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Flood T, Hughes CM, Wilson I, McLaughlin M. Applying the COM-B behaviour model to understand factors which impact 15-16 year old students' ability to protect themselves against acquirement of Human Papilloma virus (HPV) in Northern Ireland, UK. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003100. [PMID: 38630731 PMCID: PMC11023437 DOI: 10.1371/journal.pgph.0003100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 03/18/2024] [Indexed: 04/19/2024]
Abstract
High-risk strains of Human Papillomavirus (HPV) can lead to the development of a number of cancers including cervical, vulvar, penile, anal and oropharyngeal. HPV vaccination programmes offer the HPV vaccine to males and females 12-13 years old in schools throughout the UK. However, knowledge of HPV remains low in post-primary schools. The aim of this study is to capture 15-16 year old students' perceptions regarding the current provision of HPV education, and whether providing HPV education to 15-16 year olds could influence their intention to be vaccinated and/or future sexual health decisions related to HPV. Between 5th November 2021 and 6th May 2022, seven focus groups were conducted with 34 students in post-primary schools in Northern Ireland, United Kingdom. The data was analysed using the COM-B behaviour model to explore the perceived facilitators and barriers impacting students' ability to protect themselves from acquirement of HPV. Students perceived their knowledge of HPV to be poor and supported the addition of comprehensive mandatory HPV education at 15-16 years old when many of them were becoming sexually active. They identified barriers including lack of parental education, school ethos and religion and insufficient education regarding their legal rights to self-consent to HPV vaccination. Students felt that removal of these barriers would lead to safer sexual practices, increased awareness of the importance of HPV screening and increased HPV vaccination uptake. The recommendations provided by students need to be supported by the Education Authority in conjunction with the Department of Health in order to be successfully implemented into the post-primary school curriculum.
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Affiliation(s)
- Terri Flood
- School of Health Sciences, Ulster University, Londonderry, Derry, United Kingdom
| | - Ciara M. Hughes
- School of Health Sciences, Ulster University, Londonderry, Derry, United Kingdom
| | - Iseult Wilson
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, United Kingdom
| | - Marian McLaughlin
- School of Psychology, Ulster University, Londonderry, Derry, United Kingdom
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Atarere J, Chido-Amajuoyi O, Onyeaka H, Akpoviroro O, Adewunmi C, Mele AA, Faith CO, Nwani S, Kanth P. Awareness of the causal association between human papillomavirus and anal cancer among US adults. Cancer Causes Control 2024; 35:719-725. [PMID: 38103133 DOI: 10.1007/s10552-023-01830-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/11/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE The incidence of anal cancer is on the rise in the US, especially among high-risk groups. This study examined the prevalence and determinants of awareness of the causal relationship between HPV and anal cancer among US adults. METHODS Study data was obtained from the 2017 to 2020 iterations of the Health Information National Trends Survey. The prevalence of awareness that HPV causes anal cancer was estimated among HINTS respondents who were aware of HPV in general. Survey weights were used to provide estimates representative of the adult US population. Multivariable logistic regressions were used to examine the associations between awareness that HPV causes anal cancer and cancer-related behaviors/perceptions and sociodemographic characteristics of respondents. RESULTS Two thousand six hundred and eighty four (27.2%) of the study population were aware that HPV caused anal cancer. Those of gay sexual orientation were more aware than heterosexuals [OR 2.27; 95% CI (1.24, 4.14)]. Compared to respondents with a high school diploma or less, individuals with some college education [OR 1.38; 95% CI (1.03, 1.85)] and those with at least a college degree [OR 1.52; 95% CI (1.17, 1.98)] were more likely to be aware. Participants who had positive cancer information seeking behavior were more aware of the HPV-anal cancer link compared to those who did not [OR 1.57; 95% CI (1.30, 1.89)]. CONCLUSION Population-level awareness that HPV causes anal cancer remains critically low in the US. Sexual orientation, level of education and cancer information seeking behavior are associated with increased awareness of the causal relationship between HPV and anal cancer. Efforts should be directed toward addressing the awareness gap among individuals with lower education levels and promoting curiosity-driven information seeking behaviors.
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Affiliation(s)
- Joseph Atarere
- Department of Medicine, MedStar Health, Baltimore, MD, USA.
| | | | - Henry Onyeaka
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | | | - Comfort Adewunmi
- Division of Geriatrics and Gerontology, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Chilota O Faith
- Department of Medical and Laboratory Sciences, Madonna University, Okija, Anambra State, Nigeria
| | - Somtochi Nwani
- Department of Pharmaceutical Sciences, University of Nigeria, Enugu, Nigeria
| | - Priyanka Kanth
- Division of Gastroenterology, Georgetown University, District of Columbia, Washington, DC, USA
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Vu NTH, Tran TTT, Quach DT, Miyauchi S, Yoshida M, Okamoto Y, Lu DM, Tran LL, Luu MN, Hiyama T. Knowledge of common cancers among new-entry health science students in Japan and Vietnam. BMC MEDICAL EDUCATION 2023; 23:724. [PMID: 37789373 PMCID: PMC10548607 DOI: 10.1186/s12909-023-04674-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/12/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND The incidence and mortality rates of cancer are rapidly increasing worldwide. This study aimed to assess the knowledge of common cancers among new-entry health science students in Japan and Vietnam, thereby providing insights for implementing appropriate medical educational interventions. METHODS This cross-sectional study was conducted among new-entry health science students at Hiroshima University, Japan, and the University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam. A printed predesigned questionnaire consisting of eleven questions was distributed to the participants during the freshmen health screening at the beginning of the academic year to assess their knowledge of cancer. RESULTS A total of 2,748 new-entry health science students participated in the study, including 394 (14.3%) Japanese students and 2,354 (85.7%) Vietnamese students. Most cancer knowledge levels in Japanese students were significantly higher than those in Vietnamese students (p < 0.001), except for human papillomavirus (HPV) infection awareness. For this understanding, only 14.8% of Japanese students selected the correct answer, which was significantly lower than the 22.4% of Vietnamese students (p = 0.001). Both the Japanese and Vietnamese students had limited knowledge regarding the connection between HPV infection and cancer and the link between estrogen-progestogen menopausal therapy and breast cancer. Additionally, female students had better knowledge about breast, skin, and endometrial cancers than male students. CONCLUSIONS Japanese students generally exhibited higher levels of cancer knowledge than Vietnamese students, except for HPV infection recognition. Both groups had limited knowledge regarding the connection between HPV infection and cancer and the relationship between estrogen-progestogen menopausal therapy and breast cancer.
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Affiliation(s)
- Nhu Thi Hanh Vu
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - Tam Thao Tuyet Tran
- Department of Family Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Duc Trong Quach
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Shunsuke Miyauchi
- Health Service Center, Hiroshima University, 1-7-1 Kagamiyama, Higashihiroshima, 739-8514, Japan
| | - Mahoko Yoshida
- Health Service Center, Hiroshima University, 1-7-1 Kagamiyama, Higashihiroshima, 739-8514, Japan
| | - Yuri Okamoto
- Health Service Center, Hiroshima University, 1-7-1 Kagamiyama, Higashihiroshima, 739-8514, Japan
| | - Dat Minh Lu
- Department of Family Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Linh Le Tran
- Department of Family Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Mai Ngoc Luu
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Toru Hiyama
- Health Service Center, Hiroshima University, 1-7-1 Kagamiyama, Higashihiroshima, 739-8514, Japan.
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Adjei Boakye E, McKinney SL, Whittington KD, Boyer VE, Franca MC, Lee M, McKinnies RC, Collins SK, Gerend MA. Association between Sexual Activity and Human Papillomavirus (HPV) Vaccine Initiation and Completion among College Students. Vaccines (Basel) 2022; 10:2079. [PMID: 36560489 PMCID: PMC9784235 DOI: 10.3390/vaccines10122079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
HPV vaccination is most effective if received before initiation of sexual activity. Previous studies suggested that young adult women who were not sexually active were not interested in receiving the vaccine because they did not think it was necessary. Whether this misperception is still prevalent today-and also shared by men-is unknown. This study examined whether sexual activity was associated with HPV vaccine uptake (initiation and completion) among university students. A cross-sectional study was conducted between February and May 2021 among students (n = 951) at a public Midwestern University. Sexual activity was categorized as "never" or "ever" had oral and/or vaginal sex. Outcome variables were HPV vaccine initiation, defined as receipt of ≥1 dose, and completion, defined as receipt of ≥3 doses. Multivariable logistic regression models estimated the association between sexual activity and HPV vaccine uptake, adjusting for sociodemographic factors. Approximately 18% of students reported never engaging in sexual activity. Overall, 45.5% initiated the HPV vaccine, and 16.5% completed the vaccine series. After adjusting for covariates, compared to students that reported never engaging in sexual activity, those that had ever engaged in sexual activity were more likely to have initiated the vaccine series (aOR = 2.06, 95% CI: 1.34-3.17); however, no difference was observed for completion. HPV vaccination was low; sexually naïve students were less likely to initiate the HPV vaccine. Since sexually naïve students may benefit from receiving the HPV vaccination, targeted interventions should be implemented towards this population to help increase vaccination rates and prevent HPV-associated diseases.
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Affiliation(s)
- Eric Adjei Boakye
- Department of Otolaryngology—Head and Neck Surgery, Henry Ford Health System, One Ford Place, Detroit, MI 48202, USA
- Department of Public Health Sciences, Henry Ford Health System, One Ford Place, Detroit, MI 48202, USA
| | - Stacey L. McKinney
- Department of Dental Hygiene, School of Health Sciences, Southern Illinois University, 1263 Lincoln Dr, Carbondale, IL 62901, USA
| | - Kelli D. Whittington
- Department of Nursing, School of Health Sciences, Southern Illinois University, 1263 Lincoln Dr, Carbondale, IL 62901, USA
| | - Valerie E. Boyer
- Department of Communication Disorders and Sciences, School of Health Sciences, Southern Illinois University, 1263 Lincoln Dr, Carbondale, IL 62901, USA
| | - Maria C. Franca
- Department of Communication Disorders and Sciences, School of Health Sciences, Southern Illinois University, 1263 Lincoln Dr, Carbondale, IL 62901, USA
| | - Minjee Lee
- Department of Population Science and Policy, Southern Illinois University School of Medicine, 201 E. Madison Street, Springfield, IL 62794, USA
| | - Richard C. McKinnies
- Department of Radiologic Sciences, School of Health Sciences, Southern Illinois University, 1263 Lincoln Dr, Carbondale, IL 62901, USA
| | - Sandra K. Collins
- Department of Health Care Management, School of Health Sciences, Southern Illinois University, 1263 Lincoln Dr, Carbondale, IL 62901, USA
| | - Mary A. Gerend
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, 1115 West Call Street, Tallahassee, FL 32306, USA
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Du EY, Adjei Boakye E, Taylor DB, Kuziez D, Rohde RL, Pannu JS, Simpson MC, Patterson RH, Varvares MA, Osazuwa-Peters N. Medical students' knowledge of HPV, HPV vaccine, and HPV-associated head and neck cancer. Hum Vaccin Immunother 2022; 18:2109892. [PMID: 36070503 DOI: 10.1080/21645515.2022.2109892] [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
On the basis of their training, medical students are considered "the best case scenario" among university students in knowledge of the human papillomavirus (HPV). We evaluated differences in knowledge of HPV, HPV vaccine, and head and neck cancer (HNC) among medical students. A previously validated questionnaire was completed by 247 medical students at a Midwestern university. Outcomes of interest were knowledge score for HPV and HPV vaccine, and HNC, derived from combining questionnaire items to form HPV knowledge and HNC scores, and analyzed using multivariate linear regression. Mean scores for HPV knowledge were 19.4 out of 26, and 7.2 out of 12 for HNC knowledge. In the final multivariate linear regression model, sex, race, and year of study were independently associated with HPV and HPV vaccine knowledge. Males had significantly lower HPV vaccine knowledge than females (β = -1.53; 95% CI: -2.53, -0.52), as did nonwhite students (β = -1.05; 95% CI: -2.07, -0.03). There was a gradient in HPV vaccine knowledge based on the year of study, highest among fourth year students (β = 6.75; 95% CI: 5.17, 8.33). Results were similar for factors associated with HNC knowledge, except for sex. HNC knowledge similarly increased based on year of study, highest for fourth year students (β = 2.50; 95% CI: 1.72, 3.29). Among medical students, gaps remain in knowledge of HPV, HPV vaccine, and HPV-linked HNC. Male medical students have significantly lower knowledge of HPV. This highlights the need to increase medical student knowledge of HPV and HPV-linked HNC.
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Affiliation(s)
- Eric Y Du
- School of Medicine, Saint Louis University, Saint Louis, MO, USA
| | - Eric Adjei Boakye
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA.,Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, MI, USA
| | - Derian B Taylor
- School of Medicine, Saint Louis University, Saint Louis, MO, USA
| | - Duaa Kuziez
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Rebecca L Rohde
- Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jaibir S Pannu
- Department of Otolaryngology-Head and Neck Surgery, Loma Linda University, Loma Linda, CA, USA
| | - Matthew C Simpson
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St Louis, MO, USA.,Advanced Health Data Research Institute, Saint Louis University, St Louis, MO, USA
| | - Rolvix H Patterson
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Mark A Varvares
- Department of Otolaryngology, Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
| | - Nosayaba Osazuwa-Peters
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.,Duke Cancer Institute, Durham, NC, USA
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