Low Human Papillomavirus Literacy Among Asian-American Women in California: an Analysis of the California Health Interview Survey

Human papilloma virus (HPV)-related information acquisition and seeking behavior among infected women: A single center cross-sectional survey in Shanghai, China

Lacking of adequate knowledge is an obstacle to effective prevention of cervical cancer, yet factors that affect the information acquisition and seeking behavior as well as the information communication process are not well studied. We assessed information acquisition and seeking behavior, as well as perceived barriers of doctor-patient communication regarding human papilloma virus (HPV)-related information of infected women. Among 437 participants, 405 (93%) expressed demands for HPV-related information, while only a small proportion (100/437, 22.9%) actively sought information and felt obstacles comprehending. Web-based channels were most frequently utilized and medical personnel were the most trusted information source. Patients' satisfaction was significantly correlated with doctor's patience (r = 0.581, p < 0.001) and emotional caring (r = 0.555, p < 0.001). Compared to patients not actively seeking information, those actively seeking information were more likely to be single (p = 0.005), had higher education (p = 0.009) and monthly individual-level income (p = 0.023), and was more likely to undergo regular cervical cancer screening (p = 0.003), and were already or willing to be vaccinated (p = 0.008). The actively seeking information group also achieved higher scores in HPV knowledge test (p = 0.007). Public health interventions targeting HPV-infected women using specifically designed educational materials may influence information seeking behavior, increase HPV literacy and knowledge, which could potentially increase HPV vaccine uptake and cervical cancer screening rate.

Understanding the effect of new U.S. cervical cancer screening guidelines and modalities on patients' comprehension and reporting of their cervical cancer screening behavior

With recent shifts in guideline-recommended cervical cancer screening in the U.S., it is important to accurately measure screening behavior. Previous studies have indicated the U.S. National Health Interview Survey (NHIS), a resource for measuring self-reported screening adherence, has lower validity among non-White racial/ethnic groups and non-English speakers. Further, measuring diverse population groups' comprehension of items and attitudes toward HPV self-sampling merits investigation as it is a modality likely to be recommended in the U.S. soon. This study cognitively tested NHIS items assessing recency of and reasons for receiving cervical cancer screening and attitudes toward HPV self-sampling. We conducted cognitive interviews between April 2021 - April 2022 in English and Spanish with individuals screened in the past two years by either a medical center in metropolitan Seattle, Washington or a safety-net healthcare system in Dallas, Texas. Interviews probed understanding of reasons for screening, experiences with abnormal results, and interest in HPV self-sampling. We completed 32 interviews in Seattle and 42 interviews in Dallas. A majority of participants were unaware that two different tests for cervical cancer screening exist (Pap and HPV). Many did not know which type(s) of test they received. Dallas participants had more limited and inaccurate knowledge of HPV compared to Seattle participants, and fewer responded favorably toward HPV self-sampling (32% vs. 55%). To improve comprehension and accurate reporting of cervical cancer screening, we suggest specific refinements to currently used survey questions. Attitudes toward self-sampling should be explored further as differences may exist by region and/or sociodemographic factors.

Human papillomavirus-associated cancer incidence by disaggregated Asian American, Native Hawaiian, and other Pacific Islander ethnicity

BACKGROUND

Asian Americans and Native Hawaiians and other Pacific Islanders have suboptimal human papillomavirus (HPV) vaccination and cancer screening rates. Asian Americans and NHPIs are often aggregated, masking disparities characterized by varying colonization and immigration patterns and cultural and religious beliefs between populations and ethnicities. We examined the incidence of HPV-associated cancers across disaggregated Asian American and NHPI ethnicities.

METHODS

Using the Surveillance, Epidemiology, and End Results Detailed Asian/Pacific Islander database, we calculated 1990 to 2014 sex-specific, age-standardized HPV-associated cancer incidence of cervical carcinoma, oropharyngeal squamous cell carcinoma (SCC), vulvar SCC, vaginal SCC, anal SCC, and penile SCC by ethnicity: Asian Indian and Pakistani, Chinese, Filipino, Japanese, Kampuchean, Korean, Laotian, Native Hawaiian, other Pacific Islander, and Vietnamese. Trends by calendar period (1990 to 1996, 1997 to 2002, 2003 to 2008, 2009 to 2014) were estimated using Joinpoint regression.

RESULTS

The most common HPV-associated cancer was cervical carcinoma in women and oropharyngeal SCC in men. During 1990 to 2014, cervical carcinoma incidence per 100 000 ranged from 4.5 (Asian Indian and Pakistani) to 20.7 (Laotian). Cervical carcinoma incidence only statistically significantly declined for Asian Indian and Pakistani, Filipino, Korean, Laotian, and Vietnamese women (range = 19.9% to 44.1% decline per period). Among men, oropharyngeal SCC incidence per 100 000 ranged from 1.1 (Chinese) to 5.1 (Native Hawaiian). Oropharyngeal SCC incidence only statistically significantly increased (31.0% increase per period) for Japanese men. Heterogeneity across ethnicities were observed for other cancer sites.

CONCLUSIONS

HPV-associated cancer incidence varied widely between Asian Americans and NHPIs and by ethnicity, underscoring the need for improved data capture of ethnic groups in research and more tailored interventions to better address health disparities between Asian American and NHPI populations.

Overcoming constraints of the model minority stereotype to advance Asian American health

Asian Americans are the fastest growing U.S. immigrant group, projected to become the largest immigrant group by 2065, but the quantity of research on Asian Americans' health has not mirrored changing demographics. Asian Americans have been understudied for more than 25 years, with only 0.17% of National Institutes of Health (NIH) expenditures allocated to projects including Asian American, Native Hawaiian, and Pacific Islander populations (Ðoàn et al., 2019). This disproportionality may result in part from the model minority stereotype (MMS) being extended to health, perpetuating the ideas that Asian Americans are well-positioned with regard to health status and that associated research is not essential. Accordingly, the aims for this article are threefold: (a) bring attention to the inadequate representation of the Asian American population in health-related science, (b) question the MMS in health, and (c) outline potential pathways through which the MMS limits what is knowable on Asian American health issues and needs. We discuss the limited meaningfulness of nonrepresentative aggregated statistics purporting the model minority image and provide counterexamples. We also present a stereotype-constraints model with the MMS contributing to a bottleneck for Asian American health-related knowledge, accompanied by present-day circumstances (e.g., sparse data, few psychologists/behavioral medicine scientists focused on Asian American health). We conclude with initial recommendations for addressing MMS-associated constraints in psychology and more broadly. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Social media use and human papillomavirus awareness and knowledge among adults with children in the household: examining the role of race, ethnicity, and gender

BACKGROUND

Though human papillomavirus (HPV) vaccination is a safe and effective method of protecting against associated cancers, uptake rates remain low among adolescents. Few studies have examined how social media use contributes to HPV-related knowledge gaps among parents and caregivers.

OBJECTIVE

To investigate the association between social media use and HPV-related awareness and knowledge with a focus on differences by gender and race/ethnicity among a nationally representative sample of adults with children in the household.

METHODS

We used data from the Health Information National Trends (HINTS) Survey (2017-2019) (N = 2,720). Multivariate logistic regressions were used to examine the association of social media use on HPV awareness and knowledge outcomes.

RESULTS

Compared to non-users, engaging in one, two, three, or four social media behaviors were associated with greater HPV awareness (aOR: 2.09; 95%CI: 1.18-3.70, aOR: 2.49; 95%CI: 1.40-4.42, aOR: 2.64; 95%CI: 1.15-6.05, and aOR: 2.44; 95%CI: 1.11-5.36, respectively). Increased social media use was associated with increased HPV vaccine awareness. Men, African American, Hispanic, and Asian American respondents were less likely to be aware of HPV or HPV vaccine. Social media use was not associated with cancer knowledge.

CONCLUSIONS

Increased social media use is associated with an increased awareness of HPV and HPV vaccine for adults with children in the household. Social media-based efforts can be utilized to increase knowledge of the benefits of HPV vaccination as cancer prevention, which may be a precursor to reducing HPV vaccine hesitancy and encouraging uptake to decrease cancer incidence rates among vulnerable populations.