COVID-19 Pandemic: GIRASOLE Project Study. Vaccines (Basel) 2023; 11:1524. [PMID: 37896928 PMCID: PMC10610628 DOI: 10.3390/vaccines11101524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/22/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023] Open
Abstract
The COVID-19 pandemic caused a reduction in vaccination coverage for all age groups, especially in non-infant age. The main objective of the present study is to evaluate the effectiveness of an online intervention conducted among adolescents during the COVID-19 pandemic in increasing knowledge and positive attitudes toward vaccinations. The study, which took place online from March to May 2021, involved 267 students from six lower secondary schools in Palermo city (Italy); they filled out the questionnaire before and after the intervention. The questionnaire was based on the protection motivation theory (PMT), which estimates the improvement in vaccination-related knowledge and attitudes. The pre- and post-intervention comparison showed a significant increase in the perception of the disease severity: strongly agree pre-intervention n = 150 (58.6%) and post-intervention n = 173 (67.6%, p < 0.001), rated on a five-point Likert scale. In a multivariate analysis, the factor associated with the improvement in the score after the intervention was the school dropout index (low vs. very high dropout index OR 4.5; p < 0.03). The educational intervention was more effective in schools with lower early school leaving rates, an indirect index of socio-economic status. The topic of vaccination has caught the adolescents' attention, it is, therefore, important that interventions tackling teenagers are tailored to reduce their emotional tension about the perception of adverse effects and improve vaccination coverage.
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Affiliation(s)
- Vincenzo Restivo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (A.B.); (G.M.); (L.R.); (S.C.); (P.I.); (E.A.); (A.C.)
| | - Alessandra Bruno
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (A.B.); (G.M.); (L.R.); (S.C.); (P.I.); (E.A.); (A.C.)
| | - Giuseppa Minutolo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (A.B.); (G.M.); (L.R.); (S.C.); (P.I.); (E.A.); (A.C.)
| | - Alessia Pieri
- Clinical Epidemiology and Cancer Registry Unit, University Hospital “P. Giaccone”, Via del Vespro 133, 90127 Palermo, Italy; (A.P.); (M.Z.); (R.C.)
| | - Luca Riggio
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (A.B.); (G.M.); (L.R.); (S.C.); (P.I.); (E.A.); (A.C.)
| | - Maurizio Zarcone
- Clinical Epidemiology and Cancer Registry Unit, University Hospital “P. Giaccone”, Via del Vespro 133, 90127 Palermo, Italy; (A.P.); (M.Z.); (R.C.)
| | - Stefania Candiloro
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (A.B.); (G.M.); (L.R.); (S.C.); (P.I.); (E.A.); (A.C.)
| | - Rosalia Caldarella
- Clinical Epidemiology and Cancer Registry Unit, University Hospital “P. Giaccone”, Via del Vespro 133, 90127 Palermo, Italy; (A.P.); (M.Z.); (R.C.)
| | - Palmira Immordino
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (A.B.); (G.M.); (L.R.); (S.C.); (P.I.); (E.A.); (A.C.)
| | - Emanuele Amodio
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (A.B.); (G.M.); (L.R.); (S.C.); (P.I.); (E.A.); (A.C.)
| | - Alessandra Casuccio
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (A.B.); (G.M.); (L.R.); (S.C.); (P.I.); (E.A.); (A.C.)
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Asare M, Agyei-Baffour P, Koranteng A, Commeh ME, Fosu ES, Elizondo A, Sturdivant RX. Assessing the Efficacy of the 3R (Reframe, Reprioritize, and Reform) Communication Model to Increase HPV Vaccinations Acceptance in Ghana: Community-Based Intervention. Vaccines (Basel) 2023; 11:890. [PMID: 37242995 PMCID: PMC10223469 DOI: 10.3390/vaccines11050890] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/20/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
The study examined whether the 3R (reframe, prioritize, and reform) communication model intervention can impact parents' and adolescents' HPV vaccination acceptability. We used face-to-face methods to recruit participants from three local churches in the Ashanti Region of Ghana. Participants completed pre- and post-intervention assessments based on the validated Theory of Planned Behavior survey. We organized two face-to-face presentations for parents and adolescents separately for parents (n = 85) and adolescents (n = 85). Participants' post-intervention vs. pre-intervention scores for attitude (mean = 35.46 ± SD = 5.46 vs. mean = 23.42 ± SD = 8.63), knowledge (M = 28.48 ± SD = 5.14 vs. M = 16.56 ± SD = 7.19), confidence (M = 8.96 ± SD = 3.43 vs. M = 6.17 ± SD = 2.84), and intention for vaccine acceptance (M = 4.73 ± SD = 1.78 vs. M = 3.29 ± SD = 1.87) increased significantly (p < 0.001). The intervention showed that for every one-unit increase in the participants' self-confidence and attitude scores, the odds of the HPV vaccination acceptability increased by 22% (95% CI: 10-36) and 6% (95% CI: 0.1-12), respectively. Intention for vaccine acceptance, F (1167) = 6.89, and attitude toward vaccination, F (1167) = 19.87, were significantly higher among parents than adolescents (p < 0.001), after controlling for the baseline scores. These findings suggest that the intervention targeting parents' and adolescents' attitudes and knowledge has the potential to increase HPV vaccination acceptance in Ghana.
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Affiliation(s)
- Matthew Asare
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76798, USA;
| | - Peter Agyei-Baffour
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi P.O. Box UPO-1279, Ghana; (P.A.-B.); (A.K.)
| | - Adofo Koranteng
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi P.O. Box UPO-1279, Ghana; (P.A.-B.); (A.K.)
| | - Mary E. Commeh
- Non-Communicable Disease Control, Ghana Health Services, Accra P.O. Box MB-582, Ghana;
| | - Emmanuel Sarfo Fosu
- Department of Statistical Science, College of Arts & Sciences, Baylor University, Waco, TX 76798, USA; (E.S.F.); (R.X.S.)
| | - Anjelica Elizondo
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76798, USA;
| | - Rodney X. Sturdivant
- Department of Statistical Science, College of Arts & Sciences, Baylor University, Waco, TX 76798, USA; (E.S.F.); (R.X.S.)
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Choi J, Kim S, Lee SJ, Bae S, Kim S. Human Papillomavirus (HPV) Vaccination Intent among Mothers of Adolescent Sons: A National Survey on HPV Knowledge, Attitudes and Beliefs in South Korea. World J Mens Health 2023; 41:413-421. [PMID: 35791296 PMCID: PMC10042655 DOI: 10.5534/wjmh.210262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/01/2022] [Accepted: 03/20/2022] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Human papillomavirus (HPV) is one of the most common sexually transmitted infections affecting both males and females but there is an apparent lack of knowledge and apprehension towards male HPV vaccination South Korea. The purpose of the present study was to examine the associations between knowledge and perceptions of male HPV vaccination and vaccination intent among Korean mothers of adolescent sons. MATERIALS AND METHODS We conducted a cross-sectional study using a nationwide online survey. The independent variables were mothers' sociodemographic characteristics, history of HPV diagnosis, general HPV knowledge, HPV vaccine knowledge, and attitudes and beliefs towards male HPV vaccination. The outcome variable was mothers' intent to vaccinate their sons, which was classified into three categories: non-intent, undecided and intend to vaccinate. We performed univariate analysis and multinomial logistic regression analysis. RESULTS A total of 906 eligible mothers completed the survey. Mothers received low scores on the HPV-related knowledge scales with low ratings on the scale measuring perceived risk of HPV. Approximately 10% of the mothers intended to vaccinate their sons against HPV, 61.0% were undecided and 1.5% already had their sons vaccinated. According to the multinominal logistic regression analysis, having a daughter in the family, mothers' previous diagnosis with HPV, general HPV knowledge, influence, harm, and risk were significantly associated with being undecided and having intentions to vaccinate their sons (p<0.05). CONCLUSIONS Our study revealed that Korean mothers are generally less aware of male HPV vaccination, have low perceived risk of HPV, and remain highly hesitant on vaccinating their sons against HPV. It is therefore important to raise public awareness about male HPV vaccination and alleviate vaccine hesitancy. Such efforts will contribute to improving parents' vaccination intent, increasing vaccine uptake among male adolescents and prevention of HPV-associated diseases.
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Affiliation(s)
- Jihye Choi
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Seyoung Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Seung-Ju Lee
- Department of Urology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sangrak Bae
- Department of Urology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sooyoun Kim
- Institute of Health and Environment, Seoul National University, Seoul, Korea.
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5
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Zou X, Chen Q, Zhang Y, Evans R. Predicting COVID-19 vaccination intentions: the roles of threat appraisal, coping appraisal, subjective norms, and negative affect. BMC Public Health 2023; 23:230. [PMID: 36732695 PMCID: PMC9893978 DOI: 10.1186/s12889-023-15169-x] [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: 05/20/2022] [Revised: 01/25/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND As a new disease, communities possess little natural immunity to COVID-19 and vaccines are considered critical to preventing and reducing the incidence of severe illness. This study, inspired by Protection Motivation Theory (PMT), examines the relationship between citizens' threat appraisal, coping appraisal, subjective norms, negative affect, and their COVID-19 vaccination intentions. METHODS A sample of 340 citizens from two main cities in Mainland China, Xi'an and Wuxi, was used for data analysis. Structural Equation Modeling (SEM) was employed with latent and observed variables to test hypotheses. Data were analyzed using AMOS 24.0. RESULTS Several findings extend current understanding. Firstly, our proposed model explains 73% of the variance in vaccination intentions. Secondly, perceived severity only indirectly shapes COVID-19 vaccination intentions through negative affect. Thirdly, negative affect and response costs are negatively related to COVID-19 vaccination intentions. Finally, Perceived probability, subjective norms, response efficacy and self-efficacy are positively related to COVID-19 vaccination intentions; among them, self-efficacy contributes the most, followed by response efficacy and subjective norms, and lastly perceived probability. CONCLUSION Theoretically, this study increases current understanding about subjective norms and affective responses. We provoke a certain amount of thought about the role of affect response in relation to threat appraisal and vaccination intentions. Specifically, governments must be vigilant that citizens' negative affect, such as fear, may cause vaccine hesitation.
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Affiliation(s)
- Xia Zou
- grid.43169.390000 0001 0599 1243School of Journalism and New Media, Xi’an Jiaotong University, Xi’an, China
| | - Qiang Chen
- School of Journalism and New Media, Xi'an Jiaotong University, Xi'an, China.
| | - Yangyi Zhang
- grid.43169.390000 0001 0599 1243School of Journalism and New Media, Xi’an Jiaotong University, Xi’an, China
| | - Richard Evans
- grid.55602.340000 0004 1936 8200Faculty of Computer Science, Dalhousie University, Halifax, Canada
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6
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Tang S, Liu X, Jia Y, Chen H, Zheng P, Fu H, Xiao Q. Education level modifies parental hesitancy about COVID-19 vaccinations for their children. Vaccine 2023; 41:496-503. [PMID: 36494253 PMCID: PMC9705202 DOI: 10.1016/j.vaccine.2022.11.060] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 11/19/2022] [Accepted: 11/22/2022] [Indexed: 11/30/2022]
Abstract
It is important to encourage parental acceptance of children's vaccination against COVID-19 to ensure population immunity and mitigate morbidity and mortality. This study drew upon protection motivation theory (PMT) to explore the factors of parental hesitancy about vaccinating their children. A national online survey was performed in China. A total of 2054 Chinese parents of children aged 6-12 years were included in this study. They reported on measures that assessed hesitancy about children's vaccination against COVID-19, PMT constructs (susceptibility, severity, response efficacy, self-efficacy, and response costs) and sociodemographic characteristics. Chinese parents reported a hesitancy rate of 29.4% for children's vaccination. Parents with higher level education were more likely to hesitate to vaccinate their children against COVID-19. After controlling for parents' and children's demographic variables, logistic regression showed that parents' hesitancy about their children's vaccination increased if parents had lower levels of susceptibility, response efficacy or self-efficacy, as well as higher levels of response costs. In addition, a high educational level can significantly increase the promotive effect of response cost and the protective effect of response efficacy on vaccine hesitancy. In conclusion, our findings suggested that PMT can explain parents' vaccine hesitancy and that education level can modify the effect of copying appraisal, but not threat appraisal, on parental hesitancy. This study will help public health officials send targeted messages to parents to improve the rate of COVID-19 vaccination in children aged 6-12 years and thus reach a higher level of immunity in the population.
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Affiliation(s)
- Shuning Tang
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, China
| | - Xin Liu
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, China
| | - Yingnan Jia
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, China,School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Hao Chen
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, China
| | - Pinpin Zheng
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, China,School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Hua Fu
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, China,School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
| | - Qianyi Xiao
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, China; School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China.
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Reiter PL, Gower AL, Kiss DE, Shoben AB, Katz ML, Bauermeister JA, Paskett ED, McRee AL. Effects of a web-based HPV vaccination intervention on cognitive outcomes among young gay, bisexual, and other men who have sex with men. Hum Vaccin Immunother 2022; 18:2114261. [PMID: 36069662 DOI: 10.1080/21645515.2022.2114261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Knowledge, attitudes, and beliefs are important antecedents to HPV vaccination, yet remain suboptimal among young gay, bisexual, and other men who have sex with men (YGBMSM). We report the effects of a theoretically-informed, web-based HPV vaccination intervention on these cognitive outcomes. From 2019-2021, we recruited a national sample of YGBMSM ages 18-25 in the United States who were unvaccinated against HPV (n = 1,227). Participants received either standard HPV vaccination information online (control) or population-targeted, individually-tailored content online (Outsmart HPV intervention). Mixed effects models determined if pre-post changes in cognitive outcomes differed between study groups. For five of seven knowledge items about HPV, there were larger pre-post increases among the intervention group than the control group in the percentage of participants who provided correct responses (all statistically significant at p = .05 after Holm's correction). There were also larger pre-post improvements among the intervention group than the control group for most attitudes and beliefs examined, including response efficacy of HPV vaccine (pre-post increases in means: 0.57 vs. 0.38); self-efficacy for the HPV vaccination process (pre-post increases in means: 0.23 vs. 0.10); and intention to get HPV vaccine (pre-post increases in means: 0.70 vs. 0.28) (all statistically significant at p = .05 after Holm's correction). Outsmart HPV is a promising tool for improving key cognitive antecedents to HPV vaccination among YGBMSM, supporting the use of theoretically-informed interventions to affect such outcomes. If efficacious in increasing HPV vaccine uptake in future analyses, this intervention could be utilized in clinical and other healthcare settings that provide services to YGBMSM.
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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
| | - Amy L Gower
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Dale E Kiss
- College of Public Health, The Ohio State University, Columbus, OH, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Abigail B Shoben
- College of Public Health, The Ohio State University, Columbus, OH, USA.,Comprehensive Cancer Center, 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
| | - José A Bauermeister
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Electra D Paskett
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.,Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Annie-Laurie McRee
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.,Center for Scientific Review, National Institutes of Health, Bethesda, MD, USA
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Acar D, Kıcali ÜÖ. An Integrated Approach to COVID-19 Preventive Behaviour Intentions: Protection Motivation Theory, Information Acquisition, and Trust. SOCIAL WORK IN PUBLIC HEALTH 2022; 37:419-434. [PMID: 34962187 DOI: 10.1080/19371918.2021.2018082] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
COVID-19 has been a global threat since November 2019 due to its high transmission rates and the issue of unwillingness to vaccinate. Effective risk management requires accurate health communication and public compliance with reccomended preventive behaviors. Therefore, we investigated predictors of COVID-19 preventive behavior intention based on Protection Motivation Theory (PMT) in addition to frequency of public's use of and trust in a group of COVID-19 related information sources. This cross-sectional study was conducted on 458 adults in Turkey with online survey. Results showed that all PMT components (except perceived susceptibility) accounted for 49% of the variance in protection motivation and there was relationship between information sources and protection motivation. Overall, our study findings suggested that being more informed and having confidence in the feasibility (self-efficacy) and effectiveness (response efficacy) of preventive behaviors may particularly help slow the disease spread.
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Affiliation(s)
- Didem Acar
- Psychology Department, Bursa Uludağ University, Bursa, Turkey
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9
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Wang Y, Zhang X. Influence of Parental Psychological Flexibility on Pediatric COVID-19 Vaccine Hesitancy: Mediating Role of Self-Efficacy and Coping Style. Front Psychol 2021; 12:783401. [PMID: 34956003 PMCID: PMC8692367 DOI: 10.3389/fpsyg.2021.783401] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 11/08/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Pediatric COVID-19 vaccine hesitancy hinders the establishment of immune barrier in children. Psychological flexibility may be a key contributing factor to pediatric COVID-19 vaccine hesitancy, and self-efficacy and coping style play an important role in the relationship, but the underlying mechanisms remain unknown. Methods: A cross-sectional study was conducted on parents from June 2021 to July 2021. A total of 382 parents were recruited for an online-investigation. Serial mediation models were used to examine whether self-efficacy and coping style mediated in the psychological flexibility-pediatric COVID-19 vaccine hesitancy linkage. Result: Psychological flexibility was negatively related to pediatric COVID-19 vaccine hesitancy (r = −0.198, P < 0.001). Coping styles rather than self-efficacy played a mediating role independently (95% CI: −0.263 to −0.058). Serial mediation analyses indicated that self-efficacy and coping style co-play a serial mediating role in the association of psychological flexibility and pediatric COVID-19 vaccine hesitancy (95% CI: −0.037 to −0.001). Conclusion: The present study showed that high psychological flexibility, high self-efficacy, and positive coping style were conducive to the lower pediatric COVID-19 vaccine hesitancy.
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Affiliation(s)
- Yongyi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinping Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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10
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Olagoke A, Caskey R, Floyd B, Hebert-Beirne J, Boyd A, Molina Y. The interdependent roles of the psychosocial predictors of human papillomavirus vaccination among Christian parents of unvaccinated adolescents. Hum Vaccin Immunother 2021; 17:5433-5438. [PMID: 34856881 DOI: 10.1080/21645515.2021.2006027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Despite the availability of the human papillomavirus (HPV) vaccine, uptake has been sub-optimal among certain religious groups. Psychosocial factors (threat appraisal, coping appraisal, and attitudes) have been identified as independent determinants of HPV vaccination. However, their interdependent effects have not been tested. We examined the interdependency of these psychosocial factors in predicting HPV vaccination intention among Christian parents of unvaccinated adolescents (using a theory-driven conceptual model). A cross-sectional study of 342 participants showed that perceived self-efficacy (β = 0.2, 0.11-0.29, p = <0.0001) and perceived response efficacy of HPV vaccine (β = 0.65, 0.53-0.77. p < .0001) were positively associated with vaccination intention. Our mediation analysis (using the Preachers and Hayes' approach) shows that attitudes toward HPV vaccination mediated 59% of the relationship between perceived self-efficacy to vaccinate child and HPV vaccination intention; and 61% of the relationship between perceived response efficacy of HPV vaccine and HPV vaccination intention. Attitudes may be the psychosocial factor that drives the effects of coping appraisal. Therefore, designing an attitude-based intervention to address religious barrier beliefs among Christian parents may nullify the impact of low self-efficacy and response efficacy on HPV vaccination.
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Affiliation(s)
- Ayokunle Olagoke
- Division of Community Health Sciences, School of Public Health, University of Illinois, Chicago, IL, USA
| | - Rachel Caskey
- Division of Community Health Sciences, School of Public Health, University of Illinois, Chicago, IL, USA.,Sections of General Internal Medicine and Pediatrics, University of Illinois, Chicago, IL, USA.,Chicago Cancer Center, University of Illinois, Chicago, IL, USA
| | - Brenikki Floyd
- Division of Community Health Sciences, School of Public Health, University of Illinois, Chicago, IL, USA
| | - Jennifer Hebert-Beirne
- Division of Community Health Sciences, School of Public Health, University of Illinois, Chicago, IL, USA
| | - Andrew Boyd
- Department of Biomedical and Health Information Science, University of Illinois, Chicago, IL, USA
| | - Yamilé Molina
- Division of Community Health Sciences, School of Public Health, University of Illinois, Chicago, IL, USA.,Chicago Cancer Center, University of Illinois, Chicago, IL, USA.,College of Medicine, Center for Research on Women and Gender, University of Illinois, Chicago, IL, USA
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11
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Olagoke AA, Carnahan LR, Olagoke O, Molina Y. Shared Determinants for Human Papillomavirus and COVID-19 Vaccination Intention: An Opportunity for Resource Consolidation. Am J Health Promot 2021; 36:506-509. [PMID: 34738469 PMCID: PMC8851043 DOI: 10.1177/08901171211053933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Purpose This study aimed at targeting shared factors that influence the prevention of multiple diseases, which can help address various health problems simultaneously. We identified correlates of human papillomavirus (HPV) vaccination that overlap with COVID-19 vaccination. Design Cross-sectional survey data. Setting Online Qualtrics recruitment panel. Subject Religious parents of 342 adolescents who were unvaccinated for HPV (response rate was 68.1%). Measures Outcome variables were COVID-19 vaccination intention for (1) self, (2) child, and (3) HPV vaccination intention for child. Independent variables were psychological factors. Covariates were sociodemographic and socioeconomic factors. Analysis We conducted multivariate linear regressions on each outcome variable after controlling for covariates. Result Some psychological correlates of HPV overlapped as protective factors for all three outcomes. Higher perceived vulnerability of child to HPV was associated with higher vaccination intention against COVID-19 for self (β = .37, 95% confidence interval [CI] = .25–.48), child (β = .32, .21–.44), and HPV for child (β = .38, .27–.49). Higher perceived response efficacy of HPV vaccine was associated with greater vaccination intention against COVID-19 for self (β = .46, .33–.59), child (β = .41, .28–.53), and HPV for child (β = .75, .64–.85). Conclusion Given the overlap in HPV and COVID-19 vaccination correlates, interventions should target shared factors that address both diseases to maximize public health efforts. A major limitation of this study is the inability to measure the actual vaccination behavior.
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Affiliation(s)
- Ayokunle A Olagoke
- Division of Community Health Sciences, School of Public Health, 14681University of Illinois, Chicago, IL, USA.,Center of Innovations in Chronic and Complex Healthcare, Edward Hines JR VA Medical Center, Hines, IL, USA
| | - Leslie R Carnahan
- Division of Community Health Sciences, School of Public Health, 14681University of Illinois, Chicago, IL, USA.,Community Engagement Health Equity Office, University of Illinois Cancer Center, Chicago, IL, USA
| | - Olakanmi Olagoke
- 21737Barnes Jewish Hospital and Washington University, St Louis, MO, USA
| | - Yamilé Molina
- Division of Community Health Sciences, School of Public Health, 14681University of Illinois, Chicago, IL, USA.,Center for Research on Women and Gender, College of Medicine, 14681University of Illinois, Chicago, IL, USA
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12
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Predictors of Willingness to Receive the COVID-19 Vaccine after Emergency Use Authorization: The Role of Coping Appraisal. Vaccines (Basel) 2021; 9:vaccines9090967. [PMID: 34579204 PMCID: PMC8471613 DOI: 10.3390/vaccines9090967] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/19/2021] [Accepted: 08/25/2021] [Indexed: 11/17/2022] Open
Abstract
The current study aims to identify psychosocial factors based on protection motivation theory (PMT) influencing Chinese adults’ willingness to receive the COVID-19 vaccine after the emergency use authorization of the New Coronavirus Inactivated Vaccine in China. A cross-sectional online survey was conducted among Chinese residents aged 18–59 years, and 2528 respondents from 31 provinces and autonomous regions were included in the current study. Based on PMT, threat appraisals and coping appraisals were measured. Hierarchical multiple regressions and multivariate logistic regressions were used to identify the relationships between the PMT constructs and vaccination willingness after other covariates were controlled for. A total of 1411 (55.8%) respondents reported being willing to receive the COVID-19 vaccine. The PMT model explained 26.6% (p < 0.001) of the variance in the vaccine willingness. The coping appraisals, including response efficacy, self-efficacy, and response costs, were significantly correlated with the willingness to receive the COVID-19 vaccine, and response efficacy was the strongest influencing factor (adjusted OR = 2.93, 95% CI: 2.42–3.54). In conclusion, the coping appraisals for vaccination, instead of threat appraisals regarding the pandemic itself, mainly influenced people’s willingness to get vaccinated after the emergency use authorization of the COVID-19 vaccine in China. These findings are helpful for developing education and interventions to promote vaccination willingness and enhance public health outcomes during a pandemic.
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13
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Suo T, Lu Q. Parental Acceptability of HPV Vaccination for Adolescent Daughters and Associated Factors: A Cross-Sectional Survey in Bozhou, China. Res Theory Nurs Pract 2020; 34:340-357. [PMID: 33199407 DOI: 10.1891/rtnp-d-19-00108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aimed to investigate parents' acceptability of human papillomavirus (HPV) vaccination for their daughters and associated factors. METHODS This cross-sectional study was conducted in a city in China with a sample population of parents with a daughter in middle school. Participants' demographic characteristics, knowledge level regarding HPV and the HPV vaccine, perspectives on the health belief model (HBM) constructs, social norms, and acceptability of the HPV vaccine were determined through self-administered questionnaires. RESULTS Among the 523 parents who completed the questionnaire, 71.5% expressed willingness to have their daughters vaccinated against HPV infection and cervical cancer. Logistic regression analysis revealed higher acceptability in the participants with higher perceived severity of HPV infection (OR = 4.823, 95% CI = 2.683, 12.049), higher knowledge-assessment score (OR = 1.298, 95% CI = 1.055, 1.476), and higher perceived safety of the HPV vaccine (OR = 6.372, 95% CI = 3.856, 14.062). Parents influenced by social norms (OR = 4.959, 95% CI = 2.989, 14.386) and those who complied with physicians' recommendations (OR = 4.896, 95% CI = 1.936, 9.258) reported higher levels of acceptability. IMPLICATIONS Our results provide preliminary evidence on the need for health education programs and HPV vaccination campaigns. Future studies should focus on whether the factors associated with vaccination can increase parental acceptability of the HPV vaccine.
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Affiliation(s)
- Tonghui Suo
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui
| | - Qi Lu
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui .,The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui
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14
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Natipagon-Shah B, Lee E, Lee SY. Knowledge, Beliefs, and Practices Among U. S. College Students Concerning Papillomavirus Vaccination. J Community Health 2020; 46:380-388. [PMID: 32939677 DOI: 10.1007/s10900-020-00922-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2020] [Indexed: 10/23/2022]
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted disease in the U.S. Data on knowledge, attitudes, and beliefs related to HPV vaccination among college students are limited. The purpose of this study was to provide a comprehensive description of the variables influencing HPV vaccination uptake and intention among college students. This study employed a cross sectional descriptive quantitative design. Survey data were collected online from the 181 college students, aged 18-25 years. The data were analyzed to identify the students' attitudes toward HPV vaccine (perceived potential harm, effectiveness, barriers, and uncertainty), knowledge of HPV and HPV vaccine, and their intention of receiving the vaccine in the next 6 months. Descriptive statistics, Chi-square tests, ANOVA, and logistic regressions were conducted to examine the correlates of vaccination intention and uptake. Among 181 participants, 101 (55.8%) were had received at least one dose of HPV vaccine, 52 (28.7%) intended to receive HPV vaccine, and 28 (15.5%) did not intend to receive HPV vaccine. On average, participants responded correctly to less than half of the questions on the HPV knowledge and HPV vaccine knowledge scales, and those who were vaccinated were significantly more knowledgeable than their counterparts. Multivariate logistic regression showed HPV vaccine knowledge and uncertainty were significant factors associated with HPV vaccine uptake. Providing education designed to improve HPV and HPV vaccination knowledge and decrease feelings of uncertainty could improve college students' HPV vaccination uptake.
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Affiliation(s)
- Bulaporn Natipagon-Shah
- School of Nursing, California State University, San Marcos, 333 S. Twin Oaks Valley Rd., San Marcos, CA, 92096, USA
| | - Eunice Lee
- School of Nursing, University of California, Los Angeles, 700 Tiverton Ave., #-4-258, Los Angeles, CA, 90095, USA
| | - Shin-Young Lee
- Department of Nursing, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, 501-759, Republic of Korea.
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15
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Olagoke AA, Olagoke OO, Hughes AM. Exposure to coronavirus news on mainstream media: The role of risk perceptions and depression. Br J Health Psychol 2020; 25:865-874. [PMID: 32415914 PMCID: PMC7267047 DOI: 10.1111/bjhp.12427] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/16/2020] [Indexed: 12/18/2022]
Abstract
Objective The mainstream media tend to rely on news content that will increase risk perceptions of pandemic outbreaks to stimulate public response and persuade people to comply with preventive behaviours. The objective of this study was to examine associations between exposure to coronavirus disease (COVID‐19) news, risk perceptions, and depressive symptoms. Methods Cross‐sectional data were collected from 501 participants who were ≥18 years. Exposure to COVID‐19 news was assessed as our exposure variable. We screened for depression (outcome variable) with the Patient Health Questionnaire and examined the roles of risk perceptions. Multiple linear regressions and mediation analysis with 1000 bootstrap resamples were conducted. Results Participants were 55.29% female, 67.86% White with mean age 32.44 ± 11.94 years. After controlling for sociodemographic and socio‐economic factors, news exposure was positively associated with depressive symptoms β = .11; 95% confidence interval (95%CI) = 0.02–0.20. Mediation analysis showed that perceived vulnerability to COVID‐19 mediated 34.4% of this relationship (β = .04; 95%CI = 0.01–0.06). Conclusion Perceived vulnerability to COVID‐19 can serve as a pathway through which exposure to COVID‐19 news on mainstream media may be associated with depressive symptoms. Based on our findings, we offered recommendations for media–health partnership, practice, and research.
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Affiliation(s)
- Ayokunle A Olagoke
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, Illinois, USA
| | - Olakanmi O Olagoke
- Department of Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois, USA
| | - Ashley M Hughes
- Department of Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Illinois, USA.,Center of Innovations in Chronic and Complex Healthcare, Edward Hines JR VA Medical Center, Illinois, USA
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16
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A National Survey of Canadian Adults on HPV: Knowledge, Attitudes, and Barriers to the HPV Vaccine. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2019; 41:1125-1133.e6. [PMID: 31239230 DOI: 10.1016/j.jogc.2019.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 05/04/2019] [Accepted: 05/06/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Identifying human papillomavirus (HPV) vaccination motivators and barriers among adults could lead to new approaches to improve HPV vaccination rates in non-pediatric populations. This Canadian survey aimed to assess current knowledge of, attitudes towards, and barriers to the HPV vaccine among the general public. METHODS An online panel was used to survey HPV unvaccinated women (n = 802) and vaccinated women (n = 250) 18 to 45 years old, as well as 18- to 26-year-old men (n = 200), in May and June 2016. A 16-item questionnaire collected data on sociodemographic factors, health-seeking behaviours, knowledge of HPV infection and its consequences, and the HPV vaccine. Data were stratified by sex and by vaccination status among women. RESULTS The majority of individuals somewhat or strongly agreed that vaccination is an important aspect of disease prevention (vaccinated women, 93%; unvaccinated women, 85%; and men, 59%). However, a high proportion of patients were concerned about vaccine safety (vaccinated women, 26%; unvaccinated women, 40%; and men, 36%). Moreover, 58% to 61% of participants were generally cautious about taking any vaccine. The number one reported barrier to vaccination was not having a recommendation from a doctor (38%). Cost was seen as a barrier by only 18% to 20% of participants. CONCLUSION Canadian participants show a broad diversity in HPV knowledge and regarding barriers to vaccination. The youngest populations (vaccinated women and men) showed higher levels of knowledge regarding HPV.
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17
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Bird Y, Obidiya O, Mahmood R, Nwankwo C, Moraros J. Human Papillomavirus Vaccination Uptake in Canada: A Systematic Review and Meta-analysis. Int J Prev Med 2017; 8:71. [PMID: 28983400 PMCID: PMC5625360 DOI: 10.4103/ijpvm.ijpvm_49_17] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 11/06/2017] [Indexed: 11/21/2022] Open
Abstract
Human papillomavirus (HPV) is the most commonly sexually transmitted infection in the world and the primary cause of cervical cancer. Canada introduced publicly funded HPV vaccination programs in 2006. The objectives of this study are twofold and aim to (1) determine the levels and (2) examine the various factors influencing vaccine uptake among the general Canadian population. A literature search was conducted on seven databases, followed by screening, methodological quality review (using modified Newcastle-Ottawa Scale), and data extraction. Pooled meta-analysis and a subgroup analysis were conducted stratifying by a number of variables (age, sex, type of program, and method of payment) determined apriori. A total of 718 peer-reviewed articles were initially identified with 12 remaining after screening and underwent methodological quality review. HPV vaccination uptake in Canada varied from 12.40% (95% confidence interval [CI] 6.77–20.26) to 88.20% (95% CI 85.72–90.39). The pooled random effects model showed the HPV vaccination uptake to be 55.92% (95% CI 44.87–66.65). The subgroup analysis showed that vaccination uptake was 66.95% (95% CI 55.00–77.89) in participants ≤ 18 years as compared to 13.58% (95% CI 10.93–16.46) in participants > 18 years. Uptake for females was higher 57.23% (95% CI: 45.40–68.66) when compared to that of 47.01% (95% CI: 0.82–97.75) in males. HPV vaccine uptake among school-based programs was 69.62% (95% CI 57.27–80.68) as compared to 18.66% (95% CI 6.66–34.92) for community-based programs. Vaccination uptake for publicly funded programs was significantly higher 66.95% (95% CI 55.00–77.89) when compared to 13.58% (95% CI 10.92–16.46) for programs where participants had to pay out of pocket. To prevent infections and reduce the burden of HPV-related diseases (including cervical cancer), communities should be made aware and encouraged to vaccinate their children. There is a documented need to direct effort and focus interventions toward improving HPV vaccination uptake in Canada.
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Affiliation(s)
- Yelena Bird
- School of Public Health, University of Saskatchewan, Saskatoon, Canada
| | - Olatunji Obidiya
- School of Public Health, University of Saskatchewan, Saskatoon, Canada
| | - Razi Mahmood
- School of Public Health, University of Saskatchewan, Saskatoon, Canada
| | - Chijioke Nwankwo
- School of Public Health, University of Saskatchewan, Saskatoon, Canada
| | - John Moraros
- School of Public Health, University of Saskatchewan, Saskatoon, Canada
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18
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Dailey PM, Krieger JL. Communication and US-Somali Immigrant Human Papillomavirus (HPV) Vaccine Decision-Making. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:516-521. [PMID: 26687173 DOI: 10.1007/s13187-015-0959-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The current study uses a multiple goal theoretical perspective to explore how Somali immigrant families living in Ohio, USA, make decisions regarding whether to vaccinate their children against human papillomavirus (HPV)-a leading cause of cervical cancer. A focus was placed on the communication goals of parents in HPV vaccine discussions with their child and health care provider. Semi-structured interviews were audiotaped, transcribed, and analyzed using a grounded theory approach. Key themes are the implications of the vaccine for early sexual activity, confusion between HPV and HIV (human immunodeficiency virus), the perception that the HPV vaccine is unnecessary, uncertainty about the vaccine's efficacy and side effects, avoidance of parent-child communication about the vaccine, and a preference for framing the vaccine as a health promotion behavior. Framing the threat of HPV in the context of initiation of sexual activity, uncertainty regarding vaccine efficacy, and anticipated regret account for the inconsistency in HPV vaccine uptake among Somali parents. Clinicians should consider talking about HPV as a distal versus an immediate threat and HPV vaccine uptake as a health-promotion behavior rather than a sexually transmitted infection prevention behavior.
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Affiliation(s)
- Phokeng M Dailey
- School of Communication, The Ohio State University, 3041 Derby Hall, 154 North Oval Mall, Columbus, OH, 43210, USA.
| | - Janice L Krieger
- STEM Translational Communication Research Program, Department of Advertising, College of Journalism and Communications, University of Florida, Gainesville, FL, USA
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19
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Perez S, Tatar O, Gilca V, Shapiro GK, Ogilvie G, Guichon J, Naz A, Rosberger Z. Untangling the psychosocial predictors of HPV vaccination decision-making among parents of boys. Vaccine 2017; 35:4713-4721. [DOI: 10.1016/j.vaccine.2017.07.043] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 07/05/2017] [Accepted: 07/13/2017] [Indexed: 01/27/2023]
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20
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Radisic G, Chapman J, Flight I, Wilson C. Factors associated with parents' attitudes to the HPV vaccination of their adolescent sons : A systematic review. Prev Med 2017; 95:26-37. [PMID: 27932052 DOI: 10.1016/j.ypmed.2016.11.019] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 11/15/2016] [Accepted: 11/24/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The objective of the study was to identify factors associated with human papilloma virus (HPV) vaccine acceptability in parents of adolescent boys. This information is critical to the development of approaches to optimise HPV vaccine uptake among this population group. METHODS We performed a systematic search of the literature in addressing factors influencing parental attitudes to and beliefs about HPV vaccine and its acceptability for use. The findings were organised within the framework of the Health Belief Model (HBM) and summarised using a semi quantitative method. RESULTS Eighteen studies met the inclusion criteria. Parental decisions were predominantly shaped by the perceived benefits of the vaccine; perceived risk of sons contracting the HPV infection, and having recommendations from health care providers. Fear of side effects and uncertainty about vaccine effectiveness, as well as cost and lack of healthcare, were barriers to HPV vaccination. Other factors such as knowledge, family characteristics, parent-child dialogue and egalitarian values appeared to be important when deciding whether to vaccinate boys. CONCLUSIONS HPV vaccine uptake among male adolescents is suboptimal. Future programs need to address the predictors of uptake by educating parents about the boys' high susceptibility to infection, the benefits of vaccination, and reduce concerns regarding perceived barriers. Additionally, uptake may be facilitated by encouraging health care provider endorsement, particularly in countries without government-funded immunisation programs.
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Affiliation(s)
- Gorjana Radisic
- Flinders Centre for Innovation in Cancer, Flinders University, School of Medicine, GPO Box 2100, Adelaide SA 5001, Australia; Cancer Council SA, 202 Greenhill Road, Eastwood, SA 5063, Australia.
| | - Janine Chapman
- Flinders Centre for Innovation in Cancer, Flinders University, School of Medicine, GPO Box 2100, Adelaide SA 5001, Australia; Cancer Council SA, 202 Greenhill Road, Eastwood, SA 5063, Australia.
| | - Ingrid Flight
- Flinders Centre for Innovation in Cancer, Flinders University, School of Medicine, GPO Box 2100, Adelaide SA 5001, Australia; Cancer Council SA, 202 Greenhill Road, Eastwood, SA 5063, Australia.
| | - Carlene Wilson
- Flinders Centre for Innovation in Cancer, Flinders University, School of Medicine, GPO Box 2100, Adelaide SA 5001, Australia; Cancer Council SA, 202 Greenhill Road, Eastwood, SA 5063, Australia.
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21
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Perez S, Tatar O, Shapiro GK, Dubé E, Ogilvie G, Guichon J, Gilca V, Rosberger Z. Psychosocial determinants of parental human papillomavirus (HPV) vaccine decision-making for sons: Methodological challenges and initial results of a pan-Canadian longitudinal study. BMC Public Health 2016; 16:1223. [PMID: 27919239 PMCID: PMC5139028 DOI: 10.1186/s12889-016-3828-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 11/08/2016] [Indexed: 01/09/2023] Open
Abstract
Background HPV vaccination decision-making is a complex process that is influenced by multiple psychosocial determinants. Given the change in policy recommendation to include males in routine HPV vaccination, our goals were to assess the HPV vaccination uptake in Canada, to understand where Canadian parents were situated in the HPV vaccine decision-making process for their son, how they changed over time and which psychosocial determinants were relevant for this process. Methods We used an online survey methodology and collected data from a nationally representative sample of Canadian parents of boys aged 9–16 at baseline (T1, February 2014) and at 9 months’ follow-up (T2). Our analyses were guided by the Precaution Adoption Process Model (PAPM), a theoretical health behavior model that classifies parents in one of six stages: unaware, unengaged, undecided, decided not to vaccinate, decided to vaccinate and those who had already vaccinated their sons. Rigorous methods were used to filter out careless responders: response variance, bogus items, psychometric antonyms and psychometric synonyms. Results At T1 and T2, we received 3,784 and 1,608 respectively completed questionnaires; after data cleaning 3,117 (T1) and 1,427 (T2) were retained. Less than 3% of boys were vaccinated at both time points. At both T1 and T2, most parents (over 70%) belonged to the earlier vaccination adoption stages: 57% were unaware (T1) and 15.3% (T2); 20.9% were unengaged (T1) and 32.4% (T2); and 9.1% were undecided (T1) and 25.2% (T2). At follow-up, 37.7% of participants did not move from their initial PAPM decision-making stage. Most parents (55%) preferred to receive information from their healthcare provider (HCP) but only 6% (T1) and 12% (T2) had actually spoken with a HCP about the HPV vaccine for their son. Conclusions HPV vaccination uptake in Canadian boys was very low in the absence of a publicly funded HPV vaccination programs for boys. Optimal HPV information preferences were identified and can be used in interventions to increase HPV knowledge and increase HPV vaccine uptake. Intentions to vaccinate or planning to speak to one’s HCP did not translate into action for most parents over the 9-month follow up; this finding is critical to consider to inform implementation strategies. Methodological challenges are described and suggestions for future research are offered. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3828-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Samara Perez
- Department of Psychology, McGill University, 1205 Dr. Penfield Avenue, Montreal, QC, H3A 1B1, Canada. .,Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road Room 214, Montreal, QC, H3T 1E4, Canada.
| | - Ovidiu Tatar
- Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road Room 214, Montreal, QC, H3T 1E4, Canada
| | - Gilla K Shapiro
- Department of Psychology, McGill University, 1205 Dr. Penfield Avenue, Montreal, QC, H3A 1B1, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road Room 214, Montreal, QC, H3T 1E4, Canada
| | - Eve Dubé
- Institut National de Santé Publique du Québec, 2400 D'Estimauville, Quebec, G1E 7G9, Canada
| | - Gina Ogilvie
- Faculty of Medicine, University of British Columbia, BC Women's Hospital and Health Centre, Room H203G, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
| | - Juliet Guichon
- Community Health Sciences, Faculty of Medicine, University of Calgary, 3280 Hospital Drive N.W, Calgary, AB, T2N 4N1, Canada
| | - Vladimir Gilca
- Institut National de Santé Publique du Québec, 2400 D'Estimauville, Quebec, G1E 7G9, Canada
| | - Zeev Rosberger
- Department of Psychology, McGill University, 1205 Dr. Penfield Avenue, Montreal, QC, H3A 1B1, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste-Catherine Road Room 214, Montreal, QC, H3T 1E4, Canada.,Louise Granofsky-Psychosocial Oncology Program, Segal Cancer Center, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal, QC, H3T1E4, Canada
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Abstract
The human papillomavirus (HPV) infects approximately 550,000 Canadians annually. Cancers of the cervix, mouth, anus, throat and neck are caused by various strains of the virus. The virus also causes genital warts. The disease and economic burden of HPV is high. Primary prevention through vaccine administration prior to onset of sexual activity is evidenced as best practice. Two vaccines are available, Gardasil and Cervarix. Consistent with global practices in developed countries, these vaccines are currently publicly funded for females and provided in school-based clinics in all provinces and territories in Canada. Despite well-documented efficacy with minimal adverse effects, the uptake of these vaccines remains low in all countries, including Canada. Although HPV immunization rates have increased, they remain significantly below the rates of other vaccine-preventable diseases. This is puzzling since school-based clinics and public funding presumably increase vaccine access. Barriers explicated include family lack of knowledge about the vaccine, and attitudes that are not informed by science and epidemiology. There is evidence that a health provider's recommendation is the single biggest influence on uptake. However, not all providers are cognizant about emerging issues in this area, including controversies about universal coverage for boys as well as girls, new vaccines and more. Nurse practitioners are in a position to collaborate with public health agencies to expand knowledge and coverage across Canada.
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Fogel J, Kusz M. Intentions to receive a potentially available Lyme disease vaccine in an urban sample. THERAPEUTIC ADVANCES IN VACCINES 2016; 4:3-14. [PMID: 27551427 DOI: 10.1177/2051013616629881] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The only human Lyme disease vaccine of LYMErix was voluntarily removed from the market in the United States in 2002 for a number of reasons. A new human Lyme disease vaccine is currently being developed. We would like any future approved human Lyme disease vaccine to be of interest and marketable to consumers. METHODS We surveyed 714 participants to determine variables associated with intentions to receive a Lyme disease vaccine. Predictor variables included demographics, protection motivational theory, Lyme disease knowledge, Lyme disease preventive behaviors, beliefs and perceived health. RESULTS We found in multivariate linear regression analyses that Asian/Asian American race/ethnicity (p < 0.001), South Asian race/ethnicity (p = 0.01) and coping appraisal variables of response efficacy (p < 0.001) and self-efficacy (p < 0.001) were each significantly associated with increased intentions. The belief that vaccines are typically not safe was significantly associated with decreased intentions (p = 0.03). CONCLUSIONS Asian/Asian American and South Asian race/ethnicities have a strong interest in receiving a Lyme disease vaccine. Although pharmaceutical companies may benefit by advertising a Lyme disease vaccine to Asian/Asian Americans and South Asians, marketers need to address and use approaches to interest those from other race/ethnicities. Also, marketers need to address the erroneous belief that vaccines are typically not safe in order to interest those with such beliefs to use a Lyme disease vaccine.
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Affiliation(s)
- Joshua Fogel
- Department of Business Management, Brooklyn College of the City University of New York, 218A, 2900 Bedford Avenue, Brooklyn, NY 11210, USA
| | - Martin Kusz
- Department of Biology, Brooklyn College, Brooklyn, NY, USA
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Batista Ferrer H, Audrey S, Trotter C, Hickman M. An appraisal of theoretical approaches to examining behaviours in relation to Human Papillomavirus (HPV) vaccination of young women. Prev Med 2015; 81:122-31. [PMID: 26314783 PMCID: PMC4728193 DOI: 10.1016/j.ypmed.2015.08.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 08/12/2015] [Accepted: 08/13/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Interventions to increase uptake of Human Papillomavirus (HPV) vaccination by young women may be more effective if they are underpinned by an appropriate theoretical model or framework. The aims of this review were: to describe the theoretical models or frameworks used to explain behaviours in relation to HPV vaccination of young women, and: to consider the appropriateness of the theoretical models or frameworks used for informing the development of interventions to increase uptake. METHODS Primary studies were identified through a comprehensive search of databases from inception to December 2013. RESULTS Thirty-four relevant studies were identified, of which 31 incorporated psychological health behaviour models or frameworks and three used socio-cultural models or theories. The primary studies used a variety of approaches to measure a diverse range of outcomes in relation to behaviours of professionals, parents, and young women. The majority appeared to use theory appropriately throughout. About half of the quantitative studies presented data in relation to goodness of fit tests and the proportion of the variability in the data. CONCLUSION Due to diverse approaches and inconsistent findings across studies, the current contribution of theory to understanding and promoting HPV vaccination uptake is difficult to assess. Ecological frameworks encourage the integration of individual and social approaches by encouraging exploration of the intrapersonal, interpersonal, organisational, community and policy levels when examining public health issues. Given the small number of studies using such approach, combined with the importance of these factors in predicting behaviour, more research in this area is warranted.
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Affiliation(s)
- Harriet Batista Ferrer
- School of Social and Community Medicine, University of Bristol, Bristol BS8 2PS, United Kingdom.
| | - Suzanne Audrey
- School of Social and Community Medicine, University of Bristol, Bristol BS8 2PS, United Kingdom.
| | - Caroline Trotter
- Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, United Kingdom.
| | - Matthew Hickman
- School of Social and Community Medicine, University of Bristol, Bristol BS8 2PS, United Kingdom.
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25
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Perez S, Shapiro GK, Brown CA, Dube E, Ogilvie G, Rosberger Z. 'I didn't even know boys could get the vaccine': Parents' reasons for human papillomavirus (HPV) vaccination decision making for their sons. Psychooncology 2015; 24:1316-1323. [PMID: 26152776 DOI: 10.1002/pon.3894] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 05/26/2015] [Accepted: 06/02/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The study's objective was to examine parents' reasons for their decision to vaccinate their 9-16-year-old sons with the human papillomavirus (HPV) vaccine. METHODS Using the precaution adoption process model (PAPM), parents were classified according to one of six stages of decision making: unaware, unengaged, undecided, decided not to vaccinate, decided to vaccinate, or vaccinated. Parents responded to an open-ended question: 'What would influence your decision to have your son vaccinated or not against HPV?' RESULTS Three thousand one hundred and seventeen parents provided 2,874 interpretable narrative responses that were coded using thematic content analyses. The majority of parents were in the earlier precaution adoption process model stages, that is, unaware that the HPV vaccine could be given to boys (57.0%), unengaged (20.9%), or undecided (9.1%). Needing more information, vaccine cost, risks associated with vaccination, and wanting a doctor's recommendation influenced these earlier-staged parents' decisions. Parents who decided not to vaccinate their sons (6.8%) reported their decision was due to the risks, insufficient research, lack of confidence in vaccines, and/or no need for the vaccine (as their sons are not sexually active and/or too young). Parents who had decided to vaccinate their sons (5.0%) or who had vaccinated their sons (1.1%) reported that their decisions were based on protecting their sons' health and preventing disease. CONCLUSION There are important differences in the factors that influence parents' decision depending on where they are along the decision-making trajectory. Assuring that parents are well informed about the importance of male vaccination, reducing vaccine cost, accurately communicating vaccine safety, and improving patient-provider communication may augment vaccine coverage and prevent HPV-associated cancers in Canada. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Samara Perez
- Department of Psychology, McGill University, Montreal, QC, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Gilla K Shapiro
- Department of Psychology, McGill University, Montreal, QC, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Christopher A Brown
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Eve Dube
- Institut National de Santé Publique du Québec, Québec, QC, Canada
| | - Gina Ogilvie
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Zeev Rosberger
- Department of Psychology, McGill University, Montreal, QC, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.,Louise Granofsky Psychosocial Oncology Program, Segal Cancer Center, Jewish General Hospital, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada.,Department of Oncology, McGill University, Montreal, QC, Canada
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26
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Rickert VI, Auslander BA, Cox DS, Rosenthal SL, Rickert JA, Rupp R, Zimet GD. School-based vaccination of young US males: impact of health beliefs on intent and first dose acceptance. Vaccine 2014; 32:1982-7. [PMID: 24492015 DOI: 10.1016/j.vaccine.2014.01.049] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 01/09/2014] [Accepted: 01/15/2014] [Indexed: 10/25/2022]
Abstract
Little is known about adolescent males and their parents with respect to intent and first dose uptake of the human papillomavirus (HPV) vaccine outside of primay care settings. The purpose of this study was to evaluate potential predictors of parental intent to vaccinate (study was conducted in November 2010-December 2012) and of first dose uptake of HPV vaccine among a sample of young adolescent males, 11-15 years of age, who received care at a school-based health center (SBHC). We also examined intent as a potential mediator of the relationships between predictors (health beliefs and perceived spousal agreement) and vaccination. Slightly more than half (n=135 of 249) of parents reported an intention to vaccinate and 28% (n=69) of males received their first dose of the HPV vaccine. Two of three health beliefs were significantly associated with both intention and uptake as was perceived spousal agreement. We found intention to vaccinate was a partial mediatator between the perceived benefits of HPV vaccine and first dose acceptance. We also determined that intent was a strong mediator between both general immunization benefits and perceived spousal agreement and first dose uptake. While vaccine uptake was lower than expected, particularly considering that many barriers to vaccine initiation were eliminated because of the SBHC setting, this rate is higher than in traditional settings. After controlling for intent, only perceived benefits of the HPV vaccine remained a significant predictor of first dose acceptance.
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Affiliation(s)
- Vaughn I Rickert
- Indiana University School of Medicine, Indianapolis, IN, United States.
| | - Beth A Auslander
- University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Dena S Cox
- Kelley School of Business, Indiana University, Indianapolis, IN, United States
| | - Susan L Rosenthal
- Columbia College of Physician and Surgeons and New York Presbyterian Morgan Stanley Children's Hospital, New York, NY, United States
| | - Jeffrey A Rickert
- Indiana University School of Medicine, Indianapolis, IN, United States; LMU-Debusk College of Osteopathic Medicine, Harrogate, TN, United States
| | - Richard Rupp
- University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Gregory D Zimet
- Indiana University School of Medicine, Indianapolis, IN, United States
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